Define acute diarrhoea in children. List its causes. How would you assess for dehydration in such a child?
Acute diarrhoea in children is defined as the passage of three or more unusually loose or watery stools in a 24-hour period, lasting less than 14 days.
Common Causes:
- Viral: Most common, primarily Rotavirus, Norovirus, Adenovirus.
- Bacterial: Escherichia coli (E. coli), Shigella, Salmonella, Campylobacter, Vibrio cholerae.
- Parasitic: Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica (less common in acute).
- Other: Food poisoning, antibiotic-associated diarrhoea.
Assessment for Dehydration:
The WHO’s Integrated Management of Childhood Illness (IMCI) approach is widely used:
- General Condition: Look for restlessness/irritability (mild–moderate dehydration), lethargy/unconsciousness (severe dehydration), or alert/well (no dehydration).
- Eyes: Sunken eyes indicate dehydration.
- Tears: Absence of tears.
- Mouth and Tongue: Dry mouth/tongue (moderate–severe).
- Skin Pinch: Slow return of a skin pinch (turgor) on the abdomen indicates dehydration; very slow return (>2 seconds) suggests severe dehydration.
- Thirst: Drinking eagerly, thirsty (mild–moderate); drinking poorly or unable to drink (severe).
Based on these signs, dehydration is classified as no, some, or severe dehydration.
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