Intro
Diarrheal diseases remain a leading cause of preventable death, especially among children under five in developing countries. This chapter reviews and prioritizes a number of available interventions.
The normal intestinal tract regulates the absorption and secretion of electrolytes and water to meet the body's physiological needs. More than 98 percent of the 10 liters per day of fluid entering the adult intestines are reabsorbed (Keusch 2001). The remaining stool water, related primarily to the indigestible fiber content, determines the consistency of normal feces from dry, hard pellets to mushy, bulky stools, varying from person to person, day to day, and stool to stool. This variation complicates the definition of diarrhea, which by convention is present when three or more stools are passed in 24 hours that are sufficiently liquid to take the shape of the container in which they are placed. The frequent passage of formed stool is not diarrhea (Black and Lanata 2002). Although young nursing infants tend to have five or more motions per day, mothers know when the stooling pattern changes and their children have diarrhea (Ronsmans, Bennish, and Wierzba 1988). The interval between two episodes is also arbitrarily defined as at least 48 hours of normal stools. These definitions enable epidemiologists to count incidence, relapses, and new infections.
