CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Diarrhea accounts for high levels of mortality in young children in developing countries like Nigeria, despite worldwide efforts to improve overall child health levels. Each year, in the developing countries of Asia, Africa and Latin America, approximately five million children under five years of age die from acute diarrhoea. About 80 per cent of these deaths are in the first two years of life (Lucas & Gilles, 2009) In the developing world as a whole, about one-third of infant and child deaths are due to diarrhoea and approximately 70 per cent of diarrhoeal deaths are caused by dehydration – the loss of large quantity of water and salts from the body, which needs water to maintain blood volume and other fluids to function properly (Gupta & Mahajan, 2005). UNICEF (2002) submitted that in Nigeria, infant mortality rates are twice as high in rural settings as they are in urban ones due to poor hygiene and poor sanitation. Of the annual 3 million infant births in Nigeria, approximately 170,000 result in deaths that are mainly due to poor knowledge and management practices of childhood diarrhoea. Several factors are likely to contribute to the very high diarrhoea morbidity and mortality rates, in children under-five years including poverty, female illiteracy, poor water supply and sanitation, poor hygiene practices and inadequate health services (Park, 2009). Malnutrition is another established risk factor for mortality among children with diarrhoea disease. This may be due to inadequate case management. The first line of management of diarrhoea, is therefore, the prevention of dehydration. This can be achieved at home using Oral Rehydration Therapy (ORT).
Diarrhoea is the disturbance of the gastrointestinal tract comprising of changes in intestinal motility and absorption, leading to increase in the volume of stools and in their consistency (Ballabriga, Hilpert & Isliker, 2000). In diarrhoea, stool contains more water than normal stool and is often called loose or watery stool. In certain cases, they may contain blood in which case the diarrhoea is called dysentery (Obionu, 2001). Any passage of three or more watery stools within a day (24 hours) is referred to as diarrhoea (Tauxe, 1997). The consistency and the volume of stool constitute how to classify diarrhoea.