Oral rehydration solution coverage in under 5 children with diarrhea: a tri-country, subnational, cross-sectional comparative analysis of two demographic health surveys cycles

Abstract

Background More than 3 million children under 5 years in developing countries die from dehydration due to diarrhea, a preventable and treatable disease. We conducted a comparative analysis of two Demographic Health Survey (DHS) cycles to examine changes in ORS coverage in Zimbabwe, Zambia and Malawi. These surveys are cross-sectional conducted on a representative sample of the non-institutionalized individuals. Methods The sample is drawn using a stratified two-stage cluster sampling design with census enumeration areas, typically, selected first as primary sampling units (PSUs) and then a fixed number of households from each PSU. We examined national and sub-regional prevalence of ORS use during a recent episode of diarrhea (within 2 weeks of survey) using DHSs for 2007–2010 (1st Period), and 2013–2016 (2nd Period). Weighted proportions of ORS were obtained and multivariable- design-adjusted logistic regression analysis was used to obtain Odds Ratios (aORs) and 95% confidence intervals (CIs) and weighted proportions of ORS coverage. Results Crude ORS coverage increased from 21.0% (95% CI: 17.4–24.9) in 1st Period to 40.5% (36.5–44.6) in 2nd Period in Zimbabwe; increased from 60.8% (56.1–65.3) to 64.7% (61.8–67.5) in Zambia; and decreased from 72.3% (68.4–75.9) to 64.6% (60.9–68.1) in Malawi. The rates of change in coverage among provinces in Zimbabwe ranged from 10.3% over the three cycles (approximately 10 years) in Midlands to 44.2% in Matabeleland South; in Zambia from − 9.5% in Eastern Province to 24.4% in Luapula; and in Malawi from − 16.5% in the Northern Province to − 3.2% in Southern Province. The aORs for ORS use was 3.95(2.66–5.86) for Zimbabwe, 2.83 (2.35–3.40) for Zambia, and, 0.71(0.59–0.87) for Malawi. Conclusion ORS coverage increased in Zimbabwe, stagnated in Zambia, but declined in Malawi. Monitoring national and province-level trends of ORS use illuminates geographic inequalities and helps identify priority areas for targeting resource allocation.. Provision of safe drinking-water, adequate sanitation and hygiene will help reduce the causes and the incidence of diarrhea. Health policies to strengthen access to appropriate treatments such as vaccines for rotavirus and cholera and promoting use of ORS to reduce the burden of diarrhea should be developed and implemented.

Antibiotic Prescription Patterns in Children Under 5 Years of Age With Acute Diarrhea in Quito-Ecuador

“…Notably, these findings align with similar studies conducted in different regions, reporting ORS utilization rates of 40.5% in Zimbabwe, 64.7% in Zambia, 64.6% in Malawi, 67% in Ethiopia, and 52.8 in Brazil. 30 - 32 These comparative data highlight the consistency of ORS usage as a common practice for AD management across various settings.…”

Coutilisation of oral rehydration solution and zinc for treating diarrhoea and its associated factors among under-five children in East Africa: a multilevel robust Poisson regression

“…2 Less than 7% of children under the age of 5 in low-income and middle-income countries (LMICs) receive zinc treatment, according to a 2017 UNICEF report, and only 44% of them receive ORS. 18 Access to this life-saving medicine might be made easier in many of these nations, many of which have high mortality rates from diarrhoea. 19 In East Africa, only a small percentage of under-5 children receive effective treatment or ORS with Zinc for diarrhoeal disease.…”

“…However, the global prevalence of using ORS with zinc to treat diarrhoea continues to be alarmingly low 2. Less than 7% of children under the age of 5 in low-income and middle-income countries (LMICs) receive zinc treatment, according to a 2017 UNICEF report, and only 44% of them receive ORS 18. Access to this life-saving medicine might be made easier in many of these nations, many of which have high mortality rates from diarrhoea 19…”

ApoE Mimetic Peptides to Improve the Vicious Cycle of Malnutrition and Enteric Infections by Targeting the Intestinal and Blood-Brain Barriers

“…The close follow-up of this at-risk population by health professionals has led to improved child mortality through oral rehydration therapy, helping to reduce diarrheal burdens. Even with this emergency measure, enteric infections may persist, disrupting intestinal absorption and resulting in barrier functions and sustained growth stunting [11,61,62]. Early diet restrictions and enteric pathogens influence the active remodeling of the intestinal microbiota in the first months of life when the characteristics of the microbiota of adults develop.…”