Efforts to cope depend on the discipline of someone who is asking for the

cleanliness of food and drinks. By issuing clean habits, a person can avoid viruses or
other microorganisms that can cause diarrhea. Diarrhea caused by 3 aspects, namely
aspects of the host, the agent causing diarrhea, and the environment. The following
are prevention that can be done if viewed from 3 aspects of diarrhea triggers
according to WHO (1992).
1. Pathogenic or Microbial Factors (agents)
Various types of infectious agents that can cause common diarrhea are transmitted
through fecal-oral pathways such as contaminated water, food, and hands. The
steps that can be taken to reduce the number of diarrhea can be returned on this
path are as follows.
A. Receive breast milk for the first 4-6 months of life.
During the first 6 months of life, exclusive breastfeeding (without food or
additional fluids and water) protects the baby from illness and secures a
food source that is safe, clean, easily accessible, and according to its needs.
According to Keusch (2006), exclusive breastfeeding of infants from
diarrheal diseases in two ways: first, breast milk contains immune
(specific) and non-immune (non-specific) antimicrobial factors; secondly,
exclusive breastfeeding eliminates the intake of food and water requested
for contamination. Breastfeeding also provides all the nutrients a baby
needs until the age of 6 months. When receiving breast milk in diarrhea
occurs it also reduces poor nutritional status. The strategy includes:
1. Hospital policies and actions for breastfeeding assistance
and prevention of bottle-feeding
2. counseling and education provided by peers or health
workers
3. mass media and community education
4. mother support group.
B. Avoid the use of baby milk bottles;
C. Increasing the knowledge and ability of mothers related to weaning babies
to overcome microbial contamination;
D. Give probiotics. Probiotics have been proven to be proven in the use of
rotavirus diarrhea and antibiotic-related diarrhea (AAD), but its use in the
treatment of diarrhea has not been widely practiced. Probiotics work to
 compete for attachment to enterocytes so that enterocytes that are saturated
with probiotics can no longer adhere to other bacteria increasing the
growth of pathogenic germs in addition to competing with pathogens to
get a place and nutrition (Shinta, et al. 2011 ).

2. Host Factor
Steps that can be taken to increase host immunity to reduce the risk of diarrhea
include:
A. Immunization
Nearly all babies get rotavirus early on, and rotavirus accounts for more
than one-third of severe and fatal episodes of watery diarrhea in
developing countries, where an estimated 440,000 vaccine-preventable
rotavirus deaths occur each year. An effective rotavirus vaccine will
have a large effect on diarrhea mortality in developing countries
(Keusch, 2006). Oral cholera vaccine also currently appears to be safe
and quite protective in a limited period of time. However, the user's
primary vaccine is mainly focused on tourists from industrialized
countries who might be exposed to the risk of cholera when traveling in
endemic areas. Analysis of diarrhea outbreaks shows that one substance
can already be distributed with cholera. However, because diarrhea
drugs are very cheap and useful in preventing death, immunization is a
top priority. Only certain countries are routinely released by the cholera
vaccine, such as Vietnam (Keusch, 2006).
B. Vitamin A supplement
High doses of vitamin A supplementation help the body's strong immune
system and can reduce the risk of diarrhea by up to 15 percent. Although
improving vitamin A status does not reduce diarrhea and childhood illness,
vitamin A supplements can reduce diarrhea and severe death. Children
between the ages of 6-59 months must be protected with 2 high-dose
vitamin A supplements each year in countries with high under-five
mortality or where vitamin A deficiency is a public health problem.
C. Apply healthy living habits
Nearly 60 percent of deaths from diarrhea worldwide are caused by unsafe
drinking water and poor hygiene and sanitation. Washing hands with soap
 alone can reduce the risk of infection by up to 40% and reduce the risk of
respiratory infections. A clean and clean home environment that is
important to prevent the spread of pneumonia and diarrhea, and safe
drinking water and proper disposal of human waste, including children's
feces, is very important to eliminate the spread of diarrheal disease in
children and adults.
D. Improve nutritional status by eating healthy foods
Good nutrition supports a strong immune system and provides protection
from disease so that it can help reduce diarrhea. According to Keusch
(2006), malnutrition is an independent risk predictor for the frequency and
severity of diarrheal disease. There is a vicious circle where successive
diarrheal diseases cause an increase in nutrition, an increase in the immune
system, and a greater increase in host infections. This cycle can be decided
by intervention by reducing the incidence of infection, reducing
malnutrition, or improving nutritional status to reduce the burden of
infection. Microbial contamination from complementary foods and
malnourished diets during and after episodes. Unfortified complementary
foods that don't meet all essential micronutrient requirements can also be
approved to trigger diarrhea. Additional food contamination can be done by
educating caregivers about hygienic practices, increasing food storage at
home, fermenting food to increase the multiplication of pathogens, or
taking probiotics, nonpathogenic microorganisms, who seek help, and help
combat pathogens.
E. Pay attention to the cleanliness of food and drinks
Promote 5 Keys to Food Safety in food safety, namely Choose (Choose
safe raw materials); Clean (Keep hands and equipment clean); Separate
(separate raw and cooked foods); Cook (Cook until cooked); and Safe
Temperature (Store food at a safe temperature) to prevent diseases carried
through food. Only drink boiled water from sources that can be purchased.
Avoid drinks with ice whose origin is not recognized.
F. Maintain personal hygiene
G. Use clean water for daily water needs
H. Washing hands before and after starting something, especially before and
after preparing meals, as well as after defecation or small. The promotion of
 handwashing reduces the incidence of diarrhea by an average of 33 percent.
This is one of the interventions on behavior change. Washing hands with
liquid soap and water, and rubbing for at least 20 seconds. Then rinse with
water and dry with a disposable paper towel or hand dryer. If hand washing
facilities are not available, or when hands do not look dirty, hand hygiene
with 70 to 80% alcohol-based antiseptics is an effective alternative. If soap
is too expensive, ash or mud can be used while promoting access to water
use.
I. Dispose of poop safely, including baby poop.
Human feces are the main source of pathogenic diarrhea. Poor sanitation,
lack of access to clean water, and inadequate personal hygiene are
responsible for 90 percent of diarrhea in childhood (WHO 1997). The
greatest effect of improving sanitation systems will be in areas with high
population densities and wherever the whole community, rather than a
single household, adopts an intervention.
3. Environmental Factors
A. Maintain the best possible environmental cleanliness. Regularly clean and
disinfect frequently touched surfaces such as furniture, toys, and items
commonly used together.
B. Maintain good ventilation in the room and environment.
C. Improve the quality of water sources used for daily needs. One of the
interruptions in the chain of transmission of diarrhea is the provision of
clean water that meets health requirements including the location of clean
water sources and storage areas to prevent pollution, especially by feces.
D. Improve the condition of latrines at home or public toilets in the community
E. Strive to improve and maintain environmental sanitation and drainage
systems
F. Increase community knowledge about all matters related to diarrhea. This
can be done with the active role of health workers to provide education and
education to the public about the dangers of diarrhea and prevention efforts
Meanwhile, some key measures to treat diarrhoea based on WHO (2017) include the
following:
 Rehydration: with oral rehydration salts (ORS) solution. ORS is a mixture of
clean water, salt and sugar. It costs a few cents per treatment. ORS is absorbed
in the small intestine and replaces the water and electrolytes lost in the faeces.
 Rehydration: with intravenous fluids in case of severe dehydration or shock.
 Zinc supplements: zinc supplements reduce the duration of a diarrhoea
episode by 25% and are associated with a 30% reduction in stool volume. a
10-14 day supplemental treatment course of dispersible 20 mg zinc tablets
shortens diarrheoa duration and improves outcomes.
 Nutrient-rich foods: the vicious circle of malnutrition and diarrhoea can be
broken by continuing to give nutrient-rich foods – including breast milk –
during an episode, and by giving a nutritious diet – including exclusive
breastfeeding for the first six months of life – to children when they are well.
 Consulting a health professional , in particular for management of persistent
diarrhoea or when there is blood in stool or if there are signs of dehydration.