Digestive Health

Updated 26 February 2018

Risk factors

Gastroenteritis is a common disease that occurs worldwide.


It’s almost impossible to completely avoid contact with the viral and bacterial causes, and therefore almost everyone can suffer from it a few times in their life.

Anyone can get gastroenteritis. In fact, no child will escape an episode or two of gastroenteritis, no matter how good his or her socioeconomic circumstances.

Certain groups are more vulnerable to getting gastroenteritis.

These include:

Age. Infants and young children are at increased risk due to their immature immune systems; the elderly are at increased risk due to weakened immune systems.

Seniors who have weakened immune systems.

People who form part of poor, underprivileged communities. Gastroenteritis often spreads easily in communities that have bad sanitation and poor food-storage facilities.

 Gastroenteritis is more dangerous for those with poor nutrition, and is a primary cause of death in babies and young children in African countries.

 People who eat undercooked and/or unwashed foods or drink from potentially contaminated fluid sources (rivers, streams, unpasteurised milk).

 People living in crowded conditions (military, cruise ships, dorms).

• Anyone with a weakened immune system due to an illness such as HIV/AIDS or cancer, or its treatment (e.g. chemotherapy).

 Some people taking antibiotics, because the antibiotics depress the normal gut bacteria and allow bacteria or viruses to dominate and cause disease.

• People who don’t practise good hygiene and hand-washing techniques.

 Travellers (especially to areas where water and/or food may be contaminated) who come into contact with local bacteria and viruses against which their immune systems don’t have pre-existing defences. 

Children under the age of five years are most at risk of dying from gastroenteritis. Worldwide, one in 10 deaths in children under the age of five years results from diarrhoea. 

Diarrhoea is one of the leading causes of illness and death in under-five children in South Africa.

Call a doctor or go to your hospital / clinic if the person:
• Has a fever of 38.9°C or higher.
• Hasn’t urinated for six hours or more.<
• Is unable to take or keep down even clear liquids.
• Is becoming listless or lethargic.
• Shows any signs of bleeding from the gut, i.e. bloody stool or blood in vomit.
• Experiences severe abdominal pain or swelling.

If a child has the following symptoms, you should contact a doctor:
• Diarrhoea or vomiting that wakes the child during the night.
• Persistent or severe diarrhoea or vomiting.
• Dehydration symptoms, particularly persistent dry mouth or eyes that are becoming sunken.
• No improvement in symptoms after 36 hours.

If needed, a doctor will give fluids intravenously until the vomiting and diarrhoea resolve.

In very severe cases, where the person is shocked through loss of fluids, admission to an intensive care unit may be required.

Official data from Statistics South Africa estimate that diarrhoea accounts for approximately 20% of under-five deaths, but the actual burden of death from childhood diarrhoea isn’t accurately known. 

The 2010 General Household Survey, a nationally representative inquiry into the livelihood of South Africans, showed that there were over 60,000 cases of childhood diarrhoea per month and approximately 9,000 child diarrhoeal deaths in the same year.

Gastroenteritis is closely linked to socio-economic status, with South Africa’s poor communities being affected most adversely. Children from the poorer communities are 10 times more likely to die from diarrhoea.

Poor nutritional status, poor environmental conditions, and illnesses such as HIV/AIDS make children more susceptible to severe diarrhoea and dehydration.