Management Of Diarrhea In Children Research Articles

The Enterics for Global Health (EFGH) Shigella Surveillance Study in Malawi.

Malawi is among 7 countries participating in the Enterics for Global Health (EFGH) Shigella surveillance study, which aims to determine the incidence of medically attended diarrhea attributed to Shigella, a leading bacterial cause of diarrhea in children in low-resource settings. We describe the EFGH study site in the densely populated informal settlement of Ndirande Township, Blantyre, Malawi. We explore the site's geographical location, demographic characteristics, and the healthcare-seeking behavior of its population, particularly for childhood diarrhea. We also describe the management of childhood diarrhea at the health facility, and the associated challenges to attaining optimum adherence to local and national guidelines at the site. Our overarching aim is to improve global health through understanding and mitigating the impact of diarrhea attributed to Shigella.

Managing infectious diarrhea among young children in community pharmacies in Saudi Arabia and the implications for AMR.

Diarrhea remains a major global health issue for children under five, contributing substantially to morbidity and mortality. Community pharmacists play a pivotal role in the management of these children; however, their competence in managing childhood diarrhea in Saudi Arabia is under-researched. This is important to ensure optimal patient care. Simulated patients (SPs) presenting with three pediatric diarrhea scenarios were used to evaluate pharmacists' practice in terms of their counselling, history taking, over-the-counter (OTC) prescribing, medication instructions, diet/fluid advice, and/or information provision. Pharmacists' practice was categorized into adequate, less adequate, and poor. 182 community pharmacists, primarily male and non-Saudi, participated in the study, of which 60% were in chain pharmacies. Only 5% showed adequate practice in currently managing pediatric diarrhea. Of the 182 simulated patient visits, 62% received medication in all three scenarios and 20% were referred to physicians, with 16% of pharmacists failing to provide any form of intervention. The main medications recommended were kaolin (34%), pectin (34%) and metronidazole (11%). While most pharmacists (86%) asked about the patient's identity and age, 15% provided incorrect management information, 16% failed to provide guidance on the prescribed medicines, and 18% dispensed antimicrobials without a valid prescription. A high level of inadequate management of pediatric diarrhea in Saudi Arabia was observed. This highlights the need for extensive training to improve community pharmacists' practice in service delivery including providing counselling and advice on the appropriate management of childhood diarrhea. The latter is particularly important to reduce antimicrobial resistance.

Descriptive Epidemiology of Home-Based Management of Diarrhea in Children Under Five Years: The Case of Northern Ghana

Descriptive Epidemiology of Home-Based Management of Diarrhea in Children Under Five Years: The Case of Northern Ghana

Application of Honey Therapy to Decrease Stool Frequency in Children with Diarrhea: A Case Study

Diarrhea is characterized by the presence of watery bowel motions that occur three or more times within 24 hours. Inadequate management of diarrhea in children might lead to fatality. One method involves administering honey treatment to decrease the frequency of bowel movements. The objective was to elucidate the implementation of a way to reduce bowel movement frequency. The design involved a case study conducted on two toddlers suffering from diarrhea. The solution involved administering honey therapy three times daily for five days. Data analysis and presentation in case studies were conveyed through written text, which presented the facts in a narrative format. The use of honey therapy resulted in a reduction in the frequency of bowel movements in subjects 1 and 2. The post-intervention frequency of bowel movement in subject 1 was three times per day, with a mushy consistency. In subject 2, it was four times per day, again with a mushy consistency. Nurses at the Community Health Center (Puskesmas) can offer guidance on using honey therapy to parents whose children are suffering from diarrhea.

Knowledge, Attitude and Practice of Mothers regarding Oral Rehydration Solution in Acute Diarrhoea at Monno Medical College Hospital

Background: Diarrhoea is one of the major causes of morbidity and mortality among the under-five age group in Bangladesh. Effective by ORS treatment can reduce diarrhoea-related mortality and unnecessary hospitalization, for which role of mothers is important. The use of oral rehydration saline (ORS) is greatly affected by mothers’ knowledge and attitude towards using it in treating their children. Objectives: Assessment of the knowledge, attitude and practice of the mothers about ORS for better management of diarrhoea in children. Methodology: A cross-sectional descriptive study was carried out in the department of Paediatrics of Monno Medical College Hospital, Manikganj, during the period from January to December, 2022. Data were collected from 300 mothers by face-to-face interview by a questionnaire. Finally, collected data were analyzed, using SPSS software version 20. Results: Majority (195, 65.0%) of the children’s age were in between 6 month to 2 years. Most (143, 47.7%) of the mothers completed primary education. About two-thirds of the mothers (193, 64.3%) resided in rural areas. In this study, most (213, 71.0%) of the mothers always used ORS during the attack of diarrhoea, 281(93.7%) mothers had adequate knowledge about ORS, 253(84.3%) had knowledge about preparetion of ORS, 235(78.3%) informed to know when to administer ORS and 170 (56.7%) knew the exact amount of ORS to administer. Conclusion: Positive attitude was seen among the participant mothers regarding the use of ORS. But mothers’ knowledge and practices regarding its administration was insufficient. Journal of Monno Medical College, June 2023; 9 (1): 03-06

Using the Simulated Patient Method to Evaluate the Community Pharmacy Management of Childhood Diarrhoea: A Systematic Review

The simulated patient method has been widely used to assess community pharmacy practice in the management of childhood diarrhoea. In such a process, a community pharmacist is required to explore a patient’s history, choose the right medication and provide drug-related information. The aim of this review was to evaluate the aforementioned practice. A comprehensive literature search was carried out over Sage Journal, PubMed, ScienceDirect and Google Scholar, and the analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible articles were those published from 2011 to 2021 and original studies that used the simulated patient method to examine the pharmaceutical services provided by pharmacists in relation to childhood diarrhoea. The eight studies that satisfied the eligibility criteria were reviewed. These investigations were undertaken in Brazil, Nigeria, Turkey, Ethiopia and Pakistan. Five of the studies focused on history taking with regard to the characteristics of diarrhoea and revealed that the evaluated pharmacists asked about patient histories. In terms of therapy, three studies indicated that the evaluated pharmacists recommended the administration of oral rehydration salts. Pharmacies should improve their history-taking process, provide drug related information and recommend therapies to increase the knowledge of simulated patients about diarrhoea treatment in children.

Assessment of knowledge and practice of zinc sulphate supplementation in the treatment of diarrhoea among under-five children in Primary Health Care centres in Keffi, Nigeria

Zinc supplementation reduces the severity, duration and recurrence of diarrhoea in children. This study assessed the level of knowledge and practice of zinc supplementation in the management of diarrhoea in children in primary health care facilities in Keffi, Nigeria. Retrospective and qualitative studies were conducted in nine facilities. Validated data collection form and questionnaire were used to collect medications prescribed for diarrhoea in children less than five years old. Descriptive statistics was done, and associate variables were tested using Chi-square Tests. The study assessed 380 case files and 19 health care workers in nine facilities. The finding revealed that 21.1% and 10.5% of the prescribers were aware of and had formal training on the use of zinc in the management of diarrhoea respectively. Oral rehydration salt with zinc and antibiotics were prescribed in 10.5% and 57.9% cases respectively. Only 13.2%, 8.2% and 8.5% of children managed for diarrhoea had correct doses, frequencies and durations of zinc respectively. Only 44.4% facilities had zinc tablet in stock. The study revealed low knowledge and practice among primary health care workers about treatment guidelines on zinc supplementation in the management of diarrhoea in children less than five years.

Know-do gap for sick child care and drivers of knowledge and practice among health extension workers in four regions of Ethiopia: a cross-sectional study

ObjectiveThough efforts were made to expand community-based sick child healthcare in Ethiopia, the quality of care provided remained low. Improving quality of care requires understanding providers’ knowledge of appropriate care...

Diet and Management of Diarrhea.

Diet plays an important role in human health and disease. Of all human diseases, diarrheal illnesses bring diet into sharp focus as it has a direct causal and therapeutic relationship. With the advent and widespread use of next generation sequencing, significant advances have been made in unraveling the etiologies of congenital diarrheas and enteropathies, some of which are eminently treatable with dietary modification. Early institution of appropriate dietary therapy is lifesaving in congenital osmotic diarrheas. Chronic diarrhea in older children and adolescents often have an underlying dietary basis, depending on the etiology. Identification and exclusion of the offending food in the diet results in dramatic improvement in symptoms. It is equally important to be prudent and cautious in the use of exclusion diets in management of chronic diarrhea as it is associated with micronutrient deficiencies, needless escalation of cost and enable maladaptive food intake behaviors. In this review, authors discuss etiology specific dietary management of diarrhea in children with emphasis on congenital diarrheas and enteropathies.

Spatial variations and determinants of childhood diarrhea management in Uganda

ABSTRACT The study examines the variability of community-based and determinants of childhood diarrhea management including rehydration and feeding therapies using the 2016 Uganda Demographic and Health Survey, UDHS (N = 2,923). The study utilized the Bayesian model and geo-statistical techniques with location (district) and nonlinear metrical attributes (mother’s and child’s age) to gain a better understanding of childhood diarrhea management. The results show that 45% and 58% of under-5 children received less than the usual amount of fluid and food, respectively, during diarrheal episodes. However, the findings indicate that the prevalence of diarrhea among under-5 children does vary spatially within and between subregions and districts of Uganda. The fixed effects show that the covariates have no significant influence on rehydration therapy. However, the wealth index, family size, and number of under-5 children in a household have a significant impact on feeding therapy for children with diarrhea. In general, the results indicate that geography has a significant effect on the rehydration therapy, while both geography and socioeconomic variables have a significant influence on feeding therapy on under-5 children with diarrhea. These findings can support policymakers to identify subregions and districts with ineffective practices and policy strategies to better address the spatial variations and determinants of diarrhea management in Uganda.

Antibiotic-Prescribing Practices for Management of Childhood Diarrhea in 3 Sub-Saharan African Countries: Findings From the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015–2018

Despite antibiotic prescription being recommended for dysentery and suspected cholera only, diarrhea still triggers unwarranted antibiotic prescription. We evaluated antibiotic-prescribing practices and their predictors among children aged 2-59 months in the Vaccine Impact on Diarrhea in Africa (VIDA) Study performed in The Gambia, Mali, and Kenya. VIDA was a prospective case-control study (May 2015-July 2018) among children presenting for care with moderate-to-severe diarrhea (MSD). We defined inappropriate antibiotic use as prescription or use of antibiotics when not indicated by World Health Organization (WHO) guidelines. We used logistic regression to assess factors associated with antibiotic prescription for MSD cases who had no indication for an antibiotic, at each site. VIDA enrolled 4840 cases. Among 1757 (36.3%) who had no apparent indication for antibiotic treatment, 1358 (77.3%) were prescribed antibiotics. In The Gambia, children who presented with a cough (adjusted odds ratio [aOR]: 2.05; 95% confidence interval [95% CI]: 1.21-3.48) were more likely to be prescribed an antibiotic. In Mali, those who presented with dry mouth (aOR: 3.16; 95% CI: 1.02-9.73) were more likely to be prescribed antibiotics. In Kenya, those who presented with a cough (aOR: 2.18; 95% CI: 1.01-4.70), decreased skin turgor (aOR: 2.06; 95% CI: 1.02-4.16), and were very thirsty (aOR: 4.15; 95% CI: 1.78-9.68) were more likely to be prescribed antibiotics. Antibiotic prescription was associated with signs and symptoms inconsistent with WHO guidelines, suggesting the need for antibiotic stewardship and clinician awareness of diarrhea case-management recommendations in these settings.

Evaluation of Care-Takers Awareness, Training and Approaches in the Management of Diarrhea in Children in Nawampiti Paris

Evaluation of Care-Takers Awareness, Training and Approaches in the Management of Diarrhea in Children in Nawampiti Paris

Evaluation of Care-Takers Awareness, Training and Approaches in the Management of Diarrhea in Children in Nawampiti Parish

Evaluation of Care-Takers Awareness, Training and Approaches in the Management of Diarrhea in Children in Nawampiti Parish

Knowledge, attitude and practices of community health workers on managing and preventing childhood malaria and diarrhea in Fako Division, South West Region, Cameroon; A mixed method study.

In developing countries, childhood malaria and diarrhea are among the 5 leading causes of death among children under five years; the use of community health workers (CHWs) to manage these diseases has shown some degree of success. A descriptive cross-sectional study was conducted to assess knowledge, attitude and practices (KAP) of CHWs on the management and prevention of childhood malaria and diarrhea in Fako Division, South-West Region, Cameroon. A pretested questionnaire was administered to eighty CHWs in Fako Division. Three focus group discussions (FGDs) were conducted with 29 CHWs. The Chi-Square and Spearman Correlation tests were used to investigate the association between socio-demographic characteristics with CHWs' KAP on childhood malaria and diarrhea management and prevention. A total of 52.5% of the participants had good knowledge, negative attitudes (65.0%), and carried out poor practices (60.0%) on the management and prevention of childhood malaria. Up to 8.75% CHWs did not know the first-line antimalarial drug used in Cameroon. More than half (57.5%) of participants had poor knowledge, 70.0% had a negative attitude and 82.25% carried out good practices on the management and prevention of childhood diarrhea. 47.6% of CHWs used a mixture of guava leaves and 'masepo' (Ocimum gratissimum) as treatment for childhood diarrhea. Level of education (p = 0.028) and Health District (p = 0.026) were significantly associated with practices on management and prevention of childhood diarrhea. CHWs had inadequate knowledge, poor attitude, and practices on childhood malaria management. Even though a majority of CHWs carried out good practices for diarrhea management, their knowledge and attitude were poor. Therefore, there is a need for training to improve CHWs' knowledge, attitude and practices on childhood malaria and diarrhea management.

Assessment of Knowledge and Usage of Oral Rehydration Therapy in Management of Childhood Diarrhea among Mothers of Kambaza town, Kebbi State, Nigeria

Diarrhea is one of the major causes of infant and young children morbidity and mortality globally. It is characterized by passing of more than 3 watery stools within 24hr which is accompanied by loss of body fluids and electrolytes leading dehydration and death if not treated. Therefore, this study was aimed in assessing knowledge and use of Oral Rehydration Therapy (ORT) in the management of childhood diarrhea among mothers. A cross sectional descriptive study was conducted among 103 mothers living in Kambaza metropolis using a questionnaire for quantitative data collection. The data were analyzed using Statistical Package for Social Sciences (SPSS), version 20 and p-value <0.05 was considered statistically significant. The results showed that a significant proportion of respondents were below the age of 36 years (25-35years) with the mean age of 30±0.327 years and most of them (92.2%) were married. 81.6% of the respondents heard knowledge about ORT and majority of them (82.5%) indicated they know to prepare ORS/SSS. The use of ORT in the management of childhood diarrhea was also found to be high (82.5%) among the mothers. A significant portion of the mothers (95.1%) indicated already made ORS sachet was more effective in treating diarrhea than home-made SSS. There is no significant relationship between maternal level education and use of ORT in the management child diarrhea (p=0.476). However, a significant relationship exit between maternal knowledge on ORT preparation and its usage for management of childhood diarrhea (p=0.037). This study recorded high knowledge and use of ORT for management of childhood diarrhea among mothers of under-five children. Therefore, it recommended that maternal knowledge on use of ORT and its preparation should be encourage.

Mothers’/caregivers’ knowledge on aetiology, prevention and management of acute diarrhoea among children under 5 years in Engela District, Namibia


 
 
 Background. Childhood diarrhoea remains a public health problem and is among the leading killers globally of children under 5 years. Even though most childhood diarrhoea episodes are mild, episodes can result in severe loss of fluids and dehydration, leading to severe health-related consequences and death. Most diarrhoea episodes in children under 5 are treated at home by parents/caregivers; therefore, their knowledge about the nutrition and management of diarrhoea in children is critically important.
 Objective. To assess mothers’/caregivers’ knowledge of the aetiology, prevention and management of acute diarrhoea among children aged under 5 years with diarrhoea, in Ohangwena Region, Namibia.Method. A cross-sectional, non-interventional study was carried out from 17 January 2019 to 9 March 2019. A structured questionnaire was administered through face-to-face interviews. T-tests and logistic regression were applied to determine the factors associated with knowledge.
 Results. A total of 530 mothers/caregivers of children under 5 years responded to the study questionnaire. Of these, 29.4% were aged between 18 and 30 years, 79.8% were from rural areas, 46.4% had primary education and 16% were illiterate, 59.9% were single, 68.9% had access to information (owned a radio), and 93.2% had a low income of ~NAD200 - 2 000 per month. The majority, 64%, were categorised as having inadequate knowledge on the prevention and management of diarrhoea. In addition, significant associations were observed between knowledge and gender of mothers/caregivers, residential area, marital status, access to information and prevalence of diarrhoea (p<0.05).
 Conclusion. This study identified the need to develop and intensify strategies that may improve mothers’/caregivers’ knowledge, such as health education, improved literacy and women’s empowerment for them to be able to prevent and manage diarrhoea among children under 5 years old.
 
 

Mothers’/caregivers’ knowledge on aetiology, prevention and management of acute diarrhoea among children under 5 years in Engela District, Namibia


 
 
 Background. Childhood diarrhoea remains a public health problem and is among the leading killers globally of children under 5 years. Even though most childhood diarrhoea episodes are mild, episodes can result in severe loss of fluids and dehydration, leading to severe health-related consequences and death. Most diarrhoea episodes in children under 5 are treated at home by parents/caregivers; therefore, their knowledge about the nutrition and management of diarrhoea in children is critically important.
 Objective. To assess mothers’/caregivers’ knowledge of the aetiology, prevention and management of acute diarrhoea among children aged under 5 years with diarrhoea, in Ohangwena Region, Namibia.Method. A cross-sectional, non-interventional study was carried out from 17 January 2019 to 9 March 2019. A structured questionnaire was administered through face-to-face interviews. T-tests and logistic regression were applied to determine the factors associated with knowledge.
 Results. A total of 530 mothers/caregivers of children under 5 years responded to the study questionnaire. Of these, 29.4% were aged between 18 and 30 years, 79.8% were from rural areas, 46.4% had primary education and 16% were illiterate, 59.9% were single, 68.9% had access to information (owned a radio), and 93.2% had a low income of ~NAD200 - 2 000 per month. The majority, 64%, were categorised as having inadequate knowledge on the prevention and management of diarrhoea. In addition, significant associations were observed between knowledge and gender of mothers/caregivers, residential area, marital status, access to information and prevalence of diarrhoea (p<0.05).
 Conclusion. This study identified the need to develop and intensify strategies that may improve mothers’/caregivers’ knowledge, such as health education, improved literacy and women’s empowerment for them to be able to prevent and manage diarrhoea among children under 5 years old.
 
 

Determining critical gaps in implementation of WHO and UNICEF's 7-point plan in diarrhoea control and prevention strategy: A cross sectional study in District Swabi, Pakistan.

To determine the critical gaps in knowledge and practices of mothers/caregivers in the management of diarrhoea in children at home. The descriptive cross-sectional study was conducted from September 2019 to August 2020 at primary health centres across Swabi district of the Khyber Pakhtunkhwa province of Pakistan, and comprised mothers/caregivers presenting with children aged <5 years suffering from diarrhoea. Barriers to childhood diarrhoea prevention and control were identified in accordance with the 7-point plan adopted by the federal government in 2009. Data was analysed using SPSS 23. There were 287 mothers with a mean age of 26.8±5.39 years (range: 17-42 years). The mean age of the children was 24.85±12.72 months (range: 2-55 months). Among the mothers, 145 (51.5%) had received no schooling, 83(29%) had primary level schooling, 56(19.5%) secondary level and 3(1%) had received higher-level education. Only 63(22%) were aware of the use of oral rehydration salts and 32(11%) knew about the need of using zinc in diarrhoea. Safe water was available in 14(5%) households. Hand hygiene awareness was low, as 169(59%) mothers were washing hands with soap. Household access to toilet facility was 247(86%). Preventive health services were good with overall breastfeeding practices 204(71%) and children vaccination 244(85%.). Majority of mothers were found to be well aware of breastfeeding practices and the children had adequate vaccination coverage. There was a wide gap in direct awareness and practices of mothers about sanitation and hygiene and also home-based management of diarrhoeal diseases in children.

Importance of breastfeeding and complementary feeding for management and prevention of childhood diarrhoea in low- and middle-income countries.

BackgroundEarly and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea.MethodsWe conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding.ResultsThe literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea.ConclusionsDuring the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.

Knowledge, Attitudes and Practices of Mothers on Management of Childhood Diarrhoea Among Children Under Five Years in Al Mukalla City/ Yemen- 2022

Background: Good knowledge, attitude and practices of caregivers is pivotal to protection, prevention and treatment of childhood diarrhoea, hence reduce mortality thereof. Objective: Our aim in this study was to determine the level of knowledge, attitudes and practices of mothers on management of childhood diarrhoea among children less than 5 years in Al Mukalla City/ Hadhramout- Yemen. Methods: Al Mukalla, Hadhramout Governorate/Yemen is the site of a cross-sectional study that was done with the help of the local population in both urban and rural settings. The 581 women whose children were younger than 5 years old were chosen at random. Information was gathered through the use of a standardised questionnaire. SPSS Statistical Package was used for the data analysis. Results: Among 581 mothers, 58% of urban mothers knew about the meaning of diarrhoea and 66.7% of rural mothers knew that continuous vomiting is one symptoms of diarrhoea. There was 68.7% of mothers did not agree that immunization can prevent diarrhoea and given ORS during repeating vomiting or diarrhoea episode (86.8%). Around 88% of mothers continued to breastfeed their children during the diarrhoea. Mothers in urban (AOR 1.008; 95% CI 0.901- 3.104) and rural (AOR 1.906; 95% CI 0.995- 9.025) at age 30-39 years old were more likely to know about diarrhoea than mothers at age &gt;40 years. The age had significant influence in increasing the knowledge about diarrhoea (urban p= 0.001, rural p= 0.001), while mothers with good and fair knowledge were more likely to have good practice of diarrhoea than poor knowledge in both areas. Conclusion: Mother’s knowledge and practice about diarrhoea and its management with ORS was poor among the rural areas, related on their knowledge pertaining to vital issues as danger signs of dehydration, enhanced maternal knowledge would have a positive effect on their treatment of diarrhoea in children. Keywords: Diarrhoea, ORS, Knowledge, attitude, and practice.