Do Social Factors Predict Appropriate Treatment of Child Diarrheal Disease in Peru?

Volpicelli, Kathryn; Buttenheim, Alison M.

doi:10.1007/s10995-016-2049-2

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Lastly, we mapped the reported use of ORS, yet use is not equivalent to proper preparation of the solution. 47,48 Future studies should examine the factors that have affected ORS coverage, particularly those that have contributed to shortfalls in efforts to increase coverage, to inform future interventions and implementation studies. Future work should also further investigate coverage of zinc treatment, which has shown effectiveness in reducing undernourishment and diarrhoeal mortality in many countries.…”

Section: Discussionmentioning

confidence: 99%

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Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Wiens¹,

Lindstedt²,

Blacker³

et al. 2020

The Lancet Global Health

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Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2•5th and 97•5th percentiles of those 250 draws. Findings While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62•6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, withincountry geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs asses...

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Section: Discussionmentioning

confidence: 99%

“…Lastly, we mapped the reported use of ORS, yet use is not equivalent to proper preparation of the solution. 47 , 48 …”

Section: Discussionmentioning

confidence: 99%

Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Wiens¹,

Lindstedt²,

Blacker³

et al. 2020

The Lancet Global Health

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“…A study on social determinants of care-seeking in Peru found that rural residence was significantly associated with seeking care for diarrhea. Water source, maternal education and wealth were also significant predictors of seeking care for diarrhea [ 14 ]. Rural communities in South Africa may indicate spiritual and cultural beliefs as being a predictor of receiving care [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Association between WASH-Related Behaviors and Knowledge with Childhood Diarrhea in Tanzania

Bennion

Mulokozi²,

Allen

et al. 2021

IJERPH

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Background: Diarrhea remains a major cause of morbidity and mortality among children in Tanzania. The purpose of this study was to explore associations between diarrheal disease and water, sanitation, and hygiene (WASH) related behaviors and determine care-seeking predictors for diarrheal disease. Methods: Data from 9996 female primary caregivers were collected as part of a larger integrated nutrition program. Logistic regression was used to measure associations between predictor and dependent variables and diarrheal and care-seeking outcomes. Results: Knowledge of the importance of handwashing after assisting a child who has defecated (OR 0.79, CI 0.72–0.87), before preparing food (OR 0.88, CI 0.80–0.97), and before feeding a child (OR 0.89, CI 0.81–0.99) were each associated with not having a child with diarrhea in the past two weeks. Fathers or male caregivers (OR 0.65, CI 0.48–0.89) were less likely to seek medical care for a child with diarrhea. No associations were found between WASH-related knowledge or behavior and seeking medical care for a child with diarrhea. Conclusions: Findings indicate that knowledge of handwashing importance was significant in washing hands after assisting a child who has defecated, before preparing food, and prior to feeding a child. These findings demonstrate the value of parental involvement to lower morbidity and mortality among children.

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“…Our findings related to the effects of distance and wealth on care utilisation for children under five are consistent with previous studies. Across settings, wealthier households are more likely to seek any, timely and appropriate care [ 31 , 32 , 33 , 34 , 35 , 36 ], and distance to a healthcare facility is inversely related to the frequency and timeliness of care utilisation [ 37 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between symptoms, barriers to care and healthcare utilisation among children under five in rural Mali

Treleaven

Whidden

Cole

et al. 2021

Tropical Med Int Health

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Objectives To identify social and structural barriers to timely utilisation of qualified providers among children under five years in a high‐mortality setting, rural Mali and to analyse how utilisation varies by symptom manifestation. Methods Using baseline household survey data from a cluster‐randomised trial, we assessed symptom patterns and healthcare trajectories of 5117 children whose mothers reported fever, diarrhoea, bloody stools, cough and/or fast breathing in the preceding two weeks. We examine associations between socio‐demographic factors, symptoms and utilisation outcomes in mixed‐effect logistic regressions. Results Almost half of recently ill children reported multiple symptoms (46.2%). Over half (55.9%) received any treatment, while less than one‐quarter (21.7%) received care from a doctor, nurse, midwife, trained community health worker or pharmacist within 24 h of symptom onset. Distance to primary health facility, household wealth and maternal education were consistently associated with better utilisation outcomes. While children with potentially more severe symptoms such as fever and cough with fast breathing or diarrhoea with bloody stools were more likely to receive any care, they were no more likely than children with fever to receive timely care with a qualified provider. Conclusions Even distances as short as 2–5 km significantly reduced children’s likelihood of utilising healthcare relative to those within 2 km of a facility. While children with symptoms indicative of pneumonia and malaria were more likely to receive any care, suggesting mothers and caregivers recognised potentially severe illness, multiple barriers to care contributed to delays and low utilisation of qualified providers, illustrating the need for improved consideration of barriers.

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Do Social Factors Predict Appropriate Treatment of Child Diarrheal Disease in Peru?

Cited by 5 publications

References 8 publications

Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Association between WASH-Related Behaviors and Knowledge with Childhood Diarrhea in Tanzania

Relationship between symptoms, barriers to care and healthcare utilisation among children under five in rural Mali

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