Integrated management of neonatal and childhood illness



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module 5

SEVERE
PERSISTENT
DIARRHOEA
Treat dehydration before referral unless the
child has another severe classification.
Refer to hospital



No Dehydration


PERSISTENT
DIARRHOEA
Advise the mother on feeding a child who has PERSISTENT DIARRHOEA Give single dose of vitamin A Give zinc sulphate daily for 14 days. Followup in 5 days.




SEVERE PERSISTENT DIARRHOEA If a child has had diarrhoea for 14 days or more and also has some or severe dehydration, classify the child's illness as SEVERE PERSISTENT DIARRHOEA.


Treatment Children with diarrhoea lasting 14 days or more who are also dehydrated need referral to hospital. These children need special attention to help prevent loss of fluid. They may also need a change in diet. They may need laboratory tests of stool samples to identify the cause of the diarrhoea.
Two
of the following signs Lethargic or unconscious Sunken eyes Notable to drink or drinking poorly
• Skin pinch goes back very slowly.




SEVERE
DEHYDRATION
Two
of the following signs Restless, irritable Sunken eyes Drinks eagerly, thirsty Skin pinch goes back slowly.


SOME
DEHYDRATION
Not enough signs to classify as some or severe dehydration


NO
DEHYDRATION

Treat the child's dehydration before referral unless the child has another severe classification. Treatment of dehydration in children with severe disease can be difficult. These children should be treated in a hospital.
PERSISTENT DIARRHOEA A child who has had diarrhoea for 14 days or more and who has no signs of dehydration is classified as having PERSISTENT DIARRHOEA.
Treatment Special feeding is the most important treatment for persistent diarrhoea. Feeding recommendations for persistent diarrhoea are explained in the module Counsel The Mother.
Children with persistent diarrhoea are also given single dose of vitamin A and a daily dose of zinc sulphate for 14 days.

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