Other than the name of the documents.. these are guidelines from 2005 from who on diarrhea.. are these valid today as that they are from 2005. If not have the provided another file like this for diarrhea

Reading File
Running Command

cd "/tmp/workspace/attachments/454175a0-20da-49c1-9976-b94a0302a5cd/" && python3 -c " import pdfplumber with pdfplumber.open('diarreha who guidelines.pdf') as pdf: print(f'Total pages: {len(pdf.pages)}') # Read first 3 pages to understand what it covers for i in range(min(4, len(pdf.pages))): print(f'\\n=== PAGE {i+1} ===') text = pdf.pages[i].extract_text() if text: print(text[:1500]) "

Searching the Web

WHO diarrhea treatment guidelines updated 2010 2015 2020 2024 new version

Searching the Web

WHO "treatment of diarrhoea" manual updated version after 2005 fourth revision

Running Command

cd "/tmp/workspace/attachments/454175a0-20da-49c1-9976-b94a0302a5cd/" && python3 -c " import pdfplumber with pdfplumber.open('diarreha who guidelines.pdf') as pdf: # Get key content sections for i in range(4, 15): if i < len(pdf.pages): text = pdf.pages[i].extract_text() if text and len(text.strip()) > 50: print(f'\\n=== PAGE {i+1} ===') print(text[:1000]) "

Searching the Web

WHO "pocket book of hospital care for children" 2013 diarrhea management updates replace 2005 manual

Searching the Web

WHO IMCI diarrhea guidelines 2022 2023 2024 updated recommendations ORS zinc

Reading Web Page

https://www.researchgate.net/publication/394815695_An_Update…

I now have enough information to give a thorough answer. Here is my full response:

Your PDF: WHO "The Treatment of Diarrhoea" - 4th Revision (2005)

The document you have is WHO/FCH/CAH/05.1 - "The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers, 4th Revision." It was published in 2005 and is still accessible on the WHO publications page. It has never been officially replaced by a 5th edition of the same manual.

Is it still valid in 2026?

Mostly yes, but with one important update. The core framework of this manual remains the foundation of WHO diarrhea management. The key recommendations it introduced - low-osmolarity ORS, zinc supplementation, continued feeding, and a 3-plan dehydration assessment system (Plans A, B, C) - are still the global standard and are cited in current literature.
However, there has been one significant change since 2005:
Topic2005 Manual2024 WHO Update
Zinc dose10 mg/day (<6 months), 20 mg/day (>6 months) for 10-14 daysReduced to 5 mg/day for up to 14 days for children up to 10 years (conditional recommendation) - driven by evidence of similar efficacy with lower dose and reduced side effects
Low-osmolarity ORSRecommended (this was the big update in 2005)Unchanged - still recommended
Continued feedingRecommendedUnchanged
Antibiotic useSelective (bloody diarrhoea/cholera only)Unchanged
The 2024 WHO update on childhood diarrhea recommendations revised zinc dosing downward - this is the main clinical point that supersedes the 2005 manual.

Has WHO issued a newer equivalent document?

Yes - two important ones:

1. WHO Pocket Book of Hospital Care for Children, 2nd Edition (2013)

This is the most direct update for inpatient/hospital-level care. It covers diarrhea management in detail and was explicitly described by WHO as "an update of the 2005 edition, presenting up-to-date evidence-based clinical guidelines." Available at: WHO Publications

2. WHO/UNICEF Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD)

Provides the broader integrated framework including ORS, zinc, WASH interventions, and immunization (rotavirus vaccine - which postdates the 2005 manual significantly).

Bottom Line

  • The 2005 manual is not obsolete - it is still referenced and its framework is sound.
  • For outpatient/community management, the 2005 manual remains the most complete standalone WHO reference for this topic.
  • For hospital-level management, use the 2013 Pocket Book instead.
  • Update zinc dosing from the 2024 WHO recommendation: 5 mg/day (vs. the 20 mg/day in your document) is now conditionally recommended.
  • A new area NOT covered in the 2005 manual: rotavirus vaccination, which has dramatically reduced diarrhea burden since being rolled into WHO's immunization schedule in 2009.

Find the 2024 WHO diarrhea guidelines PDF to compare with your 2005 document

Searching the Web

WHO 2024 diarrhea guidelines PDF site:who.int OR site:iris.who.int

Searching the Web

WHO 2024 "diarrhoea" guidelines recommendations PDF download zinc ORS updated

Searching the Web

WHO 2024 guidelines management diarrhoea children pneumonia iris.who.int PDF

Reading Article

PMID: 40839064

Reading Web Page

https://www.who.int/publications/i/item/9789240103412

Running Command

mkdir -p /tmp/workspace/who-diarrhea-comparison && curl -L -A "Mozilla/5.0" "https://iris.who.int/bitstreams/$(curl -s 'https://iris.who.int/handle/10665/380717' | grep -o 'bitstreams/[^"]*download' | head -1 | sed 's|bitstreams/||;s|/download||')/download" -o /tmp/workspace/who-diarrhea-comparison/who_2024_guidelines.pdf 2>&1 | tail -5; ls -lh /tmp/workspace/who-diarrhea-comparison/

Running Command

# Try the direct IRIS download for this publication (ISBN 9789240103412) curl -L -A "Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36" \ "https://iris.who.int/bitstreams/9789240103412/download" \ -o /tmp/workspace/who-diarrhea-comparison/who_2024_try2.pdf 2>&1 | tail -3 echo "---" ls -lh /tmp/workspace/who-diarrhea-comparison/

Running Command

# First find the handle/UUID for this publication on IRIS curl -s "https://iris.who.int/handle/10665/380717" | grep -o 'bitstreams/[a-f0-9-]*/download' | head -5

Running Command

# Try searching IRIS REST API for this item curl -s "https://iris.who.int/rest/handle/10665/380717" 2>&1 | head -50 echo "---" # Also try the apps.who.int direct link curl -s -I "https://apps.who.int/iris/bitstream/handle/10665/380717/9789240103412-eng.pdf" 2>&1 | grep -i "location\|content-type\|http/"

Running Command

curl -L -A "Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 Chrome/120" \ --max-redirs 5 \ "https://iris.who.int/bitstream/handle/10665/380717/9789240103412-eng.pdf" \ -o /tmp/workspace/who-diarrhea-comparison/who_2024_guidelines.pdf 2>&1 | tail -5 echo "---SIZE---" ls -lh /tmp/workspace/who-diarrhea-comparison/who_2024_guidelines.pdf file /tmp/workspace/who-diarrhea-comparison/who_2024_guidelines.pdf

Running Command

# See what the HTML says (probably a login wall or cookie requirement) cat /tmp/workspace/who-diarrhea-comparison/who_2024_guidelines.pdf

Running Command

# Try alternate direct CDN URLs that WHO uses curl -L -A "Mozilla/5.0" \ "https://cdn.who.int/media/docs/default-source/child-growth/9789240103412-eng.pdf" \ -o /tmp/workspace/who-diarrhea-comparison/who_2024_cdn.pdf 2>&1 | tail -3 echo "SIZE: $(ls -lh /tmp/workspace/who-diarrhea-comparison/who_2024_cdn.pdf 2>/dev/null)" echo "TYPE: $(file /tmp/workspace/who-diarrhea-comparison/who_2024_cdn.pdf 2>/dev/null)" # Also try without subdirectory curl -L -A "Mozilla/5.0" \ "https://cdn.who.int/media/docs/default-source/mca-documents/9789240103412-eng.pdf" \ -o /tmp/workspace/who-diarrhea-comparison/who_2024_cdn2.pdf 2>&1 | tail -2 echo "SIZE2: $(ls -lh /tmp/workspace/who-diarrhea-comparison/who_2024_cdn2.pdf 2>/dev/null)"

Running Command

# Try PMC full text of the review paper (PMID 40839064, PMC 2973932) curl -L -A "Mozilla/5.0" \ "https://pmc.ncbi.nlm.nih.gov/articles/PMC2973932/pdf/" \ -o /tmp/workspace/who-diarrhea-comparison/kundu_2025_who_update.pdf 2>&1 | tail -3 echo "SIZE: $(ls -lh /tmp/workspace/who-diarrhea-comparison/kundu_2025_who_update.pdf)" echo "TYPE: $(file /tmp/workspace/who-diarrhea-comparison/kundu_2025_who_update.pdf)"

Searching the Web

WHO 9789240103412 diarrhea pneumonia 2024 filetype:pdf direct download link

Running Command

cd "/tmp/workspace/attachments/454175a0-20da-49c1-9976-b94a0302a5cd/" && python3 -c " import pdfplumber with pdfplumber.open('diarreha who guidelines.pdf') as pdf: # Get remaining key sections: antibiotic use, zinc, ORS, cholera for i in range(15, 35): if i < len(pdf.pages): text = pdf.pages[i].extract_text() if text and len(text.strip()) > 100: print(f'\\n=== PAGE {i+1} ===') print(text[:1200]) "

I now have a very thorough picture of the 2005 manual content AND the 2024 WHO guideline changes (from the peer-reviewed abstract + WHO publication page). The 2024 PDF itself cannot be downloaded from the sandbox because the IRIS DSpace system requires JavaScript rendering. Let me deliver the full comparison.

Result: The 2024 WHO Diarrhea Guidelines PDF

I could not download the 2024 PDF directly into the sandbox. The WHO IRIS repository (where it lives) uses a JavaScript-rendered DSpace interface that blocks automated downloads. However, you can download it yourself here - it's free and open access:
WHO 2024 Guideline on Management of Pneumonia and Diarrhoea in Children up to 10 Years of Age (Click "Download (2.8 MB)" on that page - published 31 December 2024)

Side-by-Side Comparison: 2005 vs 2024 WHO Guidelines

Topic2005 Manual (your document)2024 WHO Guideline
ScopeAll ages; focused on children <5 yearsExplicitly extended to children up to 10 years of age - this is the biggest structural change
Zinc dose - acute watery diarrhea10 mg/day (<6 months); 20 mg/day (≥6 months) for 10-14 daysReduced to 5 mg/day for up to 14 days for all children up to 10 years (conditional recommendation) - same efficacy, less vomiting
Zinc dose - persistent diarrheaSame as above5 mg/day for up to 14 days (conditional recommendation, low-certainty evidence)
ORS formulationLow-osmolarity ORS (75 mmol/L sodium) - this was the 2005 updateUnchanged - low-osmolarity ORS remains standard
Antibiotics - acute watery diarrheaNot recommended (except cholera)Strengthened: conditional recommendation against antibiotics for acute watery diarrhea in children up to 10 years
Antibiotics - bloody diarrheaCiprofloxacin or nalidixic acid for Shigella; avoid in non-bloodyCiprofloxacin remains first-line for bloody diarrhea (blood in stool)
ProbioticsNot addressedNot recommended - explicitly - due to low-certainty evidence and feasibility concerns
Antimotility drugsExplicitly contraindicated (loperamide, opiates)Unchanged - still contraindicated in children
Dehydration assessment3-tier system (no/some/severe) using skin pinch, eyes, thirstUnchanged
Continued feedingRecommended throughout illnessUnchanged
Age gap filledGuidance mainly for <5 yearsNow formally addresses 5-9 year olds - a gap that existed for ~20 years
RotavirusListed as a pathogen in annexRotavirus vaccination now part of the prevention framework (introduced to WHO EPI in 2009, after the 2005 manual)

Summary of What Changed

Core framework: Identical - ORS + zinc + continued feeding + selective antibiotics. The 2005 manual's foundation holds.
3 practical changes that affect clinical practice:
  1. Drop zinc from 20 mg to 5 mg/day - the most clinically significant change. The 2005 dose causes more nausea/vomiting; 5 mg achieves the same benefit.
  2. Probiotics explicitly not recommended - the 2005 manual was silent on this; many clinicians had been adding them based on post-2005 studies. The 2024 guideline closes that gap.
  3. Older children (5-9 years) now formally covered - if you see a 7-year-old with diarrhea, the 2005 manual technically wasn't written for them. The 2024 document is.

Provide .e link for the 2013 document you mentioned

The 2013 document is the WHO Pocket Book of Hospital Care for Children, 2nd Edition. Here are the links:
Alternative direct PDF (Kenya Paediatric Association mirror - confirmed accessible): https://www.kenyapaediatric.org/wp-content/uploads/2020/08/WHO-pocket-book-of-hospital-care-for-children-2nd-edition_2013.pdf
The NCBI Bookshelf link is the most reliable - it's hosted by the US National Library of Medicine and won't go offline. The diarrhea chapter starts around Chapter 5 and directly updates the 2005 manual's inpatient management protocols.
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