Public health intervention needed to curb increase in diarrhoea-related deaths in South Africa

Abstract

Sub-Sahara Africa continues to be the region most affected by the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) (WHO, 2009). South Africa alone is home to 14 % of the world’s HIV positive population (UNAIDS, 2006). Of the estimated 5.5 million HIV-infected individuals in the country, 1.54 million (28%) are resident in KwaZulu-Natal Province (Dorrington et al., 2006). While there has been an unprecedented global investment in the roll-out of antiretroviral therapy(ART) for HIV infection since 2003, health care providers and policy makers in South Africa and other parts of sub-Saharan Africa are faced with a profound challenge due to the devastating impact of HIV/AIDS (Lule et al., 2005). It is by now well established that diarrhoea is a symptom of HIV and AIDS and an important cause of death and disease in HIV-infected people. In South Africa and many other developing countries, especially where the stigma of HIV/AIDS is still very high, the cause of death is often incorrectly classified as diarrhoea or tuberculosis, for example, instead of the true underlying cause, namely HIV (Groenewald et al., 2005). The result of this is statistical data that favours health interventions that are actually not applicable to the true “underlying cause of death”. Diarrhoea is not a life-threatening disease, yet globally millions of people, mostly children, die from diarrhoea every year. The World Health Organization (2007) estimates that diarrhoea is preventable in 94% of all cases by increasing the availability of clean water, and improving sanitation and hygiene