Abstract
Objective: To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison. Methodology: Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent and dependent variables. Statistically significant associations were declared at p-values of less than or equal to 0.05. Results: Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it; antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). Conclusions: In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.
Highlights
Diarrhea is defined as passage of 3 or more unusually loose stool or watery stool of any frequency within 24 hrs [1]
Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017
The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City
Summary
Diarrhea is defined as passage of 3 or more unusually loose stool or watery stool of any frequency within 24 hrs [1]. In Africa, 800,000 children die each year from diarrhea and dehydration which account for 25% to 75% of all childhood diseases [4]. Ethiopia has one of the highest under-five mortality rates with more than 321,000 children under the age of five dying every year and 20% of the deaths are attributed to diarrheal diseases [5]. According to Ethiopia Demographic Health Survey (DHS) 2016, 12% of children younger than 5 years of age had diarrhea in the preceding two weeks and the figure was as high as 23% amongst children 6 - 11 months of age [6]. There is evidence that ORS may reduce diarrhea specific mortality by as high as 93% [8]. Coverage of ORS from 2005-2014 in Ethiopia was 26% and the coverage of zinc during the same period was amazingly nil (0%) [10]
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