Use Of Oral Rehydration Solution Research Articles

Prevalence of oral rehydration solution use and its determinants in the treatment of diarrhea among under-five children in sub-Saharan Africa.

Diarrhea is the second leading cause of under-five deaths claiming half a million children every year. Most of these deaths occurred in sub-Saharan Africa and South Asia. Oral rehydration solution (ORS) has been described as the most effective treatment of diarrhea. However, only 36% of children with diarrhea received ORS in sub-Saharan Africa. This study examined the factors associated with ORS use for children with diarrhea in the sub-region. Demographic and Health Surveys (DHS) data sets of 31 countries in sub-Saharan Africa were used in this study. The data involved 30,102 under-five children with diarrhea. The multivariable analysis involved binary logistic regression. Prevalence of ORS use was 38% in sub-Saharan Africa with countries such as Namibia (71.8%), Zambia (66.4%) and Malawi (63.8%) having the highest rates. Use of ORS was most common among children whose mothers had secondary or higher education (45%), were exposed to media (41%) and attended antenatal care (41%). ORS use was significantly associated with secondary or higher education (OR = 1.63; 95%CI: [1.47-1.81]; p<0.001), exposure to media (OR = 1.17; 95%CI: [1.07-1.27]; p<0.001), antenatal care attendance (OR = 2.33; 95%CI: [1.08-1.27]; p<0.001), child's age (OR = 1.46; 95%CI: [1.35-1.59]; p<0.001), child's size at birth (OR = 1.08; 95%CI: [1.00-1.17]; p<0.05), household size (OR = 1.28; 95%CI:[1.06-1.54]; p<0.05) and source of drinking water (OR = 1.18; 95%CI: [1.09-1.29]; p<0.001). This study revealed a 38% prevalence of ORS use during diarrhea episodes in sub-Saharan Africa. This is low as it is less than the 44% recorded for developing countries as a whole. While this study emphasises the need for a further study on effects of severity of diarrhea on ORS use and factors determining differences in ORS use among countries, it also calls for interventions that will increase use of ORS is sub-Saharan Africa. Such interventions should include increase in literacy rate among girls and women, increase in the proportion of women with access to media, involvement of health workers in programmes that would promote antenatal care utilization among women at community level and provision of social amenities like pipe-borne water.

Patient adherence to an oral rehydration solution intervention to prevent dehydration following ileostomy creation: A qualitative study

BackgroundPatients undergoing surgery for ileostomy creation frequently experience postoperative dehydration and subsequent renal injury. The use of oral rehydration solutions (ORS) has been shown to prevent dehydration, but compliance may be variable. MethodsSemi-structured qualitative interviews were conducted with 17 patients who received a postoperative hydration kit and dehydration education to assess barriers and facilitators to compliance with ORS kit instructions. ResultsQualitative analysis revealed five themes affecting patient adherence to the ORS intervention: (1) patient's perception of the effectiveness of the ORS solution, (2) existing co-morbidities, (3) kit quality and taste of the ORS product, (4) quality of the dehydration education, and (5) social support. ConclusionsGiven that patient adherence can greatly affect the success of an ORS intervention, the design of future ORS interventions should emphasize the educational component, the “patient friendliness” of the ORS kit, and ways that social supports can be leveraged to increase adherence.

Knowledge of Caretakers about the Use of Oral Rehydration Solutions in Children with Acute Diarrhea

Background: Diarrhea is known to be the major factor causing morbidity and mortality, especially among pediatric age groups globally. This study was done to assess the knowledge of caretakers regarding the use of oral rehydration solution (ORS) in children with acute diarrhea. Methods: This cross-sectional study was conducted at the Department of Pediatric Medicine, Children’s Hospital and Institute of Child Health, Multan, Pakistan, from February 2023 to July 2023. We analyzed caretakers of children aged 1-12 years who presented with acute diarrhea that had less than 14 days of duration. Both male and female caretakers, with ages ranging from 25 to 50 years, were included. Knowledge of the formulation of ORS, the process of its preparation, and usage were asked. Participants describing all correct answers about the formulation, preparation, and use of ORS were considered as having knowledge of ORS. Effect modifiers were stratified, and applying the post-stratification chi-square test, their effects on outcome were observed. A p-value≤0.05 was considered significant. Results: In a total of 240 study participants, the mean age of caretakers was 36.01±8.08 years. There were 23 (9.6%) male and 217 (90.4%) female caretakers. Among caretakers, 79 (32.9%) had knowledge of ORS while 161 (67.1%) did not know ORS. A statistically significant association of knowledge about ORS was found with residential status (p&lt;0.001), socio-economic status (p&lt;0.001), and source of drinking water (p&lt;0.001). Conclusion: This study found that among caretakers of children having acute diarrhea, there was a lack of knowledge regarding ORS use, formulation, and preparation.

Randomized Controlled Trial of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) Cholera Rapid Response Program to Reduce Diarrheal Diseases in Bangladesh.

(a) Objective: To build an evidence base on effective water, sanitation, and hygiene interventions to reduce diarrheal diseases in cholera hotspots, we developed the CHoBI7 Cholera Rapid Response Program. (b) Methods: Once a cholera patient (confirmed by bacterial culture) is identified at a health facility, a health promoter delivers a targeted WASH intervention to the cholera hotspot (households within 20 m of a cholera patient) through both in-person visits during the first week and bi-weekly WASH mobile messages for the 3-month program period. A randomized controlled trial of the CHoBI7 Cholera Rapid Response Program was conducted with 284 participants in 15 cholera hotspots around cholera patients in urban Dhaka, Bangladesh. This program was compared to the standard message in Bangladesh on the use of oral rehydration solution for dehydration. Five-hour structured observation of handwashing with soap and diarrhea surveillance was conducted monthly. (c) Findings: Handwashing with soap at food- and stool-related events was significantly higher in the CHoBI7 Cholera Rapid Response Program arm compared to the standard message arm at all timepoints (overall 54% in the CHoBI7 arm vs. 23% in the standard arm, p < 0.05). Furthermore, there was a significant reduction in diarrheal prevalence for all participants (adults and children) (Prevalence Ratio (PR) 0.35, 95% CI: 0.14–0.85) and for children under 5 years of age (PR: 0.27, 95% CI: 0.085–0.87) during the 3-month program. (d) Conclusions: These findings demonstrate that the CHoBI7 Cholera Rapid Response Program is effective in lowering diarrhea prevalence and increasing handwashing with soap for a population at high risk of cholera.

Use of oral rehydration solution and intravenous fluid in home settings for adults with short bowel syndrome.

Although both oral rehydration solutions (ORSs) and intravenous fluids (IVFs) were initially developed to treat severe dehydration from diarrhea due to cholera, they are the mainstays of treatment for patients with short bowel syndrome (SBS). Advances in medical care have provided an expansion of new concepts on existing ideas, including adaptations of ORSs, pharmaceutical introductions of new oral and enteral products, and supply chain limitations of intravenous products necessitating the development of novel clinical practices. The evaluation and understanding of a patient's hydration status, socioeconomic status, compliance to therapies, and, finally, the ability to obtain actual products all play an integral role in determining the best plan of care to manage fluid balance in the presence of SBS. Therefore, a multidisciplinary approach, including a dietitian, medical provider, pharmacist, and others, is crucial to create a collaborative and comprehensive look at a complicated patient to individualize treatment options. The purpose of this paper is to provide an overview of the historical and current use of ORSs and IVFs to maintain fluid balance and combat dehydration from SBS, describe the challenges patients and healthcare providers have been faced with, and provide recommendations for future research to overcome these barriers.

Factors Influencing the Use of Oral Rehydration Solution among Mothers of Under Five Children Attending Holy Rosary Specialist Hospital and Maternity Waterside In Onitsha North Lga, Anambra State.

Purpose: This study determined factors influencing the use of oral rehydration solution among mothers with children below five years of age attending Holy Rosary Specialist Hospital and Maternity Waterside in Onitsha North LGA, Anambra State.&#x0D; Methodology: A cross-sectional descriptive design was adopted in conducting the study among mothers with children under five years attending Rosary Specialist Hospital and Maternity, Waterside in Onitsha North Local Government Area, Anambra State. A sample size of one hundred and fifty (150) women was selected by convenience sampling techniques. A self-structured questionnaire with a reliability coefficient of 0.98 was used in gathering the necessary data suitable for the study which were analysed with SPSS version 20.0.&#x0D; Findings: It was discovered that majority of the women 141(94.6%) have heard of ORS and they have adequate understanding of the solution, the two different types of oral rehydration solutions (that is solution from oral rehydration salt and salt sugar solution) but do not use SSS hence lack adequate knowledge of its preparation. Also, the mothers 116(95.9%) used ORS when their children had diarrhoea while the remaining 5(4.1%) did not use ORS because their children never had diarrhoea. 65(43.6%) of the women have all the materials needed for the preparation of SSS while 70(47.0%) which were the majority did not know the materials required for the preparation of ORS hence they could not indicate if they had the materials or not. From the hypothesis tested, there is a significant relationship between mothers’ level of education (p=0.030), mother’s occupation (p=0.024), number of under five children (p=0.045) and the use of ORS. From the study, it was ascertained that socio-demographic factors like mother’s level of education, occupation and number of under five children affected the use of ORS in the population used. Mother’s level of knowledge of the solution, availability and accessibility of the ORS sachet (environmental factor) and the occurrence of diarrhoea in a child (Child factor) also affect use of ORS.&#x0D; Recommendations: Health workers in the health care facilities should intensify their effort in the provision of adequate health education to the mothers (may be to be incorporated into antenatal care health talks) on the preparation of Salt Sugar Solution (SSS) type which is cost effective and readily available. Also the hospital management should ensure that Oral Rehydration salt sachets are available in the hospitals and at an affordable price so as to ensure authenticity of the product used by the women.

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.

Dietary management of patients with a high-output stoma

A stoma enables faeces and flatus to be passed through a small surgically formed aperture in the abdominal wall, and may be temporary or permanent. However, in some cases, the output of a stoma can exceed normal limits. Without appropriate management, a high-output stoma can lead to dehydration, electrolyte disturbances and malnutrition in patients. Interventions to manage a high-output stoma include the use of oral rehydration solutions, restriction of hypotonic fluids and dietary modifications. This article reviews the causes of high-output stomas, and describes the assessment and management options available to nurses.

Effects of a Water, Sanitation and Hygiene Mobile Health Program on Respiratory Illness in Bangladesh: A Cluster-Randomized Controlled Trial of the CHoBI7 Mobile Health Program.

Acute respiratory infections are a leading cause of morbidity and mortality among young children globally. The objective of this study was to evaluate the impact of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) program on respiratory illness among diarrhea patients and their household members in urban Dhaka, Bangladesh. A cluster-randomized controlled trial of the CHoBI7 mHealth program was conducted among diarrhea patient households in Dhaka, Bangladesh. Patients were randomized to three arms: standard recommendation on oral rehydration solution use, health facility delivery of CHoBI7 plus mHealth (weekly voice and text messages for 12 months) (no home visits), and health facility delivery of CHoBI7 plus two home visits and mHealth. Respiratory symptoms were assessed during monthly clinical surveillance over the 12-month surveillance period. Respiratory illness was defined as rapid breathing, difficulty breathing, wheezing, or coughing. Two thousand six hundred twenty-six participants in 769 households were randomly allocated to three arms: 849 participants to the standard message arm, 886 to the mHealth with no home visits arm, and 891 to the mHealth with two home visits arm. Compared with the standard message arm, participants in the mHealth with no home visits arm (Prevalence Ratio [PR]: 0.89 [95% CI: 0.80, 0.98]), and the mHealth with two home visits arm (PR: 0.89 [95% CI: 0.81, 0.99]) had significantly lower respiratory illness prevalence over the 12-month program period. Our findings demonstrate that the CHoBI7 mHealth program is effective in reducing respiratory illness among diarrhea patient households.

Home-based management practice of diarrhea in under 5 years old children and associated factors among caregivers in Ginchi town, Oromia region, west Ethiopia.

Objective:The study was aimed to assess the home-based management practice of diarrhea and associated factors among caregivers in children under 5 years old at Ginchi town, Oromia region, West Ethiopia.Methods:A community-based cross-sectional study was conducted among 335 caregivers in Ginchi town. Data were collected using face-to-face interviewing questionnaires by using a systematic sampling technique. Data were entered into Epi-data version 3.5.1 and exported to statically software package for social science version 23.0 for analysis. Descriptive analyses were carried out. Bivariable and multivariable logistic regressions were done to identify predictors of home-based management practice of diarrhea in children under 5 years old.Result:The study had a total of 326 participants, with a 97.3% response rate. Accordingly, 193 (59%) have a good home-based management practice of diarrhea in children under the age of 5 years. Attended elementary school (adjusted odds ratio (95% confidence interval), 0.17 (0.06, 0.47)), high school education (adjusted odds ratio (95% confidence interval), 0.04 (0.013, 0.126)), monthly income in second class (adjusted odds ratio (95% confidence interval), 0.19 (0.04, 0.94)), and being mother in child relationship (adjusted odds ratio (95% confidence interval), 1.27 (1.4, 4.20)) were the identified predictors of home-based management practice of diarrhea in children under 5 years old.Conclusion:More than half of the respondents have a good home-based management practice of diarrhea in children under 5 years old. Caregivers’ educational status, being mothers of the child, and monthly income were the identified predictors. As a result, health education and awareness programs for caregivers on diarrhea control, proper use of oral rehydration solution, home-based fluid preparation, and diarrhea prevention are critical.

Knowledge and Attitude of Mothers Regarding Oral Rehydration Solution in Sulaimani

Background: Dehydration resulting from diarrhea is a significant cause of death of young children in developing countries. Oral rehydration solution (ORS) is useful to replace fluid and electrolyte loss. Objective: The main objective is to assess the knowledge, attitude and practice of mothers towards the use of oral rehydration solution in the treatment of acute diarrhea in children. Patients and Methods: This observational descriptive study was conducted at the pediatric medical emergency department of the Children‘s hospital and the institute of child health in Sulaimani city for a period of eight months from July 2012 till March 2013. The criteria of inclusion were mothers of children with diarrhea. A total of 200 mothers fulfilling the inclusion criteria were enrolled over the study period. Mothers were interviewed and information collected. A pre designed questionnaire was filled for each case by the investigator which included a detailed history highlighting their demographic data, presenting complaints , treatment given at home, mothers knowledge about ORS and drugs, maternal education, water sources, and socioeconomic history was taken and recorded carefully. All the data entered in SPSS and results were analyzed in percentages. Results: A total 200 mothers who visited the Pediatric Teaching Hospital in Sulaimani were interviewed. The median age of children group was 2 years, and minimum was (4 months)and maximum age was 8 years, of these 25(12.5%) were below 1 year, and 160 cases (80%) were between 1 to 5 years, and 15 cases (7.5%) more than 5 years. The most frequent age group was between 1 to 5 years, male were 101 (50.5%) and female were 99 female (49.5%), 58(29%) of mothers education were illiterate, and 105 (52.5%) of mothers education was low, and 37(18.5%) of mothers education was high. Among all the patients 172(86%) were from Sulaimani and 28(14%) from outside Sulaimani. Among all the patients the source of water used was well 103(51.5%), and 63(31.5%) was piped, and 34(17%) was tanks. Out of 200 mothers 199 (99.5%) heard about ORS and 1(0.5%) did not hear about it. Of these mothers 183(91.5%) used ORS. and 17(8.5%) did not use it. Among the mothers that usedORS, 7(3.5%) used it by themselves and 42(21%) were advised by family member and 85(42.5%) were advised by physician and 49(24.5%) were advised by health worker. The way of giving ORS wasby cup and spoonin 139(69.5%), and 44(22%) gaveORS by bottle. Of them 109(54.5%) amount of ORS given adequate amount and 74(37%) gave inadequately. And of them 107(53.5%) prepared ORS correctly and 76(38%) prepared the solution incorrectly. Among all mothers; 172(86%) used drugs and 28(14%) did not use drugs. Among those who use drugs 21(10.5%) used it by themselves and 151(75.5%) got advise by family physician. Conclusion: Although most of the mothers knew about ORS and used it at times of need, many had inadequate knowledge on the importance and appropriate use of ORS.

Practical Use of Oral Rehydration Solutions and their Implementation in ERAS Protocols (Literature Review)

Practical Use of Oral Rehydration Solutions and their Implementation in ERAS Protocols (Literature Review)

Comparative analysis and evaluation of current antidiarrheal prescribing trends with representative brand in pediatric population of Pakistan

Background: Prevalence of carpal tunnel syndrome (CTS) among pregnant women is very much common among the Background: Inappropriate management of diarrhea is the main cause of morbidity and mortality in the pediatric population worldwide, more especially in developing countries including Pakistan. Method: The sample size was calculated using World Health Organization (WHO) and Expanded Program on Immunization (EPI) info calculator. 240 prescriptions were collected from eight hospitals including four public hospitals (Pakistan Institute of Medical Sciences, Polyclinic Hospital, Holy family Hospital and Benazir Hospital) and four private hospitals (Hearts International Hospital, Maroof Hospital, Railway hospital, Bilal Hospital) of twin cities of Pakistan (Islamabad and Rawalpindi). Objectives: The purpose of this study was to analyze current prescribing trends of diarrheal management followed by comparative pharmaceutical evaluation of representative brands Parameters recorded from prescriptions were demographics (age and gender), presenting complaints and medications prescribed. Prescriptions were evaluated by their comparison with standard treatment guidelines. Results: Data were evaluated using a statistical package for social sciences (SPSS version 16.0) for descriptive statistics and cross-tabulations along with Chi square test. Diarrhea was presenting complaint in 106 (44%) of peads among age group 0-2 years. Out of 106 (44%) cases of diarrhea, 52 (20%) cases have prescribed an antibiotic in combination with other medications, which was not indicated according to standard guidelines. The use of oral rehydration solutions (ORS) was also limited. Zinc supplementation with ORS is indicated treatment for diarrhea and was prescribed to 21 (9%) cases. Conclusion: Hence, it has been concluded that standard treatment guidelines were not followed thoroughly which leads to increased morbidity, complications and cost.

Technological prospection of Diminazene Aceturate, an Angiotensin II Converting Enzyme activator, in front of diarrheic disorders

Diarrhea, which is a gastrointestinal disease, has as its main characteristic the rapid passage of gastric contents through the intestine, which leads to the loss of water and electrolytes and consequent dehydration. The most common fluid replacement is the use of oral rehydration solution (ORS) together with the use of the drug loperamide. However, the use of this medication can cause severe bacteremia followed by sepsis and even death. Currently, there is no effective pharmacological treatment for diarrhea, therefore, it is noted the importance of seeking new therapeutic targets for the treatment of this disease. Thus, the aim of the present study was to conduct a research on the biological activities already described for Diminazene Aceturate with a special focus on antidiarrheal agents. For this, a survey was carried out, through patent filing searches, in the USPTO, EPO, WIPO and INPI databases, using keywords and Boolean operators. Thus, it was found in the international patent databases the number of documents referring to the use of Diminazene Aceturate in several areas, mainly in the pharmaceutical industry, but with a relatively low number of documents regarding the description of possible antidiarrheal action of the compound under study , which reinforces the innovative character of research involving the use of Diminazene Aceturate as an antidiarrheal agent.

Addressing the Sub-Optimal Use of Oral Rehydration Solution for Childhood Diarrhoea in the Tropics: Findings From a Rural Setting in Nigeria.

Oral rehydration solution (ORS) is an evidence-based intervention to reduce diarrhoea-related morbidity and mortality, but consistently low rates of ORS use have been documented in Nigeria. To identify barriers to the optimal use of ORS for childhood diarrhoea in Nigeria and recommend appropriate interventions to improve uptake of ORS at community and facility levels. A quantitative cross-sectional survey of 400 mothers with children under 5 years of age was conducted in Nigeria to explore reasons for suboptimal utilization of ORS for childhood diarrhoea. An interviewer-administered questionnaire was used for data collection. Data were analysed using the statistical software SPSS version 21.0®. Sixty-one (15.3%) of the respondents were unaware of ORS. Of the 339 that were aware, their source of information was mainly hospital/health workers (81.1%). Among mothers that affirmed they could prepare ORS, only 64 (22.1%) prepared it correctly. Level of education significantly influenced awareness of ORS as well as its correct preparation. Nineteen mothers (5.6%) had difficulty getting ORS when needed, whereas 13 (3.8%) reported that it was difficult for them to remember how to prepare ORS. Four in ten children took ORS reluctantly or refused it outrightly. No cultural taboo concerning the use of ORS was reported. There is still a wide gap in the awareness of ORS and many caregivers prepared the solution incorrectly. We recommend that the method of preparation of ORS be clearly indicated on the sachets, and production of commercial 1-L water packages for ORS preparation be encouraged. Lay summaryOral rehydration solution (ORS) is an evidence-based intervention to reduce diarrhoea-related morbidity and mortality, but consistently low rates of ORS use have been documented in Nigeria. A quantitative cross-sectional study was carried out among 400 mothers to identify barriers to the optimal use of ORS for childhood diarrhoea and recommend appropriate interventions. Sixty-one (15.3%) of the respondents were unaware of ORS. Among mothers that affirmed they could prepare ORS, only 64 (22.1%) prepared it correctly. Level of education significantly influenced awareness of ORS as well as its correct preparation. Some mothers had difficulty getting ORS when needed, while some found it difficult to remember how to prepare it. Four in ten children took ORS reluctantly or refused it outrightly. No cultural taboo concerning the use of ORS was reported. The study showed that there is still a wide gap in the awareness of ORS and many caregivers prepared the solution incorrectly. Hence, we recommend that the method of preparation of ORS be clearly indicated on the sachets, and production of commercial 1-L water packages for ORS preparation be encouraged.

Effects of a Water, Sanitation, and Hygiene Mobile Health Program on Diarrhea and Child Growth in Bangladesh: A Cluster-randomized Controlled Trial of the Cholera Hospital-based Intervention for 7 Days (CHoBI7) Mobile Health Program

BackgroundThe Cholera Hospital-Based Intervention for 7 Days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh. MethodsPatients were block-randomized to 3 arms: standard message on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus 2 home visits and mHealth. The primary outcome was reported diarrhea in the past 2 weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12-month follow-up. Analysis was intention-to-treat.ResultsBetween 4 December 2016 and 26 April 2018, 2626 participants in 769 households were randomly allocated to 3 arms: 849 participants to the standard message arm, 886 to mHealth with no home visits arm, and 891 to the mHealth with 2 home visits. Children <5 years had significantly lower 12-month diarrhea prevalence in both the mHealth with 2 home visits arm (prevalence ratio [PR]: 0.73 [95% confidence interval {CI}, .61–.87]) and the mHealth with no home visits arm (PR: 0.82 [95% CI, .69–.97]). Children <2 years were significantly less likely to be stunted in both the mHealth with 2 home visits arm (33% vs 45%; odds ratio [OR]: 0.55 [95% CI, .31–.97]) and the mHealth with no home visits arm (32% vs 45%; OR: 0.54 [95% CI, .31–.96]) compared with children in the standard message arm.ConclusionsThe CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.Clinical Trials RegistrationNCT04008134.

Diarrhoeal disease knowledge among diarrhoea patient housholds: findings from the randomised controlled trial of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health program.

The objective of this study was to evaluate the impact of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) program on diarrhoeal disease knowledge among diarrhoea patients and their household members in urban Dhaka, Bangladesh. A cluster-randomised controlled trial of the CHoBI7 mHealth program was conducted among diarrhoea patient households in Dhaka, Bangladesh. Patients were randomised to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (weekly voice and text messages) (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. An open-ended questionnaire was administered to 1468 participants 12years of age or older on diarrhoeal disease transmission and prevention. These items were combined to form a diarrhoeal disease knowledge score measured at baseline and at a 1week, 6month and 12month follow-up. At baseline, when participants were asked to report three ways diarrhoeal diseases were spread 37% (546/1468) of participants reported by water, 13% (187/1468) by lack of handwashing and 4% (53/1468) by food not being covered properly. At baseline when asked to name three ways diarrhoeal diseases could be prevented, 35% (515/1468) of participants reported safe water, and 16% (228/1468) reported handwashing with soap. At the 12-month follow-up, the overall diarrhoeal disease knowledge score was significantly higher in the mHealth with no home visits arm (score coefficient: 0.69, 95% Confidence Interval: 0.36, 1.01, P<0.0001) and the mHealth with two home visits arm (score coefficient: 1.18, 95% CI: 0.87, 1.49, P<0.0001) compared with the standard recommendation arm. The CHoBI7 mHealth program significantly increased knowledge of diarrhoeal disease transmission and prevention among diarrhoea patients and their household members 12 months after in-person visits for program delivery were conducted.

Effect of a water, sanitation and hygiene program on handwashing with soap among household members of diarrhoea patients in healthcare facilities in Bangladesh: a cluster‐randomised controlled trial of the CHoBI7 mobile health program

The Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) is a water treatment and handwashing with soap intervention for diarrhoea patients and their household members which is initially delivered in a healthcare facility setting. This study evaluated the effectiveness of CHoBI7 program delivery in increasing handwashing with soap in a healthcare facility setting among diarrhoea patients and their household members. A randomised controlled trial of the CHoBI7 program was conducted among 404 diarrhoea patients and their accompanying household members in healthcare facilities in Dhaka, Bangladesh. The 'Standard Message' Arm received the standard message given in Bangladesh to diarrhoea patients on the use of oral rehydration solution. The 'Health Facility Visit+Soapy Water' Arm received the standard message, the CHoBI7 communication module delivered bedside to the patient; and a soapy water bottle in the healthcare facility. The 'Health Facility Visit+Handwashing Station' Arm received this same intervention plus a small plastic handwashing station. Within 24h of intervention delivery, three-hour structured observation of handwashing practices at stool/vomit- and food-related events (key events) was conducted in healthcare facilities of diarrhoea patients and their accompanying household members. Compared to the Standard Message Arm, there was significantly more handwashing with soap at key events in both the Health Facility Visit + Soapy Water Arm (51% vs. 25 %) (Odds Ratio: 3.02; (95% Confidence Interval (CI): 1.41, 6.45) and the Health Facility Visit+Handwashing Station Arm (58% vs. 25%) OR: 4.12; (95% CI: 1.86, 9.14). These findings demonstrate that delivery of the CHoBI7 communication module and provision of a soapy water bottle to diarrhoea patients and their accompanying household members presents a promising approach to increase handwashing with soap among this high risk population in a healthcare facility setting in Bangladesh.

Strong community-based health systems and national governance predict improvement in coverage of oral rehydration solution (ORS): a multilevel longitudinal model.

Diarrheal disease remains a leading cause of child death globally, especially in low and middle-income countries. Use of oral rehydration solution (ORS) for treatment of diarrhea in children, a very cost-effective intervention, remains below 50% in many countries. Here we use a multi-level longitudinal model to reveal important predictors of ORS use at the national level. The findings suggest that increasing government effectiveness along with increased implementation and affordability of community-based health programs can lead to substantial increases in ORS use. Key informant interviews with national health leaders in countries that significantly improved ORS coverage support these quantitative findings.

Diarrheal management approach among caregivers of under-5-year-old children in an Egyptian rural area

Objective The objective of this study was to assess the quality of diarrheal management practice and its relation to the sociodemographic characteristics of under-5-year-old children's caregivers. Background Diarrhea among under-5-year-oldchildren is a serious public health problem in many developing countries, including Egypt. Adequate diarrhea management approaches including the increased use of oral rehydration solution (ORS), extra fluid intake, and continued feeding are cost-effective in reducing the child mortality associated with diarrhea and the overall burden of the disease. Patients and methods A cross-sectional study was conducted on 100 under-5-year-oldchildren's caregivers in Munshaat Sultan village. All the studied children were evaluated through a questionnaire that involved questions about the history of diarrhea within two weeks before the interview, sociodemographic characteristics, and questions to classify the quality of diarrheal management practices into good, fair, or poor on the basis of mothers' reports for children with diarrhea, using WHO/United Nations International Children's Emergency Fund recommendations for appropriate treatment. Results Good diarrhea management practice was present among 36% of caregivers. About 24, 3, and 1% of children were given ORS and continued feeding, continued feeding and extra fluids, and ORS and extra fluids, respectively. There was a statistically significant difference between the quality of diarrheal management practice and mother's education, number of children in the family, socioeconomic standard, and child age. Children were given ORS, antibiotic, antidiarrheal medicine, and zinc in 43, 67, 52, and 21%, respectively. Conclusion Too many children are not receiving adequate management for diarrhea. Hence, the efforts should be increased to improve the quality of care for childhood diarrhea in both health facilities and at the community level.