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Diarrhoeal Diseases
GMJ News knowledge hub · last reviewed August 2026 · Georgian Medical Journal
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Diarrhoeal diseases remain the second leading infectious killer of children under five, causing approximately 440,000 child deaths per year — despite the fact that oral rehydration therapy (ORT) can prevent the dehydration that kills them (WHO). Rotavirus — vaccine-preventable — drives about a third of severe cases; contaminated water and poor sanitation drive the rest. WASH improvement and rotavirus vaccination are the most impactful prevention interventions.
Key messages
Second child killer
Diarrhoeal diseases kill approximately 440,000 children under 5 per year — the second leading infectious cause of child mortality — despite cheap, effective prevention and treatment.
ORT — a century's greatest advance
Oral rehydration therapy (ORT) — described as "potentially the most important medical advance of this century" (Lancet 1978) — prevents death from dehydration at near-zero cost and can be prepared at home.
WASH prevents it
Safe water, sanitation and handwashing with soap would prevent the vast majority of diarrhoeal disease. Yet 2 billion people still lack safe drinking water.
Rotavirus vaccine
Rotavirus causes ~1/3 of severe childhood diarrhoea hospitalisations. The WHO-recommended rotavirus vaccine reduces severe hospitalisations by 40-60% in high-coverage countries.
Zinc + ORT
WHO/UNICEF recommend 10-14 days of zinc alongside ORT — reducing episode duration, severity and recurrence for up to 3 months.
Antibiotic overuse
Most diarrhoea is viral and does not require antibiotics — yet massive overprescription drives AMR. Correct management uses ORT and zinc first.
Key statistics
Child under-5 diarrhoeal deaths (thousands) 2000-2019 — WHO/IGME
Source: UN IGME / WHO. Decline driven by ORT, rotavirus vaccine and WASH improvement.
Glossary of key terms
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