Diarrhoea, Persistent in Children

Description

General Measures

Medicine Treatment

Referral

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ICD-10 code: A09.0/A09.9/K52.2/K52.8/K52.9

DESCRIPTION

Diarrhoea for 7–14 days.

GENERAL MEASURES

• Assess for possible HIV infection and manage appropriately (See: Antiretroviral therapy, Adults).
• Prevent dehydration using homemade sugar and salt solution.
• Counsel mother regarding feeding.
  • If breastfeeding, give more frequent, longer feeds.
  • If replacement feeding, replace milk with breast milk or with fermented milk products such as amasi (maas) or yoghurt, if available.
  • Continue with solids: give small, frequent meals at least 6 times a day.
• Follow-up 5 days later. If diarrhoea persists, refer to doctor.

MEDICINE TREATMENT

Vitamin A supplementation:

• Vitamin A (retinol), oral.

Age Range	Dose  IU	Capsule  100 000 IU	Capsule  200 000 IU
Infants 6-11 months old	100 000	1 capsule	-
Children 12 months to 5 years	200 000	2 capsules	1 capsule

Administration of a vitamin A capsule:

• Cut the narrow end of the capsule with scissors.
• Open the child’s mouth by gently squeezing the cheeks.
• Squeeze the drops from the capsule directly into the back of the child’s mouth. If a child spits up most of the vitamin A liquid immediately, give one more dose.
• Do NOT give the capsule to the mother or the caregiver to take home.

Zinc supplementation:

• Zinc (elemental), oral 10mg/day for 14 days.

REFERRAL

• Child <2 months of age.
• Signs of dehydration. See: Diarrhoea, acute in children.
• Malnutrition or weight loss.
• Diarrhoea still present at 5-day follow up.

Click here to access the pdf.

Click here for the  NEMLC Recommendations for medicine amendments (2020-4 review cycle).

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Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024

Chapter 2: Gastro-Intestinal Conditions, 2.0 Diarrhoea, 2.9.2 Diarrhoea, Persistent in Children