Effect of HIV/AIDS and Malaria on the Context for Introduction of Zinc Treatment and Low-osmolarity ORS for Childhood Diarrhoea

• Published in: Journal of health, population and nutrition Vol. 26; no. 1; pp. 1 - 11
• Main Authors: Winch, Peter J, Gilroy, Kate E, Walker, Christa L. Fischer
• Format: Journal Article
• Language: English
• Published: Bangladesh ICDDR,B: Centre for Health and Population Research 01.03.2008; BioMed Central Ltd; BioMed Central; International Centre for Diarrhoeal Disease Research, Bangladesh
• Subjects: Acquired immune deficiency syndrome; Acquired immunodeficiency syndrome; Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - mortality; AIDS; AIDS (Disease); Care and treatment; Child health; Child, Preschool; Childhood; Children; Childrens health; Death; Demographic aspects; Developing Countries; Diarrhea; Diarrhea - mortality; Diarrhea - therapy; Diarrhea in children; Diarrhoea; Diseases; Female; Fluid Therapy - methods; Global Health; Health aspects; Health Policy; HIV; HIV Infections - complications; HIV Infections - mortality; Human immunodeficiency virus; Humans; Infant; Infant health; Infant, Newborn; Malaria; Malaria - complications; Malaria - mortality; Male; Management; Mortality; Neonatal care; Oral rehydration; Oral rehydration therapy; Osmolar Concentration; Policy Making; Public health; Review; REVIEW ARTICLE; Review literature; Statistics; Winches; Zinc; Zinc - therapeutic use; Zinc in the body; United States
• ISSN: 1606-0997; 2072-1315

Diarrhoea was estimated to account for 18% of the estimated 10.6 million deaths of children aged less than five years annually in 2003. Two-Africa and South-East Asia-of the six regions of the World Health Organization accounted for approximately 40% and 31% of these deaths respectively, or almost three-quarters of the global annual deaths of children aged less than five years attributable to diarrhoea. Much of the effort to roll out low-osmolarity oral rehydration solution (ORS) and supplementation of zinc for the management of diarrhoea accordingly is being devoted to sub-Saharan Africa and to South and South-East Asia. A number of significant differences exist in diarrhoea-treatment behaviours and challenges of the public-health systems between Africa and Asia. The differences in rates of ORS use are the most common indicator of treatment of diarrhoea and vary dramatically by and within region and may significantly influence the roll-out strategy for zinc and low-osmolarity ORS. The prevalence of HIV/AIDS and the endemi-city of malaria also differ greatly between regions; both the diseases consume the attention and financial commitment of public-health programmes in regions where rates are high. This paper examined how these differences could affect the context for the introduction of zinc and low-osmolarity ORS at various levels, including the process of policy dialogue with local decision-makers, questions to be addressed in formative research, implementation approaches, and strategies for behaviour-change communication and training of health workers.