Prevention Of Childhood Diarrhea Research Articles

Multi-Level Mixed-Effects Analysis of Stunting Among 6 to 59 Months Children in Ethiopia: Evidenced from Analysis of Health and Demographic Survey, 2000 to 2019

Background. Stunting remains a major public health issue in developing countries like Ethiopia. It is termed as a chronic malnutrition which leads to morbidity and mortality among children. This study aimed to assess the prevalence and factors associated with stunting among 6 to 59 months children in Ethiopia. Methods. A total weighted sample of 34 930 children aged 6 to 59 months was included in this study. A Multilevel Mixed-Effect logistic regression was carried out. The Median Odds Ratio (MOR) and the Intra class Correlation Coefficient (ICC) were calculated. An adjusted odds ratio along with a 95% confidence interval was reported and statistical significance was declared at a P-value ≤ .05. Results. The weighted prevalence of stunting in Ethiopia was 48.3% (95% CI: 47.8%, 48.8%). Being male, increased in age, having multiple births (twin), having less than 2 years birth interval, history of diarrhea, anemia, lack of maternal and paternal formal education, having poor and middle-wealth status, and living in rural areas were significantly associated with stunting. Conclusions. The prevalence of stunting is high in Ethiopia. The risk factors mentioned above increase the likely hood of stunting among children. Therefore, we recommend that responsible bodies place a greater emphasis and priority on promoting parental education, awareness on the impact of the birth interval on child nutrition, the prevention of childhood diarrhea and anemia, improving household economic status, and reducing rural-urban disparities.

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.

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 and practices of mothers of under-five children regarding Zinc supplementation in childhood diarrhea

Diarrhoea continues to plaque the developing worldresulting in morbidity of 1.7 billionand mortality of 5.25 lakhsin under- five childrenIn India diarrhea is 3 most common cause of death among under-five children with morbidity of 11.6 million and mortality of 1300 deaths and thus causing 8% of deaths per yearZinc has a major role in prevention of diarrhea. To assess the knowledge and practices of mothers of under-five children regarding zinc supplementation for prevention of childhood diarrhea, to find out the reasons for not supplementing Zinc during diarrhoeal episodes, to find out association between socio-demographic factors and awareness of zinc supplementation. : Hospital based cross sectional analytical study was conducted among 200 mothers of underfive children in outpatient department of Paediatrics of a tertiary care hospital. The data was entered in predesigned semistructured questionnaire. Data was analysed by EPI INFO 7 software. Only 18(9%) mothers were aware about use of Zn supplementation to the under-five children in childhood diarrhoea. Only 10 mothers administered zinc supplementation in childhood diarrhea. Unawareness regarding Zn supplement was common reason mentioned for not giving Zn supplementation. Association was found between religion, type of family and awareness of Zn supplementation. There is a need to increase awareness of mothers regarding zinc supplementation by conducting health education sessions.

Knowledge and Health-Belief as Predictor of Prevention and Management of Childhood Diarrhoea at Federal Medical Centre, Owo

Childhood diarrhoea is found to be the second main cause of under-five mortality the world over, in the developing countries. Therefore, the study examines the health beliefs of mothers as predictors of prevention and management of childhood diarrhoea in Federal Medical Centre, Owo, Ondo State. The study employs a descriptive cross-sectional survey research, a consecutive sampling technique to select 166 mothers of under-five children at the Children Outpatient Clinic of FMC, Owo. A mixed method analysis of quantitative and in-depth interviews was utilized to retrieve information from mothers of under-five children in FMC, Owo. The demographic information and research question was analysed using descriptive statistics while the research hypothesis was analysed using Pearson Product Moment Correlation and Linear regression. The results revealed that, more than half of the mothers have average knowledge of childhood diarrhoea. Across all the factors, there was a moderate level of health belief in the prevention of childhood diarrhoea among the nursing mothers of under-five children. 66.5% Average level of management of childhood diarrhoea. The first hypothesis indicated a significant relationship of socio-demographic characteristics and prevention of childhood diarrhoea among nursing mothers in under-five children in FMC, Owo Marital Status, 0.625, Occupation, 0.788, income of mother, 0.911, ethnicity, 0.771 and level of education, 0.604) and the prevention of childhood diarrhoea, this was significant 0.05 level of significance. However, religion was not significantly related with the prevention of childhood diarrhoea and prevention of childhood diarrhoea among nursing mothers of under-five children in FMC, Owo (p > 0.05). There was a significant relationship between knowledge and management of childhood diarrhoea among nursing mothers of under-five children in FMC, Owo (r=0.779, df=165, p<0.05). The study recommends that there is a need for public health physicians, social workers to provide nutritional educational programs about diarrhoea should be implemented for mothers in different community health services. Government should enforce good sanitation and improvement of housing conditions, especially water resources in rural areas.

Associations Between Improved Water Supply and Sanitation Usage and Childhood Diarrhea in Ethiopia: An Analysis of the 2016 Demographic and Health Survey

Background:Diarrheal disease is one of the leading causes of death in children under the age of 5. Access to and use of improved water and sanitation services is associated with this, but there is little country-level evidence for this relationship in Ethiopia. Therefore, associations between improved water supply and sanitation usage and childhood diarrhea in Ethiopia have been identified as the objective of this study.Methods:This study was a cross-sectional study using data from Ethiopia’s 2016 Demographic and Health Survey. Through interviews with mothers/caregivers who had children under the age of 5 years, data was collected. The outcome of this study was the response of the mothers/caregivers interviewed to the 2-week occurrence of diarrhea. Logistic regression analysis was used to examine the relationship between dependent and independent variables.Results:The survey results found that the use of improved drinking water and latrine facilities was 59.3% (95% CI: 58.36-60.31) and 17.3% (95% CI: 16.59-18.09), respectively. With respect to the handling practices of child feces, 24.8% (95% CI: 23.8-25.70) of the child feces of the interviewed mothers/caregivers were disposed of safely. The prevalence of childhood diarrhea in the preceding 2 weeks was 11% (95% CI: 10.36-11.61). Residence of Somali Region (AOR = 1.81, 95% CI: 1.25-2.61), having more than 2 under-5 children (AOR = 1.21, 95% CI: 1.01-1.46), having more than 5 family members (AOR = 1.18, 95% CI: 1.03-1.36), sex of the indexed child (AOR = 0.88, 95% CI: 0.77-0.99) and unsafe child feces disposal practices (AOR: 1.32; 95% CI: 1.14-1.54) were significantly associated with childhood diarrhea.Conclusion:Residing in the Somali region, having more than 2 children under the age of 5 and having more than 5 household members, indexed child sex, and safe disposal of child feces were significantly associated with diarrhea. Therefore, in Ethiopia, the prevention of childhood diarrhea should concentrate on eliminating household crowding and encouraging the safe disposal of child feces.

Knowledge and recommendation of oral rehydration solution and zinc for management of childhood diarrhoea among patent and proprietary medicine vendors in Port Harcourt, Nigeria

Background In Nigeria, where patent and proprietary medicine vendors (PPMVs) provide care in 55% of common paediatric illnesses, child deaths from diarrhoeal diseases stands at 104000; 14% of total all-cause child mortality. Our aim was to investigate PPMVs knowledge of presentation, cause, treatment and prevention of childhood diarrhoea, and their recommendation of oral rehydration solution (ORS) and zinc in the treatment of sick children in Port Harcourt, Nigeria. Methods A cross-sectional design, structured questionnaires were administered to 200 PPMVs over six weeks with a 94% response rate. The main outcome variables were knowledge of childhood diarrhoea, and recommendation of ORS and zinc. Knowledge scores were analysed numerically and categorized as satisfactory (score ≥15) and unsatisfactory (score < 15). Multivariate Poisson loglinear regression was used to analyse score ratios. Binomial logistic regression was used to assess the determinants of recommendation of ORS as well as recommendation of zinc. Results Overall knowledge of childhood diarrhoea was satisfactory among 47% of PPMVs. Eighty six percent of them reported consistent recommendation of ORS, while 63% of PPMVs consistently recommended zinc. Secondary education (Score Ratio (SR) =1.26, 95% Confidence Interval (CI) =1.01–1.56, P=0.039) and post-secondary education (SR=1.37, 95% CI=1.09 –1.72, P=0.008) were associated with significantly higher knowledge scores. Recommendation of ORS was significantly associated with knowledge score (Adjusted Odds Ratio (AOR) =1.41, 95% CI=1.19–1.66, P<0.001), availability of ORS (AOR=7.26, 95% CI=1.73-30.54, P=0.007) and prescribing of zinc (AOR=5.82, 95% CI=2.03–16.66, P=0.001). Recommendation of zinc was significantly associated with awareness of ORS/zinc guidelines (AOR=5.60, 95% CI=1.07–29.26, P=0.041. Conclusions With the low knowledge of presentation, cause, treatment and prevention of childhood diarrhoea among PPMVs, management of childhood diarrhoea by them in the community is unlikely to be optimal. The reported recommendation of ORS and zinc will need to be further investigated and confirmed by direct observation. Educational requirement for PPMVs to operate a drug shop should be increased to at least secondary education level, and supply of ORS/zinc made reliable as these have shown to be important factors in the recommendation of the products.

Knowledge of Causes, Management and Prevention of Childhood Diarrhoea among Nursing Mothers in Two Selected Primary Health Centers in Oyo State, Nigeria

Diarrhoea is widely recognized as a major cause of childhood morbidity and mortality in many developing countries, particularly in sub-Saharan Africa. The objective of this study is to assess the knowledge of causes, management and prevention of diarrhoea among nursing mothers of under-two children in two selected primary health centers in Ibadan North Local Government, Oyo state. A descriptive non-experimental research design was used for the study. One hundred and sixty nursing mothers were selected from the two primary health centers. A structured self-administered questionnaire was used to collect data from participants while descriptive statistics of frequencies and percentages were used to analyze the data on the objectives.The study findings revealed that majority (89.4%) of respondents have heard of diarrhoea before, many of them (45%) had it from health centers and (10.6%) from past experience of diarrhoea occurrence. Majority (78.1%) of respondents had knowledge of diarrhoea, having been able to define what diarrhoea is in their own perspective and were able to identify some causes of diarrhoea. Over half (63.8%) of them claimed their index child had diarrhoea out of which less than half (38.8%) of them managed it with ORS. Less than half of them (34.4%) managed the occurrence at home while (25.5%) took their children to health center. In conclusion, mothers had knowledge of diarrhoea, but knowledge translation to prevention action was very poor. It is recommended that, health education of mothers on prevention should be intensified while mass media should assist in disseminating health information on diarrhoea prevention. Government should provide vaccine against rotavirus which should be included in the routine immunization schedule.

Childhood Diarrhea Determinants in Sub-Saharan Africa: A Cross Sectional Study of Tiko-Cameroon

Introduction: Diarrhea remains the second leading cause of death among children under five years globally. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea. It kills more young children than Acquired Immunodeficiency Syndrome (AIDS), malaria and measles combined. World Health Organization has accordingly underlined the need for epidemiological surveys of infantile diarrhea in all geographical areas. The main research objectives were to estimate the prevalence of diarrhea and identify factors associated with diarrheal diseases in Tiko city in Cameroon. Method: The present study was a cross-sectional community household survey which was conducted in Tiko town from 1st to 31st of August 2012. With the use of a questionnaire, a total of 602 households that had at least one child under five years of age were interviewed. Mothers/caregivers were questioned on the morbidity of diarrhea and the logistic regression model was employed to examine the determinants of childhood diarrhea. Both univariable and multivariable data analysis was performed using SPSS version 16.0. Results: The results of this study showed that the prevalence of diarrhea was 23.8% and children under 24 months were highly affected. We found children using the main toilet and other types of toilet facilities such as bushes, diaper, and streams (OR: 0.194; p < 0.001, 95% CI) and usage of narrow-mouth container for storage of drinking water (OR: 0.492; p < 0.001, 95% CI) less likely to suffer from diarrhea. In contrast, higher rates of diarrhea prevalence were seen in children from households with two or more siblings (OR: 1.222; p < 0.001, 95% CI) and whose mothers/caregivers never had the knowledge of safe sources of drinking water (OR: 1.849; p < 0.01, 95% CI). Conclusion: Childhood diarrhea is a public health problem in Tiko city. Hence, interventions aimed at reducing the prevalence should take into consideration the integration of family planning activities in the prevention of childhood diarrhea and the deployed of health personals to educate the community to adopt a hygienic behavior. Future research on the topic should be qualitative inquiry to complement the quantitative nature of this study.

Current Caregiver Awareness of Pediatric Giardiasis and Cryptosporidiosis

Background: We undertook an online survey to gain a greater understanding of the knowledge, attitudes, and willingness to seek care among caregivers of small children. Methods: Caregivers were invited to participate via direct e-mail from Harris Poll, a company that specializes in on-line surveys. This was a prospective, web-based survey of a defined number of responders on a first come, first included basis. The survey focused on caregiver’s awareness of the potential causes of diarrheal illnesses and of available treatment options. Caregivers were required to be US residents, have a child living in the home who was 1 -12 years old and who suffered at least one episode of diarrhea in the last year. Results: The survey included 1,048 complete responses were accumulated. Responders were mostly female (59%) with one (51%) or two (39%) children in the home. The results of the survey showed a general lack of awareness of what constitutes clinical diarrhea and how best to care for a child who presents with persistent diarrhea. Conclusion: The results of this survey point to the need for broad public education on the importance of recognition, treatment, and prevention of childhood diarrhea caused by parasites such as Giardia and Cryptosporidium.

Spoiled breast milk and bad water; local understandings of diarrhea causes and prevention in rural Sierra Leone.

BackgroundGlobally, diarrhea remains a leading killer of young children. In Sierra Leone, one in seven children die before their fifth birthday and diarrhea is a leading cause. Studies that emphasize the demand-side of health interventions -- how caregivers understand causation and prevention of diarrhea -- have been neglected in research and programming.MethodsWe undertook applied qualitative research including 68 in-depth interviews and 36 focus group discussions with mothers, fathers and older female caretakers to examine the causes and prevention of childhood diarrhea in villages near and far from health facilities across four rural districts. Verbal consent was obtained.ResultsRespondents reported multiple, co-existing descriptions of causation including: contaminated water and difficulties accessing clean water; exposure to an unclean environment and poor food hygiene; contaminated breast milk due to sexual intercourse, overheated breast milk or bodily maternal conditions such as menstruation or pregnancy; and dietary imbalances and curses. Respondents rarely discussed the role of open defecation or the importance of handwashing with soap in preventing diarrhea.ConclusionsCategorizing behaviors as beneficial, harmful, non-existent or benign enables tailored programmatic recommendations. For example, respondents recognized the value of clean water and we correspondingly recommend interventions that reinforce consumption of and access to clean water. Second, respondents report denying “contaminated” breast milk to breastfeeding children. This is a harmful practice that merits attention. Third, the role of open defecation and poor hygiene in causing diarrhea is less understood and warrants introduction or clarification. Finally, the role of exposed feet or curses in causing diarrhea is relatively benign and does not necessitate programmatic attention. Further research supportive of communication and social mobilization strategies building on these findings is required to ensure that improved understanding regarding diarrhea causation translates into improved diarrhea prevention.

Promoting appropriate management of diarrhea: A systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India

Scaling up of evidence-based management and prevention of childhood diarrhea is a public health priority in India, and necessitates robust literature review, for advocacy and action. To identify, synthesize and summarize current evidence to guide scaling up of management of diarrhea among under-five children in India, and identify existing knowledge gaps. A set of questions pertaining to the management (prevention, treatment, and control) of childhood diarrhea was identified through a consultative process. A modified systematic review process developed a priori was used to identify, synthesize and summarize, research evidence and operational information, pertaining to the problem in India. Areas with limited or no evidence were identified as knowledge gaps. Childhood diarrhea is a significant public health problem in India; the point (two weeks) prevalence is 9 to 20%. Diarrhea accounts for 14% of the total deaths in under-five children in India. Infants aged 6 to 24 months are at the highest risk of diarrhea. There is a lack of robust nation-wide data on etiology; rotavirus and diarrheogenic E.coli are the most common organisms identified. The current National Guidelines are sufficient for case-management of childhood diarrhea. Exclusive breastfeeding, handwashing and point of use water treatment are effective strategies for prevention of all-cause diarrhea; rotavirus vaccines are efficacious to prevent rotavirus specific diarrhea. ORS and zinc are the mainstay of management during an episode of childhood diarrhea but have low coverage in India due to policy and programmatic barriers, whereas indiscriminate use of antibiotics and other drugs is common. Zinc therapy given during diarrhea can be upscaled through existing infrastructure is introducing the training component and information, education and communication activities. This systematic review summarizes current evidence on childhood diarrhea and provides evidence to inform child health programs in India.

Role of Zinc Administration in Prevention of Childhood Diarrhea and Respiratory Illnesses: A Meta-analysis

The quantified effect of zinc supplementation to prevent childhood diarrhea and respiratory illnesses is unclear. We conducted a meta-analysis of randomized, controlled trials on the subject. We searched PubMed, Science Citation Index, and the Cochrane Database of Controlled Trials and hand-searched the reference lists of identified articles. All randomized, controlled trials of zinc supplementation for > or = 3 months for children < 5 years of age, using blinded assessment, were eligible. The outcome measures studied were number of episodes of illness, number of days with illness, and number of episodes of severe illness. Data from 17 studies were pooled by using random-effects and fixed-effects models for data with and without significant heterogeneity, respectively. Children who received a zinc supplement had fewer episodes of diarrhea (rate ratio: 0.86) and respiratory tract infections (rate ratio: 0.92) and significantly fewer attacks of severe diarrhea or dysentery (rate ratio: 0.85), persistent diarrhea (rate ratio: 0.75), and lower respiratory tract infection or pneumonia (rate ratio: 0.80) than did those who received placebo. They also had significantly fewer total days with diarrhea (rate ratio: 0.86) but not days with respiratory illness (rate ratio: 0.95). Published studies showed a publication bias and significant heterogeneity; however, no cause for the latter could be identified. Zinc supplementation reduced significantly the frequency and severity of diarrhea and respiratory illnesses and the duration of diarrheal morbidity. The relatively limited reduction in morbidity and the presence of significant heterogeneity and of publication bias indicate the need for larger, high-quality studies to identify subpopulations most likely to benefit.

Training Manual for Treatment and Prevention of Childhood Diarrhea with Oral Rehydration Therapy, Proper Nutrition and Hygiene

Training Manual for Treatment and Prevention of Childhood Diarrhea with Oral Rehydration Therapy, Proper Nutrition and Hygiene