Management Of Diarrhea In Children Research Articles

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.

Self-reported and the actual involvement of community pharmacy professionals in the management of acute childhood diarrhea in Jazan Province, Saudi Arabia: Simulated patient visits and survey study

BackgroundAcute childhood diarrhea is one of the most common causes of dehydration, and if severe, can potentially lead to death as well. The present study was aimed at evaluating the knowledge and attitudes of community pharmacy professionals towards the management of acute childhood diarrhea and comparing them with their actual practices in Jazan Province, Kingdom of Saudi Arabia (K.S.A). MethodsSimulated patient visits and a cross-sectional survey making use of a 27-item self-report questionnaire were conducted amongst a sample of 303 community pharmacy professionals (51.2 % male and 48.8 % female) with an age range of 25–56 years, between August 1 and December 1, 2021, in Jazan Province, Saudi Arabia. Convenience sampling technique was used for the recruitment of the participants. ResultsSignificant positive correlations were seen between knowledge score (self-report survey) and practice score (simulated patient visit) regarding patients’ history taking (r = 0.65; p < 0.01), drug recommendations (r = 0.71; p < 0.01) and providing information regarding food and fluid intake (r = 0.44; p < 0.01). The alpha coefficients for all the items of the survey instrument were noted to be greater than (or) equal to the 0.70 threshold for almost all sections, hence indicating good reliability and internal consistency of the developed scale. ConclusionIn the present study, even though we observed improved participants’ performance during the self report survey, their performance level greatly dropped in actual practice. This warrants for a need for educational programs to improve their actual dispensing practices. The present study has also shown simulated patient visits to be a reliable, simple and a robust method of assessing the actual dispensing practices of community pharmacy professionals.

PCR50 Survey on the Management of Viral Diarrhoea Among Young Children in Hungary

Diarrhoeal disease is a common condition in young children. To date, however, there is still great variation among parents about how to manage this condition. The aim of our study was to assess parents' knowledge and attitudes towards the management of diarrhoea in children.

Childhood diarrhoea: a cross-sectional survey on maternal knowledge, hygienic practices and use of oral zinc for home management in a Nigerian community.

Introductiondiarrhoea is the second leading cause of morbidity and mortality in young children. The aim was to assess maternal knowledge, hygienic practices and home management (HM) of diarrhoea with oral rehyrdation therapy (ORT) and oral zinc in children aged 6-23 months in western Nigeria. Predictors of good knowledge and practice were also assessed.Methodsthis was a community based analytic cross-sectional study. Multistage sampling was used to select mothers of children 6-23 months of age. Data were collected using pre-tested, interviewer administered questionnaires and analyzed using SPSS version 20. Bivariate analysis and multiple logistic regression for predictor variables were done. Level of significance was set at 0.05.Resultsthree hundred and seventy one (371) respondents were interviewed (mean age 30.4 ± 5.02 years). 305 (82.2%) had good knowledge of diarrhoeal diseases, 208(56.1%) had good knowledge of home management of childhood diarrhoea, 274 (73.9%) had good maternal hygienic practices and 161 (61.2%) of the 263 mothers who had managed diarrhoea in their children, had good practice. Only 34 (12.9%) of them used zinc tablets and 11 (32.4%) did not complete the full course. Maternal age 30-39 years predicted good knowledge (AOR 3.19 CI 2-6.05). Predictors of good home management practices were: maternal age 30-39 years (AOR 2.78 CI 1.44-5.37), >40 years (AOR 5.55 CI 1.54-20.01) and younger age of the index child, 6-11 months (AOR 4.83 CI 2.29-10.18).Conclusionmothers had poor knowledge of the role of zinc supplementation in childhood diarrhoea and use of zinc tablets for diarrhoea was very low. Community based health education should be carried out.

Childhood diarrhoea in southwestern Nigeria: Predictors of low osmolarity ORS and zinc use among mothers

ObjectivesDiarrhoea is a leading cause of mortality among children in resource-limited countries. However, very scarce literature exists regarding the factors influencing the awareness and use of low osmolarity oral rehydration salts (Lo-ORS) and zinc supplementation in the management of childhood diarrhoea among mothers of children under 5 years of age in southwestern Nigeria. This study, performed in Lagos, Nigeria, aimed to address this lack of knowledge. MethodsThrough a cross-sectional survey design, 336 mothers of children under 5 years of age were selected through a multi-stage sampling procedure. Data were collected with a pretested, semi-structured interviewer administered questionnaire and analysed in SPSS version 23. Descriptive and inferential statistical techniques were used for data analysis. ResultsA total of 10.4% of the mothers were aware of Lo-ORS, whereas 6.5% had ever used it; 53.3% were aware of zinc supplementation, whereas 42% had ever used it. Awareness was influenced by educational level (AOR: 2.017; 95% CI: 1.123–3.626) and the age of the child (AOR: 2.257; 95% CI: 1.237–4.117) for Lo-ORS, and by average monthly income (AOR: 1.582; 95% CI: 1.144–2.187) for zinc supplementation. The utilisation level was associated with educational level (p = 0.039) and awareness (p < 0.001) for Lo-ORS, and with marital status (p = 0.018) and awareness (p < 0.001) for zinc supplementation. ConclusionAwareness and use of Lo-ORS was poorer than that of zinc supplementation among the mothers. Efforts to promote awareness regarding these treatments among mothers and health workers should be intensified to promote their use and help bridge the gap between policy change and effectiveness.

Mothers' Attitude about Treatment and Prevention of Diarrhea in Children Under Five Years at the Eastern AL Hamza city

Objectives: This study aimed to evaluate Mothers’ Attitude about Treatment and Prevention of Diarrhea in Children Under Five Years. Methodology: The study was descriptive using quantitative data collection method. In which assessment approach is applied to achieve the objectives of the study and was conducted during the period of the study from October 25th 2021 to March 1st 2022. Results: The study findings showed that (63.2%) of mothers had negative attitude regarding the treatment and prevention of diarrhea and (36.8%) only of them had positive attitude. Conclusion: Most mothers’ had negative attitude about prevention and home management of diarrhea in children under five years.. Key words: Mothers' attitude, Treatment, Prevention , Diarrhea, Children.

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.

New formulation zinc sulphate acceptability and adherence in children with acute diarrhoea: A prospective, open-label, interventional study in Bangladesh.

Zinc is an adjunct to oral rehydration salts for management of diarrhoea in children. Due to zinc's unpleasant taste, children often develop nausea and/or vomiting. We aimed to assess acceptability (tolerability) and adherence of improvised formulation of zinc tablet among under-five children with acute diarrhoea. This was an open-label intervention trial among 3-59 months old diarrhoeal children attending the outpatient department of Dhaka Hospital, who were enrolled in two age strata, 3 to <18 months and 18-59 months. Zinc tablets 10 or 20 mg per day were prescribed for a total of 10 days for <6months and ≥6months age children respectively, with follow-up. Diary-cards were used to record events. In stratum 1, 158 (90.8%) children and in stratum 2, 144 (95.4%) children completed the study as per protocol out of 325 enrolled children. Sociodemographic, clinical and anthropometric measurements were comparable in the two strata except admission diarrhoeal duration (median 3 days vs. 2 days, P= 0.001). Adherence to 10 days treatment was 123 (77.8%) in stratum 1 and 127 (88.2%) in stratum 2. Zinc tablets were tolerated very well/well in 280 (92.7%) children. Vomiting, regurgitation and nausea were observed in 99 (32.8%), 59 (19.5%) and 22 (7.4%) children respectively. Caregivers' willingness to use the same drug in future was 300 (99.3%) among all children. Our study findings demonstrate that modified taste and formulation zinc tablets were well tolerated, and caregivers' willingness to use this formulation in future supports its acceptability, adherence and palatability.

Antimicrobial Use and Management of Childhood Diarrhea at Community Drug Retail Outlets in Eastern Ethiopia: A Matched Questionnaire-Based and Simulated Patient-Case Study.

IntroductionAntimicrobial agents have saved millions of lives worldwide. However, inappropriate use has become a global concern leading to the emergence and spread of antimicrobial resistance (AMR). In this regard, the dispensing practices of pharmacy professionals in the community drug retail outlets (CDROs) plays a central role. Therefore, this study was aimed to assess the knowledge and dispensing practices of pharmacy professionals in the management of childhood diarrhea in CDROs of Eastern Ethiopia.MethodsA community based cross-sectional study was conducted in 100 randomly selected CDROs in Eastern Ethiopia from 1 August to 30 September 2020. Data were collected with a structured questionnaire matched with a simulated patient case. Descriptive statistics were employed to summarize variables. Cohen’s Kappa was analyzed to measure the degree of agreement between questionnaire-based and simulated patient-based methods. Binary logistic regression analysis was conducted to determine factors associated with inappropriate dispensing practice.ResultsMajority of the participants were aged 25–34 years (median: 29 years). High proportion of them were male (65%) and had work experiences of two or more years. Majority (61%) of the professionals were knowledgeable about AMR. Out of 2886 scores, 745 scores were agreed on Cohen’s Kappa interrater agreement scale with the overall percent agreement between the two methods being 26.0%. Besides, about 67% of dispensing practices to the simulated patient case was found inappropriate. On the multivariate analysis, insufficient knowledge of retailers on AMR was significantly associated with the inappropriate dispensing of antimicrobial agents.ConclusionA considerable proportion of retailers had insufficient knowledge regarding the emergence and spread of AMR. Only a quarter of their questionnaire-based knowledge response agreed with simulated-patient-based actual practice, indicating weak agreement between the two methods and high level of inappropriate practice. Besides, insufficient knowledge of retailers was significantly associated with their inappropriate dispensing of antimicrobials.

Universal home visits improve male knowledge and attitudes about maternal and child health in Bauchi State, Nigeria: Secondary outcome analysis of a stepped wedge cluster randomised controlled trial.

BackgroundThe World Health Organization recommends increased male involvement to improve maternal and newborn health in low- and middle-income countries, but few studies have measured the impact of male-engagement interventions on targeted men. A trial of universal home visits to pregnant women and their spouses in Nigeria improved maternal and child health outcomes. This analysis examines the impact of the visits on male spouses.MethodsIn Toro Local Government Area in Bauchi State, Nigeria, we randomly allocated eight wards into four waves, beginning the intervention at one-year intervals. The intervention comprised two-monthly evidence-based home visits to discuss local risk factors for maternal and child health with all pregnant women and their male spouses. Measured secondary outcomes of the intervention in the men included knowledge about danger signs in pregnancy and childbirth, beliefs about heavy work in pregnancy, discussion with their wives about pregnancy and childbirth, knowledge about causes and intentions about management of childhood diarrhoea, and views about childhood immunisation. The analysis compared outcomes between men in visited wards (intervention group) and pre-intervention wards (control group), using a cluster t test. Generalised linear mixed modelling accounted for the effect of socio-economic differences on the measured impact.ResultsThe analysis included 6931 men in the intervention group and 9434 in the control group. More men in the intervention group knew four or more danger signs in pregnancy (risk difference (RD) = 0.186, 95% confidence interval (CI) = 0.044 to 0.327), and three danger signs in childbirth (RD = 0.091, 95%CI = 0.013 to 0.170), thought pregnant women should reduce heavy work before the third trimester (RD = 0.088, 95% CI = 0.015 to 0.162), and had discussed pregnancy and childbirth with their spouse (RD = 0.157, 95% CI = 0.026 to 0.288). More knew correct management of childhood diarrhoea with fluids and feeding (RD = 0.300, 95% CI = 0.203 to 0.397) and less would give a child medicine to stop diarrhoea (RD = 0.206, 95% CI = 0.125 to 0.287). Socio-economic differences did not explain the effect of the intervention on any of the outcomes.ConclusionUniversal home visits improved knowledge of male spouses about maternal and child health, which could contribute to improved maternal and child outcomes.Trial registrationISRCTN, ISRCTN82954580. 11 August 2017. Retrospectively registered. http://www.isrctn.com/ISRCTN82954580

Assessment of role of zinc in the management of acute diarrhea in children at a teaching hospital

Assessment of role of zinc in the management of acute diarrhea in children at a teaching hospital

Mother&amp;apos;s knowledge and attitudes about home management of diarrhea among children under 5 years; in the Eastern Region of Saudi Arabia

Background: Diarrhea does not cause death directly. However, the insufficient knowledge of mothers about childhood diarrhea and improper management can lead to complications and death. Mothers&amp;apos; knowledge about the management of diarrhea is crucial in preventing complications. Therefore, this study aims to assess mothers&amp;apos; knowledge and attitude toward diarrhea among children under 5 years and its management at home in the Eastern Region of Saudi Arabia. Methods: This is a cross-sectional study carried out among 396 mothers. The collection of data was done during the period from 27/11/2021 to 30/1/2022. A convenience sampling technique was done to select the participants using an electronic questionnaire. Results: This study showed that mothers have insufficient knowledge of the critical signs of diarrhea and moderate knowledge of the causes and transmission of diarrhea. Among the studied subjects, 77% of mothers knew about oral rehydration therapy (ORS), and 81% have used it previously, indicating high knowledge about ORS. In addition, many mothers (85%) falsely believe that teething causes diarrhea. Conclusion: This study showed that mothers have low knowledge about critical signs of diarrhea, moderate knowledge regarding the causes and transmission of diarrhea, and high knowledge regarding using ORS. Health education is needed for mothers about critical signs of diarrhea.

Changing Perceptions of Rural Frontline Workers and Caregivers About Management of Childhood Diarrhea and Pneumonia Despite Several Inequities: The Nigraan Plus Trial in Pakistan.

PurposeDiarrhea and pneumonia greatly contribute to high childhood mortality in Pakistan. Frontline community health workers or the Lady Health Workers (LHWs) provide care at the doorstep of over 60% of Pakistan’s rural residents. Difficult terrain, lack of supplies, and inadequate supervision put these LHWs at an added disadvantage in the timely diagnosis and delivery of known treatment options to community caregivers (CCGs). This study aims to assess whether a supportive supervision intervention through Lady Health Supervisors (LHSs) using enhanced mentorship and written feedback cards have the potential to improve case management of childhood diarrhea and pneumonia.Study Setting and DesignThis perception-based qualitative inquiry nested within the Nigraan Plus trial included LHSs, LHWs, and CCGs as the participants. Twenty-two in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were conducted before a supportive supervision intervention in 2017, and 10 FGDs were conducted in 2019 once the intervention concluded. Data were analyzed using manual content analysis.ResultsThe perceived ability of LHWs and LHSs to describe the danger signs of diarrhea and pneumonia, classify dehydration and relate respiratory rate to the severity of pneumonia improved over time. Appropriate prescription of zinc in diarrhea and antibiotics in pneumonia was noted. Furthermore, CCGs’ trust in LHWs increased following the intervention, and they reported a growing inclination to contact LHWs as their first point of care. LHWs in the intervention arm were more satisfied with their job due to frequent supervisory visits and continuous feedback by LHSs.ConclusionDespite geographic, social, and economic inequities, supportive supervision has the potential to improve knowledge, practice, and skills of frontline health workers related to CCM of childhood diarrhea and pneumonia in disadvantaged rural communities. Additionally, the trust of CCGs in the health workers’ ability to manage such cases is also enhanced.

Association Between Source of Treatment and Quality of Childhood Diarrhea Management Among Under-Five Children in Nigeria

Background and Objective: Despite the availability of low-cost and effective interventions, diarrhea remains one of the leading causes of under-five morbidity and mortality in Nigeria. We assessed the relationships between the source and quality of treatment for children with diarrhea in Nigeria. Methods: We analyzed cross-sectional data on 3,956 under-five children with a recent diarrheal episode, from the 2018 Nigeria Demographic and Health Survey. The outcome was quality of diarrhea management based on the administration of the following treatment recommendations: oral rehydration salt (ORS), zinc supplementation, increased oral fluids, and continued feeding. The exposure was the source of treatment (none; traditional/informal; public hospitals/health centers; private hospitals/clinics; and community-based services). Using adjusted, multivariable logistic regression, we estimated the odds ratio (OR) and 95% confidence intervals (CI) to predict the factors related to the quality of diarrhea management. Results: In all, only 1 in 5 children received all the four recommended diarrhea interventions. The odds of good quality diarrhea management were higher among children who received treatment in public hospitals/health centers, private hospitals/clinics, and community-based services compared to those of children who did not receive treatment (OR=2.52, 95% CI=1.89-3.34; OR=2.46, 95% CI=1.90-3.16; and OR=1.91, 95% CI=1.40-2.59, respectively). Compared to children whose parents did not seek treatment, the odds of receiving ORS ranged from 2.1 times (OR: 2.11, 95% CI=1.44-3.11) for seeking care in traditional/informal sources to 12.3 times (95% CI=8.81-17.15) in public hospitals/health centers. We observed similar trends for zinc supplementation. The odds of increased oral fluids were higher in public and private hospitals/clinics (OR=1.44, 95% CI=1.03-2.01 and OR=2.08, 95% CI=1.57-2.76, respectively). Across all settings, the odds of continued feeding were significantly lower among children who received treatment compared to children who did not receive treatment. Conclusion and Implications for Translation: Our findings indicate poor quality diarrhea management across various treatment settings. Policies and programs that encourage caregivers to seek treatment and improve the quality of care may contribute to reducing childhood diarrhea-related morbidity and mortality in Nigeria. Copyright © 2021 Olorunsaiye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Combating Childhood Infections in LMICs: evaluating the contribution of Big Data Big data, biomarkers and proteomics: informing childhood diarrhoeal disease management in Low- and Middle-Income Countries

<h2>Abstract</h2> Despite efforts to reduce the global burden of childhood diarrhoea, 50% of all cases globally occur in children under five years in Low–Income and Middle- Income Countries (LMICs) and knowledge gaps remain regarding the aetiological diagnosis, introduction of diarrhoeal vaccines, and the role of environmental enteric dysfunction and severe acute malnutrition. Biomarkers may assist in understanding disease processes, from diagnostics, to management of childhood diarrhoea and the sequelae to vaccine development. Proteomics has the potential to assist in the identification of new biomarkers to understand the processes in the development of childhood diarrhoea and to aid in developing new vaccines. Centralised repositories that enable mining of large data sets to better characterise risk factors, the proteome of both the patient and the different diarrhoeal pathogens, and the environment, could inform patient management and vaccine development, providing a systems biological approach to address the burden of childhood diarrhoea in LMICs.