Pediatric diarrhoea, pneumonia cases on the rise, 80% under 2 years of age

Highlights

• Doctors attribute rotavirus infections as the main cause
• Antibiotics not necessary for treating diarrhoea, cold
• Children must be given oral saline in the correct amount 
• Diarrhoea typically takes 5 to 7 days to resolve  

As the winter season sets in, a significant rise in cases of diarrhoea and pneumonia among children has been reported, with the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) receiving an average of 650–700 diarrhoea patients daily, 80% of whom are under two years old.

Alongside diarrhoea, the number of pneumonia patients is also increasing in icddr,b, Bangladesh Shishu Hospital, and other healthcare facilities.

Doctors are advising parents to take preventive measures for diarrhoea and pneumonia, including keeping children warm, breastfeeding, and administering oral saline correctly during diarrhoea episodes.  

Situation at icddr,b

This winter, icddr,b is seeing 20% more patients compared to previous years. 

During a visit to the icddr,b this afternoon, a long queue of mothers, carrying their children, was seen in front of the main hospital building. They were waiting patiently in front of three makeshift booths where nurses were registering patients, while doctors attended to them.

This was happening under a large tent, set up just beyond the main gate, though no beds had been arranged there yet. 

This correspondent spoke to Nabila, the mother of 1-year-5-month-old Naushin, who was standing in the queue and came from Azampur, Uttara. 

Naushin had been suffering from vomiting and diarrhoea for five days. Despite receiving saline and suppositories at a private hospital in Uttara, her condition did not improve, prompting the mother to bring her child to icddr,b this morning.

Speaking to The Business Standard, Dr Shoeb Bin Islam, clinical lead of the short stay diarrhoea unit at icddr,b, said rotavirus-induced diarrhoea outbreaks are common at the onset of winter each year. However, this year, patient numbers have increased by 20% compared to 2022-2023. 

"For the past three weeks, our hospital has been receiving an average of 850-900 patients daily. Patients are coming not only from Dhaka but also from outside the capital," he added.

When talking about treatment, the doctor explained, "This type of diarrhoea does not require antibiotics. In fact, taking antibiotics often worsens the condition. It typically takes 5 to 7 days for recovery."

He advised the correct preparation and administration of oral saline to prevent dehydration. 

Meanwhile, Bangladesh Shishu Hospital and Institute currently has 134 children admitted with diarrhoea.

When to see a doctor for diarrhoea

If a child appears weak or lethargic, is unable to eat, shows signs of dehydration, has a high fever, experiences bloody stools, or suffers from seizures, it is crucial to seek medical attention immediately.

Correct use of oral saline is crucial

Dr Shoeb emphasised that oral saline is not a food item but a form of medicine. 

"The saline packet specifies that it must be mixed properly with half a liter of water. Improper mixing can cause harm," he explained.  

In cases of diarrhoea, saline should be given after each loose stool based on the child's weight. For instance, a 5-kg child should be given 5 teaspoons (measured with a 5 ml spoon) of saline water, while a 10-kg child should be given 10 teaspoons.  

Additionally, breastfeeding should continue, rotavirus vaccinations should be administered, and care should be taken to prevent the child from catching a cold. "If diarrhoea occurs, remain calm and provide normal food and oral saline patiently," Dr Shoeb advised.

Pneumonia patients on the rise 

In the first five days of January, 139 children received outpatient treatment for pneumonia at the Bangladesh Shishu Hospital and Institute, while 19 were admitted. Currently, 31 pneumonia patients are hospitalised there.  

So far this month, two patients have died at the hospital due to pneumonia and related complications.  

Meanwhile, pneumonia patients are also being treated in the wards and ICU of icddr,b hospital, indicating a broader spread of the illness.
Pneumonia is one of the main reasons for the death of under five year's old children in Bangladesh. According to the icddr,b data, Pneumonia kills around 24,000 children in Bangladesh every year, approximately 677,000 hospitalisations each year.

Dr Kamruzzaman Kamrul, associate professor in the Department of Paediatric Pulmonology at Bangladesh Shishu Hospital, told TBS that pneumonia and diarrhoea cases have increased due to the winter season.  

"Parents must recognise the symptoms of pneumonia and seek medical attention without delay," he said, emphasising, "Pneumonia is a serious health condition that can quickly become fatal if not treated promptly."

Key symptoms of pneumonia parents should not ignore  

Dr Kamruzzaman explained that a normal respiratory rate for babies aged 0–2 months is below 60 breaths per minute, below 50 for children aged 2 months to 1 year, and below 40 for those aged 1–5 years.  

"If a child has a fever and difficulty breathing, along with an elevated respiratory rate, refuses to eat or vomits everything they consume, and experiences chest retractions with each breath, it is a clear indication of pneumonia," he said. 

Dr Kamruzzaman advised that parents should take their child to the nearest healthcare centre or doctor if pneumonia symptoms appear. 

"The doctor will determine whether the child has pneumonia and decide if hospitalisation or antibiotics are necessary. Antibiotics should not be given to children based on advice from pharmacy staff without a proper medical prescription," he further emphasised.

Dr Kamruzzaman also outlined several measures to prevent pneumonia in children. 

"Breastfeed babies exclusively for the first six months and ensure they receive all scheduled vaccines under the EPI programme," he advised.  

He also stressed the importance of hygiene. He advised washing of hands before approaching a child after returning from outside. Additionally, taking children outside unnecessarily should be avoided.