Children living in slums of Nepal face significant risk of diarrhea

Diarrhea is one of the leading causes of child mortality in developing countries. Two million children die of diarrhea in the world every year. Research published recently in the Journal of Lumbini Medical College has found that children living in the slums of Nepal's small hill towns are at significant risk of diarrhea.

The research article, titled Risk Factors of Diarrhea in Children Under Five Years in Urban Slums: An Epidemiological Study, revealed that, of the 450 children under five years of age living in the slums of the Tansen municipality in the Palpa district (250 kilometers west of Nepal's capital Kathmandu) 40% were found to have suffered from diarrhea in the previous three months.

The research found that the risk of diarrhea was much less for children who had been exclusively breast-fed for six months, says lead author, Dr Balakrishna Kalakheti, Associate Professor at Department of Paediatrics at Lumbini Medical College Teaching Hospital, Palpa, Nepal.Of the 181 children who had diarrhea, 174 had not been breast-fed exclusively for more than six months while only seven had been breast-fed exclusively.

Nutrition, the source and treatment of drinking water, hand washing practice and family income were other variables related to diarrhea in the slums. Interestingly, the research found that children drinking natural-source spring water had a lower risk of diarrhea than children drinking water from a Government-supplied source.

According to Dr Kalakheti, nutrition had a strong impact on vulnerability to diarrhea. "At present, the children are trapped in a cycle of malnutrition and diarrhea," he explains. "Children in the slums suffer from malnutrition. When they suffer from malnutrition their immunity reduces and they become prone to diarrhea. When they suffer from diarrhea, food absorption is affected and they cannot absorb nutrition well."

Dr. Kalakheti says that the focus should be shifted from a curative approach to a preventive approach to address this problem and more awareness-raising programs should be organized to inform the mothers about the importance of nutrition and sanitation. "Ironically, because the mothers have to go for work, they cannot spare time to learn more about causes of diarrhea and methods to reduce it," he says.