Treating diarrhoeal disease in children under five: the global picture

Arch Dis Child. 2014 Mar;99(3):273-8. doi: 10.1136/archdischild-2013-304765. Epub 2013 Nov 6.


Rates of childhood mortality due to diarrhoea remain unacceptably high and call for renewed global focus and commitment. Affordable, simple and effective diarrhoeal treatments have already been available for many years, yet a shift in international health priorities has seen coverage of recommended treatments slow to a near-standstill since 1995. This article reviews coverage of recommended childhood diarrhoeal treatments (low-osmolarity oral rehydration solution (ORS) and zinc), globally and regionally, and provides an overview of the major barriers to wide-scale coverage. It is argued that to ensure smooth supply and equitable distribution of ORS and zinc, adequate financing, relevant policy changes, strong public, private and non-government organisation (NGO) collaboration, local manufacturing of pharmaceuticals, mass media awareness and campaigning, in conjunction with strong government support, are necessary for successful treatment scale-up.

Keywords: Comm Child Health; Epidemiology; General Paediatrics; Infectious Diseases.

Publication types

  • Review

MeSH terms

  • Bicarbonates / administration & dosage
  • Child, Preschool
  • Diarrhea / drug therapy*
  • Glucose / administration & dosage
  • Health Services Needs and Demand
  • Humans
  • Potassium Chloride / administration & dosage
  • Sodium Chloride / administration & dosage
  • Zinc / administration & dosage*


  • Bicarbonates
  • World Health Organization oral rehydration solution
  • Sodium Chloride
  • Potassium Chloride
  • Glucose
  • Zinc