Readings on diarrhoea : student manual

Abstract

A collection of eight teaching units conveying essential information about the pathophysiology, clinical features, diagnosis, epidemiology, treatment and prevention of diarrhoea in children. Addressed to medical students undergoing clinical training in paediatrics, the manual aims to equip students with all the knowledge needed to assess patients, plan treatment, and prevent deaths through proper case management. Information, which is specific to conditions in developing countries, ranges from an explanation of the clinical features seen in different forms of dehydration, through advice on how to communicate with mothers, to a discussion of the role of feeding in the management of diarrhoea. Recommended lines of action draw their authority from published research and extensive WHO experience in programmes for the treatment and prevention of diarrhoea. The first two teaching units provide fundamental information about the epidemiology, clinical types of diarrhoea, causative agents, modes of transmission, pathophysiology, and implications for treatment. Subsequent units explain how the clinical assessment of patients should be performed and interpreted, discuss ways of teaching mothers to treat diarrhoea at home, describe clinical measures for the treatment of dehydrated patients, and discuss the special procedures to be followed during the treatment of dysentery, persistent diarrhoea, and diarrhoea associated with other illnesses. The remaining unis cover the nutritional management of diarrhoea in children, including those suffering from severe malnutrition, and explain how physicians can promote prevention, particularly through the education of mothers and other family members. Each unit concludes with a list of exercises for testing the knowledge acquired. Further practical information is presented in a series of annexes, which set out guidelines for determining whether a child is malnourished, list antimicrobial agents for the treatment of specific causes of diarrhoea, and provide illustrated, step-by-step instructions for intravenous rehydration and nasogastric rehydration