-Health Ministry urges good hygiene
Following a slight increase in diarrheal illnesses since the start of the year, Health Minister Dr Leslie Ramsammy is urging the public to adopt good hygiene practices to curb incidences.

In a statement issued on Saturday, Ramsammy disclosed that the Health Ministry has received “an unusual” number of calls from the pubic about diarrhoeal illnesses. Coinciding with the public interest, the ministry also has found that in the first four epidemiological weeks for 2010, 11,017 cases were reported to the ministry. “The overall total for the first four weeks of the year is slightly increased from the first four weeks of 2009,” Ramsammy said, while also admitting that the ministry is not in a position to identify the specific cause for the illnesses.

Children under one year old accounted for 788 or 7.2% of the cases for the year, and the one to five years old age group accounted for 3,202 or 29.1%. Meanwhile, those aged five to 14 years old numbered 3,070 or 29.7% and those 15 years and older accounted for 3,957 or 35.9%.

Last year, Guyana recorded a total of 60,246 diarrhoeal cases, with children under one year old accounting for 5,673 (9.4%) of those cases, while children between ages one and five years old accounted for 17,059 or 28.3%. For the age group five to 14 years old, there were 15,325 cases or 25.4%; and for those aged 15 years old and above diarrhoeal illnesses were numbered at 22,191 or 36.8% of the cases.

Ramsammy noted that the occurrence of gastroenteritis is seasonal, with the highest incidence occurring in December, January, February and March. He said the ministry has been monitoring the incidence of diarrhoeal illnesses throughout the country and all health facilities, including private doctors and private hospitals must report incidences weekly to the ministry. However, he also revealed that there has been unreliable reporting from health institutions across the country. In 2009, he said, only 55% of the facilities reported consistently and on a timely basis. For the past four epidemiological weeks in 2010, the reporting facilities rose to between 65% and 80%. As such, the Chief Medical Officer has been instructed to write to all health authorities to ensure compliance to the ministry’s requirements.

The minister noted that acute gastroenteritis is not a new illness in Guyana and almost 30% of deaths in children under five is the result of diarrhoeal illnesses. “For every 10,000 population in Guyana, about 800 episodes of gastroenteritis occur each year. For children under five, the rate is about 1,200 episodes for every 10,000 children,” Ramsammy further explained. He emphasised that it is a public health problem that largely can be stopped by practising good hygiene.

He added that this is one of the main reasons the ministry has been active in promoting good hygiene, since it will lead to the reduction of diarrhoeal cases.

Globally, he pointed out, more than half the time no specific cause is identified, although contaminated water, food and poor hygiene have been identified as the major causes. In Guyana, about 35% of all diarrhoeal cases in children are caused by the rotavirus, he said, adding that this is main reason why the ministry is ensuring that most children are vaccinated against the virus.

Common bacterial infections such as the staphylococcus aureus can form a toxin that is commonly the cause of food poisoning. Escherichia coli, commonly found in contaminated water, is another possible cause. This was the causative agent for serious diarrhoeal illnesses last year in Region One. Salmonella, usually contracted from handling poultry, eggs and other animal products; Shigella, typically spread from one person to another because of poor hygiene; and Clostridium difficle, which may overgrow in the large intestine after someone has been on antibiotic treatment for some other illness, are also among the common bacterial that are among the main causative agents for diarrhoeal diseases in Guyana.

Common parasites and protozoan that cause diarrhoeal diseases, including Giardia, are also agents.

Ramsammy said that so far the ministry has not yet identified what may be causing diarrhoeal illnesses this year but he said it is possible that more than one of the said agents are the causative factors.

However, the ministry advises the public to practise good hygiene, as “good hygiene will work all the time.” The ministry advises regular hand-washing or the use of sanitisers, boiling water for drinking purposes or using bleach to disinfect it, cooking food thoroughly and washing fruits and vegetables before use.

Persons, particularly children and the elderly or persons with other serious illnesses, should visit health centres or their doctors if they have been experiencing diarrhoeal illnesses. Persons should keep a supply of Oral Rehydration Solution at home. This solution can be made with one half teaspoon of salt with two tablespoons of sugar in 8ozs of water. Also, coconut water can be substituted for ORS, while easily digested food such as bananas, biscuits, soups, potato are recommended and milk, dairy products, alcohol and caffeine products are advised against.