What is the commonest cause of diarrhea in children <5 years of age?

Appeared in: MNS 2024

Explanation

Rotavirus is the leading cause of severe, dehydrating diarrhea in children under 5 years of age globally.
The peak incidence of severe rotavirus gastroenteritis occurs in children aged 6–24 months.
Transmission is primarily through the fecal-oral route, and the virus is highly contagious, spreading easily in settings like daycare centers.
Clinical presentation includes acute onset of watery diarrhea, vomiting, and fever, which puts the child at high risk for dehydration.

Option A: Epstein-Barr Virus (EBV) is not a primary cause of gastroenteritis.
Option C: Entamoeba histolytica is a protozoan parasite that causes amebiasis, which is less common than viral gastroenteritis in this age group.
Option D: Salmonella typhi causes a systemic illness, typhoid fever, not primarily acute localized diarrhea.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of infectious diarrhea in the pediatric population as background academic context rather than a clinical decision trigger.
The primary nursing goal in managing pediatric diarrhea is preventing and treating dehydration. Nurses must be skilled in assessing hydration status (skin turgor, fontanelle, mucous membranes, urine output).
Oral Rehydration Therapy (ORT) is a cornerstone of treatment. Nurses play a crucial role in administering ORT and educating parents on how to continue it at home.
Vaccination is a key public health strategy. The inclusion of the Rotavirus vaccine in national immunization schedules has drastically reduced hospitalizations for severe gastroenteritis.

How to Approach the Question

First, identify the key elements of the question: the condition ('diarrhea'), the patient population ('children <5 years'), and the specific question ('commonest cause').
This is a factual recall question based on epidemiology and infectious diseases.
Systematically evaluate each option based on your knowledge of common pediatric pathogens.
Recall that viruses are the most frequent cause of acute gastroenteritis in young children.
Compare the viral options. Rotavirus is classically taught as the number one cause of severe diarrhea in infants and young children worldwide.
Eliminate the other options by identifying the primary diseases they cause (EBV -> Mononucleosis; E. histolytica -> Amebic dysentery; S. typhi -> Typhoid fever), which do not fit the description of the 'commonest cause' of simple diarrhea.

Concept Tested & Keywords

Concept Tested: Etiology of infectious diarrhea in the pediatric population.
Stem keywords: commonest cause, diarrhea, children <5 years
Lead-in keywords: What is
Clinical cues: Age group <5 years is a key determinant for identifying the most likely pathogen.

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 78-80

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 796-798

Practise the full MNS 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.