Basing on UNICEF/WHO (2009) "Nearly one in five child deaths – about 1.5 million each year – is due to diarrhea. Today, only 39 per cent of children with diarrhea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000." Enteric infections, however, are not only occurring only in developing countries. In the United States it is estimated that children less than 5 years old will have 2.2 episodes of diarrhea per year, in those above the age of 16 years this rate is still 1.7. German sources describe that one third of the total population will have diarrhea at least once annually. There were some 16,000 deaths from diarrhea recorded in Europe in 2002. Lastly, travelers originating in industrialized countries must expect an incidence rate of travelers’ diarrhea exceeding 20%, sometimes even exceeding 50%, during a two weeks’ stay in a developing country.
The objective of the WDHD 2011 is to focus attention on the prevention and management of diarrheal diseases to improve child survival in developing countries and also to reduce morbidity and mortality in the industrialized world. Special attention will be given to at risk travelers. Obviously the strategies will vary in different parts of the world.
For instance clean water, clean food and clean environment initiatives will play a greater role in low resource countries. Improvement of the infrastructure will reduce the risk of children developing the disease in the first place. The World Gastroenterology Organisation selection of the topic for the WDHD is timely: On July 28, 2010 the United Nations General Assembly declared access to clean water and sanitation a human right. Also vaccines will increasingly play a role in prevention. Still, reducing deaths “depends largely on delivering life-saving treatment of low-osmolarity oral rehydration salts and zinc tablets” (UNICEF/WHO, 2009).
While sanitation is not perfect everywhere in industrialized countries, even greater emphasis will be given here on the option of diarrheal prevention by vaccines, sometimes also by medication. Therapeutic guidelines will be propagated, and appropriate travel kits will be recommended to those planning to visit high-risk countries.
Thus, gastroenterologists worldwide as ‘Global Guardians of Digestive Health’ are expected to greatly contribute in the global fight against enteric infections on May 29 and throughout next year.
Dr. Robert Steffen
Chairman, WDHD 2011