Treatment patterns of childhood diarrhoea in rural Uganda: a cross-sectional survey

Jenny Löfgren,Elin Larsson,Birger C Forsberg,Wenjing Tao,Francis Kyakulaga

doi:10.1186/1472-698x-12-19

Jenny Löfgren, Elin Larsson + Show 3 more

Open Access

https://doi.org/10.1186/1472-698x-12-19

Copy DOI

Abstract

BackgroundDiarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. In order to seek options for such improvements this study explored the knowledge and practices of diarrhoea case management among health care providers at health centres and drug shops in Uganda.MethodsRecords were reviewed for case management and structured interviews concerning knowledge and practices were conducted with the staff at all health centres and at all identified drug shops in the rural district of Namutumba, Uganda.ResultsThere was a significant gap between knowledge and documented practices among staff. Antibiotics, antimalarials and antipyretics were prescribed or recommended as frequently as Oral Rehydration Solution (ORS). In almost a third of the health facilities, ORS was out of stock. 81% of staff in health centres and 87% of staff in drug shops stated that they prescribed antibiotics for common diarrhoea. Zinc was not prescribed or recommended in any case.ConclusionsThe findings indicate that many children presenting with diarrhoea are inadequately treated. As a result they may not get the rehydration they need and are at risk of potential side effects from unjustified usage of antibiotics. Practices must be improved at health centres and drug shops in order to reduce childhood mortality due to diarrhoeal diseases.

Highlights

Diarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly
This study investigated knowledge and practices among staff at health centres (HC) and drug shops (DS) in a rural setting in Uganda in order to explore the scope for improvement of diarrhoea case management
Health centres in Namutumba district range from level two to level four. (Health facilities in Uganda are divided into seven levels where level 1 is the village health team, 2–4 HC, 5–6 hospitals and 7 the national referral hospital in Kampala.) There were no pharmacies in the district while 10 drug shops were registered with the district headquarters

Summary

Introduction

Diarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. Diarrhoea is the second leading cause of under five mortality globally and it accounts for 1.8 million deaths annually [1]. The majority of these deaths occur in south Asia and Africa [2]. In order to reduce mortality and morbidity due to childhood diarrhoea, the “Programme for Control of Diarrhoeal Diseases” (CDD) was initiated by WHO at the beginning of the 1980s [4]. Diarrhoea caused an estimated 4.6 million deaths in children under five at that

Methods

Discussion

Conclusion