Improved Childhood Diarrhea Treatment Practices in Ghana: A Pre-Post Evaluation of a Comprehensive Private-Sector Program

El-Khoury, Marianne; Banke, Kathryn; Sloane, Phoebe

doi:10.9745/ghsp-d-16-00021

Cited by 19 publications

(17 citation statements)

References 17 publications

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“…Consistent with studies done in Bangladesh [ 24 ], Nepal [ 20 ], India [ 27 ], and Ghana [ 23 ], in this study the likelihood of using zinc for the management of diarrhea in under-five children was higher among mothers who had media exposure as compared to mothers with no media exposure. This might be because of advertising through both television and radio regarding zinc syrup or tablets are the quickest media channels in terms of creating or disseminating information on the benefits of zinc in the country.…”

Section: Discussionsupporting

confidence: 91%

Factors associated with zinc utilization for the management of diarrhea in under-five children in Ethiopia

2020

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Background Zinc has a tremendous advantage to save the life of children. It reduces the mean duration of diarrhea and mortality due to diarrhea. Besides, it reduces the severity of the initial episode, and also it prevents future diarrhea episodes. But there is low utilization of zinc for the management of diarrhea in under-five children in Ethiopia and there is a paucity of literature regarding the factors associated with the utilization. Method The 2016 Ethiopian demographic and health survey data were used as a data source. A total weighted sample of 1228 under-five children with diarrhea within 2 weeks preceding the survey were used. A mixed-effects logistic regression analysis was done to account for the complex sample design of the data. Variables with p-value < 0.20 in the bivariable analysis were eligible for multivariable analysis and those variables with p value< 0.05 in the multivariable analysis were declared to be determinants of zinc utilization for the management of diarrhea in under-five children. Result In this study, we found multiple determinants of zinc utilization. Mothers with formal education (adjusted odds ratio (AOR) = 1.83;95% CI; 1.30–2.58) and media exposure (AOR = 1.46;95% CI; 1.04–2.04) had higher odds of zinc utilization. But mothers from five and above household size (AOR = 0.57;95% CI; 0.39–0.82) had lower odds of zinc utilization for the management of diarrhea in under-five children. Conclusion In our study maternal education, media exposure, and household size were determinants of zinc utilization for the management of diarrhea in under-five children. Being having a formal education and being exposed to all or either of the three media (radio, TV, and newspaper) increases the likelihood of zinc utilization while being mothers from large household size decreases the likelihood of zinc utilization. Therefore, giving special attention to those mothers with no formal education, and mothers from high family size could increase the utilization of zinc for the management of diarrhea in under-five children. Also, media campaigns regarding diarrhea management could be scaled up to potentially achieve the desired impact.

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Section: Discussionsupporting

confidence: 91%

Factors associated with zinc utilization for the management of diarrhea in under-five children in Ethiopia

2020

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“…Use of these over-the-counter drugs (e.g., kaolin-pectin or anti-motility agents) for children has long been recognised as contraindicated due to their lack of benefit and increased risk of side effects, including ileus, drowsiness, and nausea. In Ghana, a 4-year initiative (Strengthening Health Outcomes through the Private Sector (SHOPS) project) sought to decrease inappropriate use of such treatments (and antibiotics) for childhood diarrhoea using a number of strategies including training, support, and media campaigns [ 39 ]. Although antibiotic use declined markedly during the project, at follow-up it remained high, especially in cases of non-bloody diarrhoea.…”

Section: Discussionmentioning

confidence: 99%

Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria

et al. 2019

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BackgroundDiarrhoea remains an important cause of childhood mortality in Nigeria, with Rotavirus and Cryptosporidium reported to have the highest contribution. However, high use of antibiotics for treatment of paediatric diarrhoea has been observed, although World Health Organization guidelines discourage the use of antibiotics for treating acute diarrhoea. Here we investigated more closely management and treatment practices for acute paediatric diarrhoea, both in home and healthcare settings.MethodsChildren under 5 years of age (n = 199) presenting at healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea were included in the study. Background information on the children was collected by questionnaire, including home treatments, and clinical information including symptoms and treatment were provided by the healthcare centres. Analysis of faecal samples from the children indicated that over 90% had Rotavirus infection and over 6% Cryptosporidium infection. Data were compiled in a spreadsheet and analysed for associations between variables and use of antibiotics using logistic regression analysis.ResultsAlthough most children were treated supportively (oral rehydration solution and intravenous fluids at home and in healthcare settings, respectively) over 15% were given anti-diarrhoea drugs at home and over 85% were also prescribed antibiotics at the healthcare centre, mostly ciproflaxin, but also metronidazole and gentamycin. The only variable positively associated with antibiotic prescription was diarrhoea more than three times per 24 h at admission.ConclusionsIt is clear that young children presenting with acute watery diarrhoea to healthcare centres in Abakaliki are likely to be prescribed antibiotics, despite there being no obvious reason that this treatment is appropriate. Our study results support the need for institution-based antimicrobial stewardship being implemented in Nigeria.

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“…A very limited studies conducted so far identified maternal education [21,22], economic status [21,23,24], mass media exposure [24][25][26][27][28], knowledge about zinc [29,30] and residence [21,23,24] as the factors that are associated with zinc utilization among under-five children with diarrhea.…”

Section: Introductionmentioning

confidence: 99%

Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

et al. 2020

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Introduction Diarrhea is the leading cause of illness and death among under-five children in low and middle income countries. Through the provision of zinc supplements has been shown to reduce the severity and duration of diarrhea, as well as the risk of mortality, the use of zinc for the treatment of diarrhea is still very low in low-income countries. Therefore, this study was conducted to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. Methods A secondary data analysis of the recent Demographic and Health Surveys (DHS) of East African countries were used to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. A total weighted samples of 16,875 under-five children with diarrhea were included in the study. A generalized linear mixed model (using Poisson regression with robust error variance) was used. Prevalence Ratios (PR) with their 95% confidence interval (CI) were calculated for those variables included in the final model. Results The overall prevalence of zinc utilization among under-five children with diarrhea in this study was 21.54% (95% CI = 20.92–22.16). Of East African countries, Uganda had the highest prevalence of zinc utilization (40.51%) whereas Comoros had the lowest (0.44%). Maternal primary education (Adjusted Prevalence Ratio(aPR) = 1.29, 95% CI: 1.16–1.44), secondary education (aPR = 1.36, 95% CI = 1.19–1.55) and higher education (aPR = 1.91, 95% CI = 1.52–2.40), high community women education (aPR = 1.12, 95% CI = 1.02–1.24), high wealth index (aPR = 1.12, 95% CI = 1.01–1.24), high community media exposure (aPR = 1.17, 95% CI = 1.06–1.29) were associated with a higher prevalence of zinc utilization. Conclusion The prevalence of zinc utilization among under-five children was found to be low in East Africa. Maternal education, wealth index, community women education, and community media exposure were significantly associated with zinc utilization. Increased mass media exposure, maternal education and wealth index is recommended to improve zinc utilization among under-five children with diarrhea.

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Improved Childhood Diarrhea Treatment Practices in Ghana: A Pre-Post Evaluation of a Comprehensive Private-Sector Program

Cited by 19 publications

References 17 publications

Factors associated with zinc utilization for the management of diarrhea in under-five children in Ethiopia

Factors associated with zinc utilization for the management of diarrhea in under-five children in Ethiopia

Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria

Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

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