Caregiver Recognition of Childhood Diarrhea, Care Seeking Behaviors and Home Treatment Practices in Rural Burkina Faso: A Cross-Sectional Survey

Abstract

IntroductionTo design effective national diarrhea control programs, including oral rehydration solution (ORS) and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices.MethodsA cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥3 liquid or semi-liquid stools/day). Multiple logistic regression models were used to examine factors associated with illness recognition and treatment.ResultsClinically defined diarrhea was present in 7.6% (95% CI: 7.1–8.1%) of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55%) of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area.ConclusionsCaregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional assistance to recognize diarrhea correctly, and both caregivers and health care providers need updated training on current diarrhea treatment recommendations.

Knowledge and attitude towards oral rehydration therapy among mothers of under-five children of South Rajasthan, India

“…10,11 The awareness of home available fluids for rehydration was higher in our study compared to the Aligarh study. 10 This might be explained by the urban setting of the study with ready availability of ORS at low cost and hence rendering home-made ORS unnecessary.…”

“…10,12 On the other hand, knowledge of specific warning signs related to severe dehydration was low. Mothers are still deficient in knowledge regarding danger sign in diarrhoea and indication of admission.…”

Study of health-care seeking behavior of parents for child health problems in an urban slum area of Solapur

“…[4] A study conducted in a rural setting found higher male child preference in seeking health-care seeking behavior. [15] In our study, the high utilization of private facilities could be attributed to the proximity of private clinic. The parents engaged in occupation mainly based on daily wages, so private clinic was an easier and quicker alternative as it consumed less time.…”

Factors Influencing Timely Response to Health Care Seeking for Diarrheal Episodes Among Children Under Five by Caregivers in Rural Uganda

“…Some of the commonly reported signs were child not playing normally, blood in stool, fever for more than 24 hours and 03 or more loose stools in one day. However these signs are sometimes attributed to other illnesses other than diarrhoea [19]. Those who did not understand the signs reported that they would wait to first be sure as they would mistake this for other conditions such as teething or learning how to sit.…”