Interventions for Diarrhoeal diseases

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign Mass media based awareness Community mobilisation for routine immunisation	Breastfeeding Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements Vaccination: rotavirus	Recognition of diarrhoea signs and symptoms	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods including breast feeding Zinc supplements Immediate transfer of severe cases to a higher-level health care facility
Primary Care
Health education on prevention and treatment of diarrhoea	Implementation of exclusive breastfeeding policies Adoption of Baby Friendly Initiative to promote exclusive breastfeeding Immunization for newborns Early initiation of breastfeeding	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods including breast feeding Immediate transfer of severe or complicated cases to a higher-level health care facility
Referral Facility: General
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign Mass media based awareness Community mobilisation for routine immunisation Create awareness on diarrhoea including prevention measures Distribution of IEC materials on diarrhoea Advocacy for proper sanitation and good housing Community mobilisation for routine immunisation	Breastfeeding Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements Vaccination: rotavirus Observation of good hygiene practices in food preparation for the children Encourage utilization of safe portable water in homes and communities Counselling on WASH services (use of safe water supply, sanitation and hygiene) Early recognition of danger signs by the family members Preventive zinc supplements Vaccination: rotavirus	Recognition of diarrhoea signs and symptoms	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods including breast feeding Zinc supplements Immediate transfer of severe cases to a higher-level health care facility Home based provision of oral rehydration therapy Zinc tablets in mild cases Vitamin A supplementation Refer moderate to severe cases and cases with vomiting or fever
Primary Care
Health education on prevention and treatment of diarrhoea	Vaccination: rotavirus Vaccination: typhoid Oral vitamin A supplementation for children Observation of good hygiene practices in food preparation for the children Encourage utilization of safe portable water in homes and communities Counselling on WASH services (use of safe water supply; sanitation and hygiene) Early recognition of danger signs by the family members Preventive zinc supplements Vaccination: rotavirus Access to safe drinking water Use of improved sanitation Monitoring of correct hand washing techniques Early recognition and action on danger signs Preventive zinc supplements Vaccination: Rotavirus	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods including breast feeding Immediate transfer of severe or complicated cases to a higher-level health care facility History and physical examination for diarrhoea, abdominal pain. Assess and classify for diarrhoea using IMNCI strategy Point of care testing Basic laboratory tests Oral zinc supplementation Oral rehydration solution Counselling on increased fluid intake Oral antimicrobials for enteric and diarrhoeal infections Intravenous fluids Oral multivitamins for persistent diarrhoea Referral for management of severe dehydration for other complications.
Referral Facility: General
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign on sanitation, hygiene, and safe water supply Community mobilisation for routine immunisation	Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements Access to safe drinking-water Use of improved sanitation Hand washing with soap Good personal and food hygiene	Recognition of diarrheal diseases signs and symptoms Recognition of danger signs	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods Zinc supplements Immediate transfer of severe cases to a higher-level health care facility Home based provision of oral rehydration therapy Zinc tablets in mild cases Refer moderate to severe cases and cases with vomiting or fever Vitamin A supplementation
Primary Care
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap Early recognition and action on danger signs Preventive zinc supplements	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods Immediate transfer of severe or complicated cases to a higher-level health care facility History and physical examination for diarrhoea, abdominal pain. Assess and classify for diarrhoea using IMNCI strategy Point of care testing Basic laboratory tests Oral zinc supplementation for diarrhoeal infections Oral rehydration solution Counselling on increased fluid intake Oral antimicrobials for enteric and diarrhoeal infections Intravenous fluids Oral multivitamins for persistent diarrhoea Referral for management of severe dehydration for other complications.
Referral Facility: General
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign on sanitation, hygiene, and safe water supply Community mobilisation for routine immunisation	Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements	Recognition of diarrhoea signs and symptoms Recognition of danger signs of dehydration	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods including Zinc supplements Immediate transfer of severe cases to a higher-level health care facility
Primary Care
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap Early recognition and action on danger signs Preventive zinc supplements	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods Immediate transfer of severe or complicated cases to a higher-level health care facility
Referral Facility: General
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign Mass media based awareness	Good sanitation and hygiene practices Safe water supply	Recognition of diarrhoea signs and symptoms Recognition of danger signs of dehydration	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods Zinc supplements Immediate transfer of severe cases to a higher-level health care facility
Primary Care
Community-based awareness campaign Mass media based awareness	Access to safe drinking water Use of improved sanitation Hand washing with soap	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods Immediate transfer of severe or complicated cases to a higher-level health care facility
Referral Facility: General
Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc. Distribution of IEC materials on enteric infections	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc. Distribution of IEC materials on enteric infections	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness campaign Mass media based awareness	Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements	Recognition of diarrhea signs and symptoms	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods Zinc supplements Immediate transfer of severe cases to a higher-level health care facility
Primary Care
Community-based awareness campaign Mass media based awareness	Guidance and counselling on good sanitation, hygiene and use of safe water supply Early identification of danger signs Preventive zinc supplements	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods Immediate transfer of severe or complicated cases to a higher-level health care facility
Referral Facility: General
Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc. Distribution of IEC materials on enteric infections	Vaccination: rotavirus Vaccination: typhoid	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc. Distribution of IEC materials on enteric infections	Vaccination: rotavirus Vaccination: typhoid	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements