“No single intervention is sufficient to eliminate the global burden of enteric and diarrheal disease.” We’ve explored many different solutions to diarrheal disease, and there are many options for moving forward…..so, what should we do? How do we approach diarrheal disease?
Diarrheal disease is a multi-combination disease, meaning that there are many factors that go into having acute, persistent, or chronic diarrhea. Therefore, we should approach diarrheal diseases using a multi-combination strategy. Implementing probiotics into the community is a great way to start. It helps balance out the good bacteria and the bad with people who have to deal with diarrhea on a daily basis. It is easy and cheap to manufacture and give out, which is a huge plus in a developing world where expensive treatments do not have a life-long sustainability and are not a “fix it once and leave it solution”. Although it is beneficial for people to take probiotics everyday for the rest of their lives and that would use a lot of resources, since it is cheap and can be manufactured by the masses, it helps that problem. I think that probiotics is a great solution that people should not ignore. Although I do not believe it would solve the solution entirely, I do think that it could help tremendously. A few other main issues with diarrheal diseases is sanitation, water, and hygiene. If even one of those parts is bad off then this disease will prevail. We need to be able to tackle all three of those aspects to be able to fight diarrheal diseases completely. There are obviously many aspects of sanitation and water that need help with, but I think an easy one that we could start working on is hygiene. I think that educating people about proper hygiene could help a lot when it comes to diarrheal diseases. Teaching people about safe hygiene practices is an easy and cheap way to help the economy by hiring people from the community and help the people themselves by showing them a better way to avoid parasites and harmful bacteria just by simply wearing shoes. I think that the ability to the fight diarrheal diseases is in our reach, we just need to take the proper steps to combat it altogether.
Strunz, E., Addiss, D., Stocks, M., Ogden, S., Utzinger, J. and Freeman, M. (2014). Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine, 11(3), p.e1001620.
Preidis, G., Hill, C., Guerrant, R., Ramakrishna, B., Tannock, G. and Versalovic, J. (2011). Probiotics, Enteric and Diarrheal Diseases, and Global Health. Gastroenterology, [online] 140(1), pp.8-14.e9. Available at: https://www-sciencedirect-com.prox.lib.ncsu.edu/science/article/pii/S0016508510016148 [Accessed 31 May 2018].
How do we close the sanitation gap? Should we?
I believe that when it comes to closing the sanitation gap, there is a line that should not be crossed. Improving sanitation to the extent of helping people suffer from diarrheal diseases, parasites, and more, I think that it is important to improve their overall sanitation. When it comes to trying to make everyone across the world use our toilets and sanitation system no matter cost or how it may impede on their daily living, we should not impose. So overall, yes the gap in sanitation between developing and developed countries should close some, but we could easily cross the line of westernizing these countries to our way of living, which is not what our main goal should be. To help close the sanitation gap, I believe that a company like LifeStraw is a great example. The fact that the people that they hire are from the local community and come in for an hour to teach these families how to use the product and why the product is so important is a perfect example that shows educating these people is a great way to improve sanitation. To avoid gut-eating parasites that live in the ground, teaching people just to simply wear shoes could help them extremely. Teaching WASH practices around local communities is an easy and safe way to help people try to be as cautious as they can. I think that the more people know how to stay safe and proper sanitation practices in their environment, the more we can decrease all these types of infections that are easily avoidable. Strunz notes that WASH practices showed a 33% decrease in STH infections. That is a huge statistic for just practicing clean and safe hygiene, water, and sanitation. Statistics like that make me believe that closing this huge gap is possible, but education is the key to success. We need for-profit companies to hire local people in the community, which in turn will help the local economy, and get them to teach surrounding communities about safe sanitation practices in all kinds of ways and prove to them that it is efficient. When the LifeStraw guy went through the whole process of cleaning the water and then at the end drank the water, that was proof that it was safe and that anyone can drink it. That is going to be more successful in showing these people how to do things than any other way.
Strunz, E., Addiss, D., Stocks, M., Ogden, S., Utzinger, J. and Freeman, M. (2014). Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine, 11(3), p.e1001620.
Are probiotics a realistic solution for diarrheal disease in the developing world?
I believe that probiotics are a great step in the right direction for fighting diarrheal diseases in a developing country. I do not believe that it is a “fix it all” solution to this massive problem because there are so many different problems associated with this disease. With that being said, probiotics are cheap, easy, and do not have any harmful effects associated with them. People in a developed world take them regularly for a healthy gut so why can’t it be beneficial to those in a developing world too? As long as the way probiotics are manufactured are kept in a safe and sterile environment and then given to those in the community who need it, there should be no problems. They could potentially help people from devastating diseases by fighting off infections such as Listeria and many other infections that could be potentially fatal if not treated. I believe this solution to be better than broad spectrum antibiotics because it is adding good bacteria to your body rather than wiping out all bacteria in your body altogether. The overuse of antibiotics have their own conflicts and problems associated with them but probiotics do not. People could take probiotics everyday for 10 years and not have harmful side effects associated with that, which is huge in a developing world. Why not provide something to the people that can only help them? Studies have shown that it has helped with children’s growth, immunity, and vaccine efficacy. I don’t believe you can fix diarrheal diseases without fixing the water and sanitation problem, I do believe that you can help it significantly. Probiotics are a great way to start helping reduce diarrheal diseases in a developing world.
Preidis, G., Hill, C., Guerrant, R., Ramakrishna, B., Tannock, G. and Versalovic, J. (2011). Probiotics, Enteric and Diarrheal Diseases, and Global Health. Gastroenterology, [online] 140(1), pp.8-14.e9. Available at: https://www-sciencedirect-com.prox.lib.ncsu.edu/science/article/pii/S0016508510016148 [Accessed 31 May 2018].
Addison's Medical Service Trip 