Diarrhoeal Disease Challenges

April 5, 2025

Diarrhoeal diseases remain public health challenge in India. The World Health Organization (WHO) marks diarrhoea as the third leading cause of death among children under five. In India, approximately 1.7 billion cases occur annually. Unsafe water and poor sanitation are key contributors. Over 780 million people lack access to safe drinking water. Additionally, around 2.5 billion people do not have improved sanitation facilities.

Current Situation of Diarrhoeal Diseases

India has one of the highest rates of diarrhoeal illnesses globally. Children under five experience an average of 2 to 2.3 episodes per year. This incidence is higher than in many low- and middle-income countries. Rotavirus and E. coli are major risk factors, leading to severe dehydration. Regions like Uttar Pradesh and Bihar face higher diarrhoeal burdens due to inadequate sanitation infrastructure.

Recognising Symptoms and Treatment Options

Early recognition of dehydration symptoms is vital. Signs include lethargy, excessive thirst, and irritability. Parents must monitor these symptoms closely. Oral rehydration solutions (ORS) can manage mild cases at home. However, severe cases may require hospitalisation. Rapid hydration is critical since antibiotics do not work against rotavirus. ORT can effectively treat 90% of diarrhoea cases, but only 50-60% of affected children in India receive it.

Rotavirus Vaccination and Its Impact

The rotavirus vaccine was introduced in India’s Universal Immunisation Programme in 2016. This initiative has reduced hospitalisations related to rotavirus. Studies show a 40-50% drop in mortality from rotavirus diarrhoea in areas with high vaccination coverage. India administers three doses of the vaccine at 6, 10, and 14 weeks of age. This schedule is adapted to accommodate the oral polio vaccine, which can interfere with the rotavirus vaccine.

Sanitation and Hygiene Improvements

Improving sanitation could prevent up to 60% of diarrhoeal deaths in India. Simple hygiene practices are crucial in preventing rotavirus infections. Contaminated food and unsafe drinking water are common transmission routes. The WHO emphasises that addressing sanitation is a critical public health priority. Following the vaccine rollout, there has been a decline in diarrhoeal diseases, particularly those caused by rotavirus.

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