Pedia Flash Vol-6, No-2, 2020

Diarrheal disease is considered to be a major health problem in children. It contributes to remarkable mortality and morbidity in children under the age of 5 years with the problem being more pronounced in developing countries. It has been estimated that about 2.5 billion cases of childhood diarrhea are reported annually and it accounts for 9% of deaths in under-five children globally. Such data makes diarrhea the second leading cause of death in this population. Furthermore, in South Asian and African countries, about 82% of under-five deaths are caused by diarrhea.1 Its prevalence in the Indian subcontinent has been estimated to range between 2.2% and 55.6% with children in rural areas less affected as compared to those residing in urban areas (Figure 1).2 Diarrhea is usually described as an abnormal increase in daily stool fluidity, frequency, and volume from what is considered normal for an individual or more specifically as three or more loose or liquid stools per day due to abnormally high fluid content.1 However, several forms of diarrhea have been identified based on the duration of symptoms (Box 1).

The world is witnessing a rapid epidemiological and nutritional transition characterized by persistent nutritional deficiencies with a concomitant increase in the prevalence of obesity, diabetes and other chronic diseases associated with nutrition. These transitions have also been reported in the pediatric population. Obesity is one of the emerging health problems of growing importance.1 A child is defined as overweight if his/her BMI-for-age percentile is ≥85th percentile and 95th percentile while obesity refers to BMI- for-age ≥95th percentile.2 Childhood obesity has emerged as a significant health problem reaching epidemic levels in developed nations. In addition, a steady rise in obesity prevalence is also seen among children of developing nations with a higher predominance observed in females thought to be due to inherent hormonal differences.1 This was evident in a review of studies conducted in Indian children and adolescents which showed increasing overweight and obesity rates not just among the higher socio-economic groups but also in the lower income groups where underweight still remains a major problem.