New study finds diarrhea a serious family burden

A new study on infants with infectious diarrhea reveals that it is not only a serious health problem but a huge burden on the family as well, as caregivers miss days of work, spend for medical care and suffer worry and anxiety.

Conducted by a group of local pediatricians including pediatric gastroenterologist Dr. Felizardo Gatcheco, Research Development Head of the Manila Central University, the research is part of an international study assessing the impact of children’s hospitalization due to infectious diarrhea—caused by rotavirus—on the quality of life of parents and caregivers.

Based on survey results conducted in 10 private and public hospitals in Metro Manila from May 2007 to September 2008, the study found that a child suffering from acute diarrhea was usually hospitalized for an average of five days, leading to difficulties not only for the patient, but also for parents and caregivers, who were physically, emotionally and financially affected.

The diarrhea lasted an average of four days; in many cases, accompanied by vomiting and fever for an average of almost two days. During this period of sickness, 50 percent of the parents surveyed observed their children to be crying “often” or “always” more than usual, more irritable, exhausted, and less playful.

Seeing their child suffering left many caregivers physically and emotionally drained. Almost 98 percent of them said that they felt “broken-hearted to see their child ill” while 86 percent said that they felt upset. Seven out of 10 said they felt tired and exhausted physically and mentally, and six out of 10 said they felt helpless. Three out of 4 caregivers reported losing 3 of more days of sleep.

The sickness also brought anxiety to the parents and caregivers, with majority admitting they were very worried about the diarrhea, vomiting, dehydration, and fever associated with the disease. Dehydration is a common offshoot of serious diarrhea that sometimes causes death.

Having a child hospitalized also had an impact on the family finances. Almost all the working caregivers had to miss 1-3 days of work or more to take care of their sick child. As a result, many reported lost income amounting to an average of PhP1,000 per day. On the other hand, they spent an average of PhP7,870 for hospitalization and other medical needs, eating up about one third of the average family income among the respondents.

“All these show that we should not take acute diarrhea lightly. It is considered a serious public health problem that requires urgent attention not only to reduce its incidence among infants and the deaths arising from it, but also to reduce its burden on families and communities to alleviate its economic impact,” Dr. Gatcheco said.

Infectious diarrhea, also referred to as acute gastroenteritis, is caused by rotavirus infection and accounts for 25 to 55 percent of hospitalized children less than five-years-old due to diarrhea in Asia, Africa, and Latin America.

In the Philippines, acute diarrhea is one of the five leading causes of sickness and deaths among children. Data from the Department of Health show that for every 100,000 live births in 2004, 914 died because of diarrhea, leading to almost 12,000 infant deaths every year from a preventable and easily curable illness.

This makes vaccination against rotavirus a necessity. “Vaccination can easily prevent these hospitalizations and deaths,” Gatcheco stressed, urging the government to include rotavirus vaccination in the national Expanded Program on Immunization.

In the Philippines, a live oral human attenuated rotavirus vaccine offers protection against the most commonly circulating rotavirus types. Licensed in more than 100 countries worldwide, the vaccine manufactured by GlaxoSmithKline (GSK) works by simulating a rotavirus infection, prompting the production of antibodies, but removes the harmful symptoms of rotavirus gastroenteritis like fever, vomiting and diarrhea. The vaccine, however, should be given to infants during the first 6 months of life as the peak incidence of the disease occurs at 6- 24 months.

GSK’s oral rotavirus vaccine is registered and approved by Bureau of Food and Drugs (BFAD). It is the only two-dose rotavirus vaccine that provides protection against rotavirus as early as possible to infants. With a simple dosing schedule, GSK’s oral rotavirus vaccine allows completion of the course by 10 weeks of age, giving infants effective protection before the disease’s peak incidence.