Abstract
Introduction: Since it’s a common observation that most cases of acute diarrhea are not managed according to WHO guidelines. Irrational use of drugs is a major problem of present day medical practice, as well as use of ORS is underesti-mated. The mothers /grand mothers reduce or stop feeding(except for breast feeding) do not know the importance of fluid therapy or ORS and cannot prepare ORS properly. This study was designed to know the exact situation. Objective: To assess the knowledge, attitude and practices of the mothers and doctors in acute diarrhea in children ≤ 5 years of age about feeding, preparation and use of oral rehydration solution (ORS) and drugs. Design: Cross Sectional. Place and duration: ORT corner of Pediatric OPD at Sir Ganga Ram Hospital, Lahore from May, 2007 to September, 2007. Patients and Methods: Nine hundred and fifty children under 5 years of age having acute diarrhea were included in the study. Data was collected on a specified questionnaire by a doctor who entered the required information after interviewing the mothers/grandmothers accompanying the children. The information was collected regarding use of ORS and who prescribed, or they already had knowledge that it should be given, how to prepare ORS, whether or not continued feeding and used drugs during current acute diarrhea episode. The data was entered and interpreted as frequency distribution. Results: ORS was used (given) by only 464 (49.67%) of the mothers, out of which 125(27%) used it by their own know-ledge (through newspaper, television, told by neighbours or previous consultation by the doctor). 400 (42.82%) mothers knew about preparation of ORS. Feeding was continued by 697 (74.62%) of the mothers and 400 (42.82%) used drugs, prescribed by general practitioners, medical officers of government hospitals, few by paediatrician and self during acute diarrhea. Conclusion: It is concluded that ORS was given by 49.67% of the mothers, 42.8% could prepare it properly, feeding was stopped/reduced/diluted by 25% of the mothers. Drugs were used in 42.82% of the cases. Diarrhea control programme needs to be reinforced to improve existing practices regarding management of acute diarrhea in children ≤ 5 years of age. Inappro-priate use of drugs during diarrhea should be discouraged. Key Words: ORS(oral rehydration solution), acute diarrhea, ORT( oral rehydration therapy).
Highlights
Since it’s a common observation that most cases of acute diarrhea are not managed according to World Health Organization (WHO) guidelines
Feeding was continued by 697 (74.62%) of the mothers and 400 (42.82%) used drugs, prescribed by general practitioners, medical officers of government hospitals, few by paediatrician and self during acute diarrhea
Was assessed indirectly by collecting information from the mothers/grand mothers who visited them in the current episode before reporting to our ORT corner
Summary
Since it’s a common observation that most cases of acute diarrhea are not managed according to WHO guidelines. The mothers /grand mothers reduce or stop feeding(except for breast feeding) do not know the importance of fluid therapy or ORS and cannot prepare ORS properly. This study was designed to know the exact situation. The World Health Organization (WHO) suspects that there are >700 million episodes of diarrhea annually in children < 5 years of age in developing countries. While global mortality may be declining, the overall incidence of diarrhea remains unchanged at about 3.2 episodes per child per year.[1]. Rota virus infection (the most common identifiable viral cause of gastroenteritis in all children) account for at least 3.5% of severe and potentially fatal watery diarrhea episodes, with an estimated 500,000 deaths per year worldwide. The case fatality of diarrhea in children under 5 years has been shown to be 19.7/1000 (9%) as compared to an overall mortality of 55.3/1000.2.
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