Evaluation of the Therapeutic Management of Childhood Diarrhea

Therapeutic management of childhood diarrhea had led to a significant decrease in diarrhea related morbidity and mortality. However, diarrhea diseases remain one of the leading cause of preventable deaths worldwide, especially in children under 5 years. The work presented in this dissertation intended to evaluate the current the management of childhood diarrhea, to identify the major gaps in the management and introduce a novel approach to address these gaps. First, an assessment of oral rehydration therapies (ORT) coverage in the management of childhood diarrhea is performed to evaluate healthcare providers’ prescriptive practices of ORT in South Asia. Next, we assess the effect of breastfeeding cessation in reported episodes of diarrhea using a national database. The study highlighted suboptimal breastfeeding practices among American mothers who participated in the study and its impact on reported onset of diarrhea episodes in infants during their first year of life. The results show that breastfeeding cessation before the first 6 months is a significant predictor of diarrhea between 7 and 12 months. Lastly, sensitivity of a diarrheagenic pathogen identification tool was tested in two laboratory simulated environments. Despite the limitation of the experiments, the study offers insight of the tool’s properties under specific environment, guiding future optimization. The manuscripts comprised in this dissertation provide evidence for the need to re-evaluate the use of therapies known to be effective and to conduct future research in innovative approach to the management of childhood diarrhea