Treatment patterns of childhood diarrhoea in rural Uganda: a cross-sectional survey

Abstract

BackgroundDiarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. In order to seek options for such improvements this study explored the knowledge and practices of diarrhoea case management among health care providers at health centres and drug shops in Uganda.MethodsRecords were reviewed for case management and structured interviews concerning knowledge and practices were conducted with the staff at all health centres and at all identified drug shops in the rural district of Namutumba, Uganda.ResultsThere was a significant gap between knowledge and documented practices among staff. Antibiotics, antimalarials and antipyretics were prescribed or recommended as frequently as Oral Rehydration Solution (ORS). In almost a third of the health facilities, ORS was out of stock. 81% of staff in health centres and 87% of staff in drug shops stated that they prescribed antibiotics for common diarrhoea. Zinc was not prescribed or recommended in any case.ConclusionsThe findings indicate that many children presenting with diarrhoea are inadequately treated. As a result they may not get the rehydration they need and are at risk of potential side effects from unjustified usage of antibiotics. Practices must be improved at health centres and drug shops in order to reduce childhood mortality due to diarrhoeal diseases.

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

“…It found that knowledge was strongly associated with level of education. 41 As with present study, age, sex, and having received any formal medical trainings, were also shown to have no significant relationship with knowledge in a previous study that was conducted in Kogi and Kwara states. 14 Regular recommendation of ORS was reported by 87% of participants in this study, whereas 64% of PPMVs reported regular recommendation of zinc.…”

“…44 It has, however, been reported by one study that there was a significant gap between knowledge and documented practices, and though health workers reported carrying out an activity, this did not reflect what was actually done. 7,41 High knowledge score, ORS availability at time of survey and zinc supplement use were significant predictors of ORS recommendation. This study also reports that awareness and possession of treatment guidelines, stocking of zinc, recommendation of ORS, as well as satisfactory knowledge category were strong predictors of recommendation of zinc.…”

“…This is in keeping with studies that were conducted in Lagos and Kwara states, as well as Uganda where it was identified that many PPMVs lacked the knowledge to treat childhood diarrhoea. 7,14,41 Another study that was conducted in Enugu, south-east Nigeria found that 64% of PPMVs had good knowledge of cause, types, signs and effects of diarrhoea; with 68% of them being able to identify ORS as first line treatment of childhood diarrhoea. 42 The same study revealed only 33% and 49% respectively demonstrated knowledge in prevention activities, and therapeutic use of ORS.…”

“…7 Another study conducted in Uganda revealed that 70% of workers at drug shops claimed to recommend ORS. 41 These reported increases in prescribing ORS products might be explained by an increased information penetration within the community due to mass media campaigns, access to the internet and activities of community-based organisations. This differs from a study conducted in Benin, Nigeria, which reported that 35% of healthcare providers used zinc and 10% used it in every case of child diarrhoea.…”

Appropriateness of Antibiotic use for the Management of Acute Diarrhea Among Under-Five Children Treated at Primary Care Centers in Northwest Ethiopia: A Cross-Sectional Study

“…It accounts 1.8 million deaths annually. Majority of these death happen in South Asia and Africa [4]. In Ethiopia, diarrhea remains a serious public health problem as it is the major killer of children with an estimated 73,700 deaths of under-ve children.…”