Diarrhea and Malnutrition: Interactions, Mechanisms, and Interventions

Description

There are several reasons why a consolidation of recent advances in our understanding of the interaction of diarrhea and malnutrition is indi­ cated and timely. It is now widely recognized that diarrhea is a major cause of morbidity and mortality among children of poor countries. Due to recent advances in laboratory and field diagnostic techniques, many of the previously unrecognized etiologic agents responsible for diarrhea have been identified, thereby providing new scientific knowledge for rational control strategies. Increasingly these advances suggest that the morbidity burden of diarrhea may be of equal, if not greater, public health consequence than mortality. Diarrhea only rarely causes disease severe enough to require institutionalized medical care. The vast major­ ity of diseases are of mild or moderate severity, and because of high prev­ alence, diarrhea imposes an enormous morbidity burden and exerts a sig­ nificant negative impact on child growth and development. Moreover, the effects of successive episodes of diarrhea are likely to be cumulative. In contrast to several other childhood infections, the treatment of the diarrheal diseases is feasible because it uses simple, effective, and low­ cost medical technologies. Within the context of these developments, there has been a major resurgence of international interest in, and commitment to, the control of the diarrheal diseases. The World Health Organization recently has launched a global program for the control of diarrhea, and simulta­ neously, an independent international research center on diarrhea has been established in Bangladesh. Front Matter....Pages i-xv Front Matter....Pages 1-1 Interactions of Diarrhea and Malnutrition....Pages 3-19 Front Matter....Pages 21-21 Pathophysiology of the Enterotoxic and Viral Diarrheas....Pages 23-43 The Epidemiology and Pathophysiology of Invasive Bacterial Diarrheas....Pages 45-72 Epidemiological Aspects of Diarrhea Associated with Known Enteropathogens in Rural Bangladesh....Pages 73-86 Epidemiology of Childhood Diarrhea in The Gambia....Pages 87-98 Malnutrition and Susceptibility to Diarrhea....Pages 99-109 Front Matter....Pages 111-111 Food Intake During and After Recovery from Diarrhea in Children....Pages 113-123 The Energy Cost of Diarrheal Diseases and Other Common Illnesses in Children....Pages 125-141 Effects of Acute Diarrhea on Absorption of Macronutrients During Disease and After Recovery....Pages 143-154 Direct Nutrient Loss and Diarrhea....Pages 155-160 Diarrhea and Nutrient Requirements....Pages 161-173 Front Matter....Pages 175-175 Promotion of Breast-Feeding, Health, and Growth among Hospital-Born Neonates, and among Infants of a Rural Area of Costa Rica....Pages 177-202 Oral Rehydration in the Treatment of Diarrhea: Issues in the Implementation of Diarrhea Treatment Programs....Pages 203-221 Feeding Practices in Relation to Childhood Diarrhea and Malnutrition....Pages 223-234 Environmental and Educational Interventions against Diarrhea in Guatemala....Pages 235-266 Front Matter....Pages 267-267 Diarrhea and Nutrient Requirements....Pages 269-286 Therapeutic Interventions in Diarrhea....Pages 287-295 Prevention and Control of the Diarrheal Diseases....Pages 297-303 Diarrhea and Malnutrition Research Priorities....Pages 305-308 Back Matter....Pages 309-318