There are three classification tables for classifying diarrhoea:

  • All children with diarrhoea are classified for dehydration.
  • Diarrhoea for 14 days or more, the child should be classified as persistent diarrhoea.
  • A child has blood in the stool; the child should be classified as having dysentery.

Now you are going to look at each of these classifications, beginning with classifying dehydration. There are three possible classifications of dehydration in a child with diarrhoea:

  • Severe dehydration
  • Some dehydration
  • No dehydration

Classification of Dehydration in a Child With Diarrhoea

SIGNS CLASSIFY TREATMENT
All children for
Two of the following signs:
  • Restless, irritable.
  • Sunken eyes.
  • Drinks eagerly, thirsty
  • Skin pinch goes back slowly.
    		•  SOME DEHYDRATION
  • Give fluid and food for some dehydration (Plan B).
  • Give zinc treatment for 10 days.
  • Advise mother when to return immediately.
  • Follow-up in 5 days if not improving.
    		•
    Not enough signs to classify some or severe dehydration. NO DEHYDRATION
  • Give fluid and food to treat diarrhoea at home (Plan A).
  • Give zinc treatment for 10 days
  • Advise mother when to return immediately.
  • Follow-up in 5 days if not improving.
    		•
    Dehydration present. SEVERE PERSISTENT DIARRHOEA
  • Give Vitamin A.
  • Refer URGENTLY to health/hospital with the mother giving frequent sips of ORS on the way.
  • Advise the mother to continue breastfeeding.
  • Advise the mother for a referral.
    		•
    No dehydration. PERSISTENT DIARRHOEA
  • Give Vitamin A
  • Advise mother on the need of referral
  • Advise the mother to continue breastfeeding
  • Refer to the health centre/hospital.
    		•
    Blood in the stool. DYSENTERY
  • Advise the mother to continue breastfeeding.
  • Advise mother on the need for referral.
  • Refer URGENTLY to the health centre/hospital.
    		•

    To classify the child's dehydration, begin with the top (pink) row.

    • If two or more of the signs in the pink row are present, you should classify the child as having SEVERE DEHYDRATION
    • If two or more of the signs are not present, look at the middle (yellow) row. If two or more of the signs are present, you should classify the child as having SOME DEHYDRATION.
    • If two or more of the signs from the yellow row are not present, classify the child as having NO DEHYDRATION (bottom, green row).The child does not have enough signs to be classified as having SOME DEHYDRATION.

    The Case Study below provides an example for you to see how you would classify a child in practice.

    Case Study. Amina's Story

    A four-month-old child named Amina was brought to the health post because she had had diarrhoea for five days. She did not have danger signs, and she was not coughing. However, Amina was restless and irritable every time the health extension worker touched her and would not settle even when her mother tried to soothe her. The only time she was calm was when her mother was breastfeeding her. Amina was able to feed strongly. The health extension worker assessed the child's diarrhoea. She recorded the following signs:


    Look at the box below; Amina does not have any signs in the pink row. Therefore, Amina does not have severe dehydration.

    Amina's Signs for Classification in the Yellow Row


    Amina had two signs from the yellow row. Therefore the health worker classified Amina's dehydration as SOME DEHYDRATION. The health extension worker recorded Amina's classification on the recording form which is reproduced in the Box below.

    Recording Form for Amina


    Last modified: Wednesday, 1 March 2017, 1:54 AM