Diarrhea and Malnutrition Interactions, Mechanisms, and Interventions

There are several reasons why a consolidation of recent advances in our understanding of the interaction of diarrhea and malnutrition is indi cated and timely. It is now widely recognized that diarrhea is a major cause of morbidity and mortality among children of poor countries. Due to recent advances in laboratory and field diagnostic techniques, many of the previously unrecognized etiologic agents responsible for diarrhea have been identified, thereby providing new scientific knowledge for rational control strategies. Increasingly these advances suggest that the morbidity burden of diarrhea may be of equal, if not greater, public health consequence than mortality. Diarrhea only rarely causes disease severe enough to require institutionalized medical care. The vast major ity of diseases are of mild or moderate severity, and because of high prev alence, diarrhea imposes an enormous morbidity burden and exerts a sig nificant negative impact on child growth and development. Moreover, the effects of successive episodes of diarrhea are likely to be cumulative. In contrast to several other childhood infections, the treatment of the diarrheal diseases is feasible because it uses simple, effective, and low cost medical technologies. Within the context of these developments, there has been a major resurgence of international interest in, and commitment to, the control of the diarrheal diseases. The World Health Organization recently has launched a global program for the control of diarrhea, and simulta neously, an independent international research center on diarrhea has been established in Bangladesh.