Number of diarrhoea cases stabilising

The number of diarrhoea cases in flood-hit Bangladesh shows signs of stabilisation, health experts on the ground say.

“This has been a particularly difficult year,” Dr Alejandro Cravioto, executive director of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) in Dhaka, said. The ICDDR,B is the main source of information on diarrhoea in Bangladesh.

“But the numbers have been going down since 15 August, and stabilising over the past four or five days,” he told IRIN, adding: “We hope it continues this way.”

As of 2 September, the country’s National Disease Surveillance Centre reported 128,957 diarrhoea cases nationwide since 30 July, resulting in 21 deaths and a case fatality rate of about 0.02 percent; an extremely low number under the circumstances.
 
“It’s low and it’s low for a reason. We’re used to this. We go through this every monsoon season. We know how to treat this,” Cravioto explained.

Downstairs, Mizanur Rahman Shaheen, is living proof of that fact and is already on his way to a fast recovery.

“I arrived almost 20 hours ago,” the 26-year-old typist remarked, sipping a glass of oral rehydration solution, critical in resupplying the body with much needed liquids. “I feel much better now.”

A total of 630 diarrhoea patients were admitted to the ICDDR,B on 2 September, the vast majority of whom will be released within 24 hours.


Photo: David Swanson
Suffering from diarrhoea, Mizanur Rahman Shaheen is now on the road to recovery

Caution

But while a reprieve of sorts on the number of diarrhoea cases now coming in seems evident, caution remains the rule of the game.

“It’s very hard to predict what will happen in the future,” said Dr Silvia de Weedt of Médecins Sans Frontières Holland, which has recently set up a diarrhoea treatment centre on the outskirts of Dhaka to boost the efforts of the ICDDR,B.

“The numbers [being admitted to ICDDR,B] seem to be stabilising… Nevertheless, we’re not out of the woods yet,” she warned.

Cravioto said the normal number of people they treat each day was 150-200. Currently they were seeing three times this number, but this was much less than a few weeks earlier when they were treating over 1,000 patients a day.

“We could still have another surge of cases,” he said - a fact prompting hospital officials to maintain the makeshift tented treatment centre in the hospital’s parking lot.

Vector-borne diseases

Meanwhile, in addition to diarrhoea and other water-borne diseases, there also remains a continued risk of vector-borne diseases.

“This is our main concern at this point, but we’re monitoring the situation closely,” Dr Duangvadee Sungkhobol, country representative for the UN World Health Organization (WHO), told IRIN in Dhaka, citing incidences of diarrhoea, pneumonia, typhoid, hepatitis B, and conjunctivitis, as well as an array of various skin diseases.

With flood waters receding, stagnant pools of water provide fertile ground for diarrhoeal and water-borne diseases, including acute-watery diarrhoea, as well as insect-borne diseases such as malaria and dengue fever, she said.

Over 10 million people were affected and hundreds of thousands left homeless since the end of July, after above average monsoon rains battered the river-delta nation, leaving 39 of the country’s 64 districts partially or fully inundated.

The worst diarrhoea-affected districts were Sirajgonj, Gaibandha and Kurigram located in the country’s northwest Rajhani Division, and Jamalpur, Dhaka, Kishoregonj, Tangail, Netrokana, Mymenshing, Sherpur and Mannikgonj districts in central Dhaka Division.

At the same time, across the country over 6,000 people have been affected by water borne-diseases over the last 24 hours (2 September), including 1,916 cases of diarrhoea, 454 with acute respiratory infections, 504 with skin infections, 558 with eye infections, and over 2,000 with other ailments.

According to Bangladesh’s Directorate General of Health Services which currently has over 3,400 medical teams in the flood-affected districts, as well 28 mobile hospitals working round the clock, nearly 800 people have died in this year’s flooding, mainly due to drowning, snakebite and disease.

Working closely with the government, WHO is closely monitoring the flood situation in an effort to minimise any increased incidences of diarrhoea, dysentery, acute respiratory infections, as well as skin, eye and ear infections.

“This is an ongoing effort and the current disease situation all over the country is well contained,” Sungkhobol said.

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Health services “coping” in battle against diarrhoea