Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community.

Abstract

Abstract. In a household survey in Guinea-Bissau, 319 episodes of diarrhea in children were followed by interviews every second day with the aim of investigating perceived morbidity and subsequent actions taken. The majority of the mothers had good knowledge of oral rehydration salts (ORS). However, only 58% of the episodes were treated with ORS and the amount given was insufficient. Mothers with no knowledge of ORS did not use it during the observed attack of diarrhea regardless of contact with a health center, which suggests that maternal knowledge is an important determinant of whether health personnel provide ORS. Children with diarrhea considered to be caused by teething were less likely to receive ORS in the acute phase (risk ratio ϭ 0.6, 95% confidence interval [CI] ϭ 0.5-0.9). Univariate analyses showed that the use of ORS was related to number of reported symptoms, the mother being the care taker, consultations, previous use of ORS, good knowledge of ORS, and having ORS sachets at home. Multivariate Cox regression analyses showed that the presence of ORS sachets at home at the onset of diarrhea was the strongest predictor of use (hazard ratio ϭ 3.3, 95% CI ϭ 1.9-3.6). Improved health education should focus more on the quantity of ORS needed, early signs of dehydration, treatment of teething diarrhea, and breast feeding, and address mothers who have no prior knowledge of ORS. Management of diarrhea may be improved by a more liberal distribution of ORS sachets.

Predictors of Oral Rehydration Therapy use among under-five children with diarrhea in Eastern Ethiopia: a community based case control study

“…This finding is in agreement with studies done in Guniea – Bissau [14] and Nigeria [9], where caregivers who gave ORT for their children at any time in the past were more likely to use ORT during the current episode of diarrhea. This may be explained by the fact that familiarity with ORT could be gained through experience.…”

“…A recent review of literature showed that only 39% of the children with diarrhea in developing countries receive ORT [5]. Some studies have found that maternal perception of the causes of diarrhea, perception of ORT usefulness, barriers regarding its preparation were associated with ORT use [14-16]. Other studies indicated the relationship of ORT use with maternal education, residence, income of the household and age of the patient [15,17-19].…”

Mothers’ misconception and traditional practises towards infant teething’ symptomsin Khartoum

“…On the other hand attribution of serious systemic signs and symptoms to teething may result in delayed management and in some cases to death. Findings fromthis study showed that a vast majority of mothers (96%) attribute child ailment to teething which coincide with OG et al (95.2%) (11), higher than Oyejide et al 58 % ( 12) This misconception is prevalent not only in Sudan but also in other parts of the world, especially east Africa like Nigeria(11)Guinea Bissau (13) and Ethiopia (14) The finding of this study showed that majority of mothers (80.3%) believed that diarrhoea in infants was caused by teething which coincide with other study done in Sudan (90%) (15). These strong mothers' beliefs to attribute infants symptoms to teething contrast the finding of most of contemporary researchers, who did not confirm this strong association and conclude that the symptoms may occur contemporaneously with teething,and only weak association may exist (16,17,18).…”

Evaluation of a social marketing intervention promoting oral rehydration salts in Burundi

“…Kenya et al demonstrated a positive effect of communication campaigns on knowledge and acceptability of ORS within a district in Kenya [23]. A study of an intervention providing direct distribution of ORS in Guinea-Bissau showed that availability of the product and educational sessions improved ORS uptake [24]. Ross-Degnan et al concluded that similar educational campaigns can influence pharmacists, as an intervention for Kenyan pharmacists was linked to increased sale of ORS and a decline in the use of antibiotics to treat diarrhea [25].…”