Diarrhea In Under-five Children Research Articles

Spatio-temporal distributions and determinants of diarrhea among under-five children in Ethiopia.

The purpose of this study was to evaluate the spatio-temporal pattern of Ethiopia's childhood diarrheal disease and identify its contributing factors. We conducted analyses on secondary data from four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. Moran's I was used to determine spatial dependence and spatial models were used to evaluate variables associated with diarrhea in under-five children at the zonal level. Childhood diarrhea showed spatial clustering in Ethiopia (Moran's I; p < 0.05). The spatial regression model revealed significant factors at the zonal level: children born at home ( = 1.355, 95% CI: 1.052-1.544, p < 0.001), low birth weight ( = 1.18, 95% CI: 1.017-1.691, p < 0.05), and unimproved source of water ( = 0.8568, 95% CI: 0.671-1.086, p < 0.01). The prevalence of diarrhea among under-five children varied over time by zone, with the Assosa, Hundene, and Dire Diwa zones having the highest rates. Home births and low birth weight contributed to the prevalence of childhood diarrhea. In high-risk zones of Ethiopia, reducing childhood diarrhea requires integrated child health interventions and raising awareness about the potential hazards associated with unimproved water sources.

Contextual factors associated with diarrhea among under-five children in the Gambia: a multi-level analysis of population-based data

BackgroundDiarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia.MethodsThis research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05.ResultsThe prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33–0.98) and Basse (aOR = 0.59; 95% CI = 0.35–0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86–0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01–1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26–0.99) after controlling for confounders.ConclusionThe study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia.

Assessing water, sanitation and hygiene (WASH) practices and their association with diarrhoea in under-five children in urban Chandernagore: Community-based evidence from a small municipal corporation in Hooghly District of West Bengal, India.

The study aims to understand the relationship of childhood diarrhoea (under-five children) with water, sanitation and hygiene factors in the light of other contextual factors in an urban setting in the district of Hooghly in West Bengal, India. This primary study was carried out by SIGMA Foundation, Kolkata from 4 to 24 January 2023 across 404 households having at least one under-five child. The findings suggested that the water score was 'good' in 85.1% of the households whereas the hand hygiene score was 'good' in 14.6% of households. More than 90% of the households had piped water supply. Less than half of them treated water before consumption among which 45.3% used cloths for straining water; 59.2% of the caregivers followed safe disposal of child's faeces; 66.8% of households had no handwashing arrangement, and 30.5% had taps and wash basins for handwashing; 20.3% of the under-five children had suffered from diarrhoea in the last month before the survey and its prevalence was higher in children aged 12-23 months. Multivariate results suggested diarrhoea prevalence was lower in households that were pucca and had good water and hand hygiene scores, lower in children that had received iron fortification and whose caregivers followed safe child's stool disposal.

Mapping of Diarrhea among Under-Five Children Based on Household Basic Sanitation in Pagurawan Health Center, Batu Bara Regency

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p align="center"&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;Diarrhea in under-five children continued to be the leading cause of morbidity in Batu Bara District. This research investigated the relationship between basic sanitation and diarrhea among under-five children and its spatial distribution in the Pagurawan Health, Batu Bara Regency. The research employed a cross-sectional observational analytical design. The population was all mothers who have under-five children as many as 2310 population then determining the sample size using the Lemeshow formula with a total of 105. The samples were taken by purposive sampling selected by proportional from 9 rural. Data analysis used the is-square test for bivariate analysis and the overlay technique for spatial analysis. The technique performed for spatial is the overlay technique. The research revealed a relationship between the incidence of diarrhea in under-five children and water supply (p=0.034), while latrines (p=0.191), waste management (p=1.000), and wastewater disposal (p=0.825) were not. Spatial results found that the highest cases of diarrhea were in Pematang Nibung Village with a vulnerability status. Based on this research, water supply is related to the incidence of diarrhea among under-five children. Meanwhile, the latrines, waste management, and wastewater disposal are not related to the incidence of diarrhea among under-five children in the Pagurawan Community Health Center with a vulnerability status in Pematang Nibung Village.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Diarrhea, Sanitation, Under-five children&lt;/em&gt;&lt;/strong&gt;

Correlation Between Climate Variations and Rotavirus Diarrhea in Under-Five Children in Sidoarjo District Year 2016 – 2019

Introduction: Rotavirus infection is one of the main causes of severe diarrhea and dehydration in toddlers. Climate variation is one of the factors that influence the outbreak of infectious diseases. This study aimed to clarify the relationship between climate variations and the incidence of rotavirus diarrhea among patients at the Soerya Mother and Child Hospital, Sidoarjo District in 2016 – 2019. Methods: This study used an ecological study with the Pearson correlation test. Rotavirus infection data was taken from the Viral Diarrhea Laboratory, Institute of Tropical Diseases, Universitas Airlangga, which was derived from fecal samples of patients with acute gastroenteritis with the unit of analysis at the individual level living in Sidoarjo district. Meanwhile, climate variation data were obtained from the Meteorology, Climatology, and Geophysics Agency Indonesia official website with units of analysis at the population level. Results and Discussion: The number of rotavirus diarrhea for 48 months as many as 149 cases with an average air temperature of 28.2℃, rainfall of 191.4 mm², humidity of 77.31%, and wind speed of 2.82 knots. There was a weak correlation between rainfall and the incidence of rotavirus diarrhea (p=0.01 r=0.367) and a weak correlation with humidity (p=0.016; r=0.347). Meanwhile, the air temperature (p=0.909 r=0.017) and wind speed (p=0.272 r=-0.162) had no relationship with the incidence. Conclusion: Rainfall and high humidity are factors associated with the prevalence of rotavirus diarrhea in children under-five years in the Sidoarjo District.

Prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under five diarrheic children attending public health facilities in Debre Markos town, Northwest Ethiopia.

Under five children are at risk of diarrhea-associated morbidity and mortality. Salmonella and Shigella are major causes of diarrhea in under-five children, especially in developing countries. This study aimed to assess the prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under-five diarrheic children in Debre Markos town public health facilities. A cross-sectional study was conducted at public health facilities in Debre Markos town using a consecutive convenient sampling technique. Data on socio-demographic and associated factors were collected using a structured questionnaire. Salmonella serovars and Shigella species were identified using MacConkey, Xylose Lysine Deoxycholate, Salmonella Shigella agar, and biochemical tests. The antimicrobial resistance pattern was determined by using the modified Kirby-Bauer disk diffusion technique. The overall prevalence of Salmonella and Shigella was 11.7% (26/222; 95% CI = 7.2-17.5%). Isolated Salmonella serovars showed a higher rate of resistance (85.7%, 6/7) for both Ampicillin and Amoxicillin/Clavulanic acid while Shigella isolates showed a higher resistance rate to Amoxicillin/Clavulanic acid (78.9%, 15/19) and Ampicillin (73.7%, 14/19). The overall multidrug resistance (MDR) rate of Salmonella and Shigella isolates was 88.5% (23/26). Parent/guardian educational status ≤ elementary school (AOR = 3.783; 95% CI = 1.28-11.19; P = 0.016), presence of two or more under-five children in the family (AOR = 8.999; 95% CI = 2.93-27.69; P < 0.001), unimproved source of drinking water (AOR = 5.010; 95% CI = 1.56-16.10; P = 0.007), the habit of storing cooked foods for later use (AOR = 3.199; 95% CI = 1.07-9.54; P = 0.037), attendance of the child at social gatherings (AOR = 5.387; 95% CI = 1.78-16.35; P = 0.003), and infrequent child fingernail trimming (every ≥ 2 weeks; AOR = 4.693; 95% CI = 1.47-14.94; P = 0.009) showed statistically significant association with the prevalence of culture-confirmed Salmonella and Shigella isolates. The prevalence of culture-confirmed Salmonella and Shigella isolates was significantly high in the study area. Salmonella and Shigella isolates exhibited a high rate of MDR pattern. Parent/guardian education level below the elementary school, the presence of two or more under-five children in the family, using unimproved water source, a habit of storing cooked food, and infrequent fingernail trimming were independent predictors of culture-confirmed Salmonella and Shigella. Therefore, besides public health measures, regular surveillance of the prevalence and antimicrobial resistance pattern of Salmonella and Shigella should be routinely practiced in the study setting.

The relationship of mother’s feeding practices and the frequency of diarrhoea in under-five children

To determine the relationship between a mother's feeding practice and the incidence of diarrhoea in children aged <5. The quantitative, descriptive-analytical, cross-sectional study was conducted in June 2021, in Tropodo village, Waru district, Sidoarjo, Indonesia, and comprised mothers having children who were aged <5 years. Mother's feeding practice was the independent variable, while the dependent variable was the incidence of diarrhoea in children. Data was collected using the Comprehensive Feeding Practices Questionnaire and the relevant portions of the Demographic and Health Survey questionnaire. Data was analysed using Spearman Rho test. Of the 217 mothers, 110(50.7%) were aged 30-40 years, and of the 217 children, 96(44.2%) were aged 1 year. There were 124(57.1%) girls and 93(42.9%) boys among the children. There was a significant relationship between mother's feeding practice and the incidence of diarrhoea in children <5 (p=0.004; r=0.194). Inappropriate maternal feeding practices were found to have the potential to cause diarrhoea in children aged <5.

The Co-Utilization of Oral Rehydration Solution and Zinc for Treating Diarrhea and Its Associated Factors Among Under-Five Children in Ethiopia: Further Analysis of EDHS 2016.

IntroductionDiarrhea causes a loss of body water and salt, which can lead to dehydration and death. The use of oral rehydration salts and zinc together is regarded as an effective treatment for diarrhea in resource-poor settings like Ethiopia. However, studies that examine the co-utilization of oral rehydration solution and zinc in the treatment of diarrhea are limited Ethiopia.ObjectiveTo assess the prevalence and associated factors of oral rehydration solution and zinc co-utilization to treat diarrhea in children under the age of five in Ethiopia, EDHS 2016.MethodsSecondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used to investigate the prevalence and factors associated with the co-utilization of ORS and zinc to treat diarrhea in under-five children. A multilevel binary logistic regression model was fitted to identify factors associated with the co-utilization of ORS and zinc. Adjusted odds ratios (AOR) with 95% CI were calculated and used as a measure of associations, and variables having a p-value of less than 0.05 were declared as statistically significant.ResultsThe national prevalence of ORS and zinc co-utilization was 16.65% (14.66%, 18.84%). Maternal educational status (AOR = 1.45; 95% CI; (1.01, 2.09)), household size (AOR = 1.53; 95% CI; 1.09, 2.16) and distance to health facilities at the community level (AOR = 1.60, 95% CI = 1.02, 2.58) were variables significantly associated with the co-use of ORS and zinc.ConclusionThe co-utilization of ORS and zinc for the management of diarrhea was low in Ethiopia. Education, household size, and distance to health facilities at the community level were significantly associated with the co-utilization of ORS and zinc in Ethiopia.

Clinical Characteristic of Bloody Diarrhea in Under- Five Pediatric Inpatients

Background: Diarrhea is the most common cause of death in under-five children. Bloody diarrhea comprises around 10% of all cases of diarrhea and may lead to severe complications until death. This study examined the characteristics of bloody diarrhea in children under five years old in Dr. Soetomo General Hospital Surabaya from 2013 to 2017.&#x0D; Material and Methods: A retrospective, cross-sectional study was conducted using secondary data from Dr. Soetomo General Hospital's inpatients with bloody diarrhea from 2013 to 2017. Gender, age, nutritional status, clinical symptoms, degree of dehydration, and laboratory results were assessed, and the data were presented in percentage (%)&#x0D; Results: Fifty-six samples were included in this study. The main demographics were male (58,9%), aged 7-24 months (44,6%), and normal nutritional status (66,1%). Meanwhile, the most notable manifestations were stool mucous (55,3%), mild to moderate degree of dehydration (60,7%), and leukocytosis (62%). Eleven patients (39,2%) had temperatures ≥380C. Leukocytes were positive in 93.7% of the stools. Furthermore, amoeba was found in 46,8% of samples. The serum electrolyte result showed hyponatremia (18%) and hypokalaemia (15%).&#x0D; Conclusion: The primary demographics of bloody diarrhea in under-five children admitted to Dr. Soetomo General Hospital were males, 7-24 months of age, and with normal nutritional status. The most frequent manifestations were mucous in stool, mild to moderate dehydration, leucocytosis, as well as positive leucocytes and amoeba in the stool.

Knowledge and Use of Oral Rehydration Solution in the Management of Childhood Diarrhoea among Mothers in a Tertiary Health Facility in Port-Harcourt, Nigeria

Introduction: Oral rehydration solution (ORS) has been a life-saving remedy in the home and hospital management of dehydration, particularly in infants and children under the age of five. The improper use has however resulted in morbidity and mortality in children. The purpose of this study is to assess proper use of ORS by mothers in the management of diarrhoea in under-five children.&#x0D; Methods: A cross-sectional study was conducted over 3 months. Mothers of children under five years of age presenting with diarrhoea at the Diarrhoea Training Unit of a tertiary hospital were interviewed using a pretested structured interviewer-administered questionnaires. Data was analysed using SPSS version 20.0.&#x0D; Results: A total of 90 mothers were interviewed. 86.7% of respondents were of a high socioeconomic class. 51.1% of children with diarrhoea were between 6-15months of age. (Mean age of 17 + 12.3 months). Although 93.3% of mothers were aware of ORS, 64.4% reported using it to treat their children. Only 40 (44.4%) respondents constituted ORS appropriately and discarded unused portions at 24 hours.&#x0D; Conclusion: Although mothers of under-five children are aware of the efficacy of ORS in the management of diarrhoea, their knowledge of its proper use is limited. Increased awareness among mothers of under-five children about the proper use of ORS is necessary to avoid debilitating complications such as dehydration, electrolyte imbalance, etc.

IDENTIFICATION OF BACTERIA CAUSING DIARRHEA IN UNDER-FIVES CHILDREN USING CULTURE METHODS IN BIMA, INDONESIA

Background: Diarrhea is still a world health issue which is one of the leading causes of morbidity and mortality, with a mortality rate of close to more than 1.30 million deaths globally in 2015. The prevalence period of diarrhea in Indonesia for under-five children in 2018 is 12.30%. The West Nusa Tenggara province is third of the ranks based on doctor’s diagnosis (13.45%) and clinical symptoms (15.12%). Purpose: This study aims to identify the bacterial infection that causes diarrhea among under-five children in Bima District, West Nusa Tenggara Province. Methods: The cross-sectional study was conducted on under-five children brought to Bolo and Wawo’s Public Health Center with diarrhea and diagnosed with acute gastroenteritis. Results: The samples involved in this study were 102 samples and the results obtained were 1 to 2 types of bacteria in 1 sample. The order of bacteria from the most is E. Coli (29.53%), Klebsiella, sp (25,50%), Shigella, sp (18,79%), Staphylococcus aureus (16,78%), Salmonella Thypii (8,73%), Proteus, sp (0,67%), male (61.76%) had more diarrhea than female (38.24%), with an age range of 1-3 years (53.92%), 0-1 years (37.26%), and 3 until &lt;5 years (8.82%). Conclusion: In this research, it was proven that E. coli bacteria are the leading cause of diarrhea in under-five children.

Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India.

Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years. One hundred children aged one month to five years who developed diarrhoea (≥3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel-Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay. Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases. The findings of this study suggest that the aetiological profile of hospital-acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms.

Prevalence of Diarrhoeal Diseases among Under-Five Paediatric Patients in a Tertiary Health Care Facility, South Eastern Nigeria: A 5-Year Review

Background: Diarrhoeal disease remains a major cause of morbidity and mortality in children, especially in developing countries. Although Nigeria has already achieved remarkable progress in reducing under-five mortality in the last decades, studies done in different parts of Nigeria had shown that diarrhoea is still a major public health problem. Objectives: This study aimed at determining the prevalence of diarrhoea in under-five children who presented to Nnamdi Azikiwe University Teaching Hospital Neni through the period of January 2016 - December 2020, a 5-year review. It is also aimed at noting the influence of other socio demographic factors such as age, sex and seasonal variation on the occurrence of diarrhoeal diseases. Methods: A retrospective study design was used as patients’ records were obtained from the medical records for the said duration of study and a pro forma was used in extracting needed information. Results: A total of 128 cases of diarrhoeal disease were recorded out of the 897 under-five aged children that visited the hospital at the said period of study. Thus with a prevalence of 14.27%. Higher number of cases were recorded in the dry season 96 (75.0%) than the wet season; 32 (25.0%) cases. More males were affected; 78(60.1%) than females;50 (39.1%). Children aged 0-11 months were affected more; 62 (48.4%) followed by those within the age bracket of 12-23 months 32(25.0%) with those within the ages 48-59months having the least number of cases; 8 (6.3%). Conclusions: From the study it was concluded that diarrhoea occurs more in the dry season in this region than in the wet season. It was also concluded that the general risk of diarrhoeal disease decreases with increasing age in children and toddlers are the most at risk group of suffering the disease.

Determinants of Diarrhea in Under-Five Children Among Health Extension Model and Non-Model Families in Wama Hagelo District, West Ethiopia: Community-Based Comparative Cross-Sectional Study.

BackgroundDiarrhea is a major leading cause of under-five morbidity and mortality in developing countries. Although the health extension program has been implemented for decades, diarrhea continues to be a major public health problem.ObjectiveTo determine determinants of diarrhea among under-five-year-old children in the health extension model and non-model families of Wama Hagelo District 2019.MethodsA community-based comparative cross-sectional study was conducted among 512 under-five children among 257 model and 255 non-model health extension families. A multi-stage sampling technique was used. Households with at least one under-five child were selected using a simple random sampling method. Data were collected using an interviewer-administered questionnaire. Bivariate analysis was done to select candidate variables at p ≤ 0.2. Determinants of childhood diarrhea were determined by a multivariable logistic regression model at p-value less than 0.05.ResultsThe two-week prevalence of diarrhea among under-five children in model and non-model families was 7.8% (95% CI=4.5–11.1%) and 27.8% (95% CI 22.3–33.3%), respectively. Unimproved water sources (AOR [95% CI] =5.5[2.2, 97.7]) and no vaccination against Rotavirus (AOR [95% CI] = 49.8 [4.2–94.8]) were associated with diarrhea among under-five children in model families. Family size > 5 (AOR [95% CI] = 5.2 [1.7–17.6]), using unimproved water sources (AOR [95% CI] = 7.2 [1.6–13.2]), not using latrine (AOR [95% CI] = 6 [1.8–20.6]), child not vaccinated against Rotavirus (AOR [95% CI] = 10.9 [2.9–41.1]), child not supplemented with vitamin A (AOR [95% CI] = 3.2 [1.4–7.2]), and not being health extension model families (AOR [95% CI] = 2.4 [1.15–4.99]) predict diarrhea among under-five children in non-model families.ConclusionDiarrhea was more frequent among non-model than model families. Family size, type of water source, using a latrine, place of childbirth, child vaccination against Rotavirus, and vitamin A supplementation were independently associated with the occurrence of diarrhea in under-five children. Encouraging all non-model families to become models in implementing all health extension packages by strengthening community participation is important to decrease childhood diarrhea in under-five children.

Everything is not on track in management of diarrhoea in under-five children: Evidence from rural area of India.

Context:Diarrhea is one of the leading causes of death and morbidity in under-five children. Effective management can significantly influence survival of children with diarrhea.Objectives:This study was carried out to assess extent of diarrhea, its source of treatment, and type of therapy.Settings and Design:This snapshot study was conducted in rural setting of India.Methods and Material:This study was conducted on 217 under-five children selected through multistage sampling procedure.Statistical analysis used:Statistical association of diarrhea with age and gender of children was established by computing Chi-square.Results:Period prevalence (Recall period 2 weeks of visit) of diarrhea in rural under-five children was 35.9% (95%C.I. 29.3–42.2%). Highest prevalence in age group 0–12 months (47.8%) and lowest in 49–59 months (18.2%). Number of episode per child is 1.08. Diarrhea was watery in 69.4%. Quacks were treatment provider for 36.4% cases. In 17.6% episodes, no treatment was taken. Only 9.4% episodes were treated in government facilities. For the treatment of diarrhea, antibiotic was used in 71.8% cases, ORS use was 33.3% cases, and zinc was used 21.8% of diarrhea episodes.Conclusions:Diarrhea is a significant problem in under-five children from a rural area of India. In spite of existence of National Program for Control of Diarrheal Diseases (NPCDD) since four decades, management of diarrhea is not on track. Focusing on primary care provision to under-five children can help in bringing the management of diarrhea on track.

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

BackgroundZinc 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.MethodThe 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.ResultIn 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.ConclusionIn 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.

Basic Knowledge of Childhood Diarrhea and Health-seeking Practices of Caregivers of Under-five Childrenin Calabar-South, Calabar, Nigeria

Background: Diarrhea claims the lives of more children than malaria, HIV and measles combined. Prompt identification of symptoms of diarrhea by Caregivers and timely commencement of oral rehydration therapy using oral rehydration solution (ORS) or appropriate home available fluids are recommended corrective measures. This study was to ascertain the basick nowledge of childhood diarrhea and the health-seeking practices among caregivers of under-five children in Calabar- South, Calabar, Nigeria.&#x0D; Materials and Methods: Six wards were chosen from the 12 wards in the study area by casting lot. Ten streets were randomly selected from each of the 6 wards. Eleven compounds were selected randomly per street to give a total of 660 compounds. A household with an under-five child or children was randomly selected per compound and therefore 660 Caregivers were enlisted on giving consent. Semi-structured questionnaires were used to collect data from respondents.&#x0D; Results: In this study, 638 (98.2%) of respondents had good basic knowledge of childhood diarrhea in under-five children, 12 (1.8%) had fair basic knowledge, no group was rated as having poor basic knowledge. Occurrence of childhood diarrhea was marginally higher among respondents with good knowledge of diarrhea (50.3%) than respondents with fair basic knowledge, (50%). In practice during advent of childhood diarrhea, some caregivers chose to seek health-care from traditional healers 6.1% (19), churches 1.9% (6), pharmacies 16.9% (53), patent drug stores 18.8% (59), hospital, 14.3% (45), or self medication at home 42% (132).&#x0D; Conclusion: Although most Caregivers possessed good basic knowledge of childhood diarrhea, there were constrains translating this knowledge into intervention practices due to inadequate presence. Of social amenity framework in the study area. Government and non Governmental authorities should make provision of social amenities such as hospitals, pipe borne water, waste disposal facilities, power supply, water drainagesetc, a priority.

Food hygiene practice among mothers and its association with occurrence of diarrhea in under-five children in selected rural community area

Background: Diarrhea is the condition of having at least three loose or liquid bowel movements each day. Diarrhea is the main cause of death among under-five children in India. It often lasts for a few days and can result in dehydration due to fluid loss. Mother’s basic knowledge of diarrhea depends on various factors such as educational status, prior experience of managing the disease, and food hygiene. Diarrheal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. Objective: The main aim is to measure the food hygiene practice among mothers and occurrence of diarrhea in under-five children. Materials and Methods: A non-experimental descriptive research design was conducted among 186 under-five children, mothers were selected using convenient sampling technique who fulfill inclusion criteria from the rural area of Doiwala block. Information was collected with the help of structure questionnaire on child feeding hygiene practice and practice checklist on food hygiene. Ethical permission and written consent were taken from the ethical committee of university and participants. Results: The research finding highlights that less than half of mothers (44.6%) use bowel spoon for feeding to their child. Majority of mothers (84.9%) wash his child hand with soap. Most of the mothers (74.2%) were not wash vegetables after cutting. Only 63% had check expiry of the food material before giving it to the child. Most of mothers (97.3%) wash hand of child before eating food. Nearby 38.2% of children had diarrhea in the past 6 months due to the unhygienic food practice. Conclusion: The investigator observed that there is a need to improved food hygiene practice among under 5-year children mothers because diarrhea is directly related to unhygienic food condition. The under-five children are totally depend on the mothers. If mothers will not improve food hygiene practice, then children will suffer from the diarrhea disease again and again.

Out-of-pocket health expenditure on diarrheal illness among under-five children in a teaching hospital ins Odisha, India.

Diarrhea is the most common illness in children under 5 years of age, accounting for a financial burden for families in developing countries. The aim of this study is to determine the out-of-pocket health expenditure for the management of diarrhoeal illness among the under-five children in in-patient and out-patient cases. A cross-sectional study was conducted during January-April 2018 among 60 under-five children with diarrheal illness reporting to pediatric outpatient department (OPD) and 60 under-five children admitted to pediatric ward of a tertiary care teaching hospital. For determining the out-of-pocket health expenditure, both direct and indirect costs for the management of diarrheal illness were estimated both for out-patient and in-patient cases. The cost of the treatment has been presented as the cost of prehospital visits, during a hospital visit and posthospital visit. Overall, median out-of-pocket health expenditure for the management of diarrheal illness for out-patient and in-patient cases were Rs. 1186 (interquartile range [IQR]: Rs. 510) and Rs. 6385 (IQR: Rs. 5889), respectively. The median direct expenditure for OPD cases was Rs. 778.50 (IQR: Rs. 263) and indirect expenditure for OPD cases were Rs. 407.50 (IQR: Rs. 336) The median direct and indirect expenditure for inpatient cases were Rs. 3823 (IQR: Rs. 1942) and Rs. 2237 (IQR: Rs. 4256) respectively. Only 13% of in-patient cases had some kind of medical insurance. A considerable economic burden is faced by the families for treating diarrhea in under-five children. Improved access to safe drinking water and sanitation, promotion of hand hygiene, exclusive breastfeeding, rotavirus vaccination, and use of oral rehydration therapy will reduce hospitalization and out-of-pocket expenditure. The study findings recommend for appropriate policy for provision of financial protection while seeking health care services.

Covariates of diarrhoea among under-five children in India: Are they level dependent?

Program interventions like access to improved water supply, sanitation and hygiene do not have a systematic response to the aggregate health outcomes. Therefore, this is an attempt at recognising the concept of level sensitivity while verifying the association between prevalence of diarrhoea in under-five children in a district and its corresponding coverage of improved water supply and sanitation and hygiene. Information obtained in the DLHS—4 including 275 districts from 19 states and 2 union territories of India forms the database for this analysis. Universal access to safe drinking water, improving coverage of sanitation in a district beyond 71 percent across the country and beyond 78 percent among the non-south DLHS districts, has the potential to realise reductions in the prevalence of diarrhoea in under-five children in a district. The effect of improved sanitation seems to work synergistically with these indicators only at better levels of prevalence of diarrhoea in under-five children in a district. This offers lessons for the Clean India Mission in terms of universalising access to safe water and coverage up to three-fourths of households with sanitation in a district for the positive externalities to manifest in reduced prevalence of diarrhoea in under-five children.