Knowledge and Practices on the Prevention and Management of Diarrhea in Children Under-2 Years Among Women Dwelling in Urban Slums of Karachi, Pakistan

Abstract

Background Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps in the slums of Gadap Town, Karachi, Pakistan. Method A community-based cross-sectional study was conducted from November 2016 to May 2017 among mothers of children under 2 years, who were residents of Gadap Town, Karachi, Pakistan. The participants were approached by a multistage sampling method. A validated dichotomous questionnaire, piloted on 40 participants, translated into local language Urdu was used for data collection and the data was analyzed by SPSS® version 20.0. Results 51.8% (n = 199) of participants were aged between 25 and 34 years. Among all participants, 68% (n = 261) had primary level education or less, compared to 4.7% (n = 18) of women who had graduate-level education. The mean number of children per woman was 2.52 ± 1.62. Self-reported pediatric diarrhea incidence was 72.1% (n = 277). More than half (55.2% n = 149) of participants reported frequent diarrhea episodes during the 2nd year of their child’s life. In this survey, we found the knowledge of women regarding diarrhea management and how to reduce diarrhea morbidity to be inadequate (p > 0.05). However, many women reported appropriate practices which can significantly reduce diarrhea morbidity (p < 0.05). Conclusion While the knowledge among women on preventive measures for pediatric diarrhea was insufficient, the translation of the right knowledge into appropriate practices showed promising outcomes for reducing diarrhea morbidity. An integrated approach for improving feeding, sanitation, and hygiene practices along with continuous health education could curtail the burden of diarrhea among infants living in urban slums.

Association of Infant Feeding Indicators and Infant Feeding Practices with Coexisting Forms of Malnutrition in Children under Six Months of Age

“…Lack of association between various types of SBF and CFM in our study might be due to the cross-sectional study design and social desirability bias, or overreporting of socially desirable behaviors during an interview and survey [49]. The social desirability biasness of the participants can be controlled by conducting indirect questioning, qualitative research and intervention trials [50,51].…”

Assessment of Determinants of Paediatric Diarrhoea Case Management Adherence in Pakistan

“…Similarly, the cultural practice of food abstinence during diarrhoeal illness and lack of maternal knowledge about diarrhoea case management also contributes to the low adherence (34). Different studies conducted in Pakistan reflected that most mothers are well-aware of zinc and ORS use for managing paediatric diarrhoea (18,35,36). However, a study conducted in the urban slums of Karachi reported inappropriate diarrhoea case management practices despite having adequate knowledge regarding diarrhoea case management (18).…”

“…Different studies conducted in Pakistan reflected that most mothers are well-aware of zinc and ORS use for managing paediatric diarrhoea (18,35,36). However, a study conducted in the urban slums of Karachi reported inappropriate diarrhoea case management practices despite having adequate knowledge regarding diarrhoea case management (18). The knowledge-practice gap for diarrhoea case management can be averted by performing ethnographic studies, and these ethnographic studies would explore the underlying barriers to diarrhoea case management among Pakistani children.…”

“…Based on the findings of our study, we proposed a need for standardized dietary practices to manage paediatric diarrhoea aged between 6 to 59.9 months (38). Different literatures published in the past proposed using yogurt, banana, and rice with lentils because of their pre-biotic, hyperkalemic, and antidiarrhoeal properties (18,20,21). In this regard, promoting the coadministration of zinc & ORS with adequate food and fluid intake during diarrhoea case management is essential.…”

Peran Serta Masyarakat dengan Angka Kejadian Diare

“…Sementara pengetahuan di antara wanita tentang langkah-langkah pencegahan untuk diare anak tidak cukup, terjemahan pengetahuan yang tepat ke dalam praktik yang tepat menunjukkan hasil yang menjanjikan untuk mengurangi morbiditas diare. Pendekatan terpadu untuk meningkatkan praktik pemberian makan, sanitasi, dan kebersihan bersama dengan pendidikan kesehatan berkelanjutan dapat mengurangi beban diare di antara bayi yang tinggal di daerah kumuh perkotaan (Khaliq et al, 2022). Piperlukan kolaborasi lebih lanjut antara pemerintah dan lembaga swadaya masyarakat untuk mengidentifikasi faktor-faktor penularan diare yang masih ada di berbagai komunitas di wilayah tersebut (Mekonnen et al, 2019).…”