Why are there delays in seeking treatment for childhood diarrhoea in <scp>I</scp>ndia?

Malhotra, Nisha; Upadhyay, Ravi Prakash

doi:10.1111/apa.12304

Cited by 36 publications

(39 citation statements)

References 17 publications

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“…Our findings revealed that caretakers were 1.8 times more likely to delay consulting a health facility if their child was a female than male. Similar findings were reported in studies done in Pakistan, India and Africa [16,18,19]. Surprisingly, age of child was not found to influence health facility consultation in this study.…”

Section: Discussionsupporting

confidence: 92%

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Ndungu¹

2018

AJP

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Acute respiratory infection (ARI) is a leading cause of childhood morbidity and mortality in developing countries. In Kenya, diagnosis and treatment of ARI remains predominantly health facility based. This presumes that caretakers can recognize ARI symptoms promptly and make a decision to take the child to an appropriate health facility for treatment. Unfortunately, these presumptions have not been assessed. This study sought to establish determinants of health care seeking among caretakers of children under five years (CU5) of age with ARI. An analytic cross sectional survey was carried out in Githunguri Sub-County of Kiambu County. Households with CU5 who had recently suffered an episode of ARI were enrolled. Structured questionnaires, focused group discussions and key informant guides were used to gather information. Structured questionnaires were administered to caretakers to obtain information on socio-demographics, knowledge and health seeking practices. Bivariate and multivariate analysis was carried out with a p value of < 0.05. From 438 households sampled, 323 (73.7%) had CU5 in their households. Out of these, 240 (74.3%) of the children had an episode of ARI in the preceding 2 weeks. The mean age of the children was 29.2 months, with male to female ratio of 1:1. The mean mothers' age was 29.4 years, 71.2% were married, 54.8% had secondary education and 66.6% were of Christian-protestants faith and (90.0%) were in informal employment. Poor knowledge of pneumonia was documented in 92.5% of caretakers. One hundred and forty nine (62.1%) caretakers had delayed health facility consultation for ARI. The main factors associated with delayed facility consultation were poor knowledge of symptoms (p = 0.007) long distance to the nearest health facility (p = 0.002), means of transport used to access the nearest health facility (p = 0.001) and previous high expenditure at health facility (p = 0.011). On logistic regression, the main factors that independently determined delayed facility consultation were long waiting time (>1hour) before service provision (p = 0.001), use of a motorbike to access the nearest health facility (p = 0.001) and traveling for 4-4.9 kilo meters to the nearest health facility (p = 0.002). Travelling for long distance and long waiting time before service provision during the previous facility visit were the main determinants of delayed facility consultations. The study recommends increased sensitization on symptom recognition among caretakers, and intensified efforts to reduce turnaround time during health facility consultations in order to minimize delays in health facility consultation.

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Section: Discussionsupporting

confidence: 92%

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Ndungu¹

2018

AJP

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“…These studies showed no differences in care-seeking behaviour or at times even a preference of the female sex (24–26). Nevertheless, there is evidence supporting the assumption that girls experience higher treatment delays (27–29) and are less likely to be examined by a qualified health care provider (30). Besides, the higher prevalence rates of diarrhoea in the first two years of life are analogous to previous findings (31).…”

Section: Discussionmentioning

confidence: 99%

Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level

Diouf

Tabatabai

Rudolph

et al. 2014

Global Health Action

107

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BackgroundDiarrhoea is the second leading cause of child mortality worldwide. Low- and middle-income countries are particularly burdened with this both preventable and treatable condition. Targeted interventions include the provision of safe water, the use of sanitation facilities and hygiene education, but are implemented with varying local success.ObjectiveTo determine the prevalence of and factors associated with diarrhoea in children under five years of age in rural Burundi.DesignA cross-sectional survey was conducted among 551 rural households in northwestern Burundi. Areas of inquiry included 1) socio-demographic information, 2) diarrhoea period prevalence and treatment, 3) behaviour and knowledge, 4) socio-economic indicators, 5) access to water and water chain as well as 6) sanitation and personal/children's hygiene.ResultsA total of 903 children were enrolled. The overall diarrhoea prevalence was 32.6%. Forty-six per cent (n=255) of households collected drinking water from improved water sources and only 3% (n=17) had access to improved sanitation. We found a lower prevalence of diarrhoea in children whose primary caretakers received hygiene education (17.9%), boiled water prior to its utilisation (19.4%) and were aged 40 or older (17.9%). Diarrhoea was associated with factors such as the mother's age being less than 25 and the conviction that diarrhoea could not be prevented. No gender differences were detected regarding diarrhoea prevalence or the caretaker's decision to treat.ConclusionsDiarrhoea prevalence can be reduced through hygiene education and point-of use household water treatment such as boiling. In order to maximise the impact on children's health in the given rural setting, future interventions must assure systematic and regular hygiene education at the household and community level.

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“…The WHO predicts that there will still be about 5 million deaths in children younger than 5 years by 2025; most of these will be in developing countries, and most will be due to infectious diseases such as diarrhea (12). Diarrheal disease deaths are largely preventable if adequate treatment is sought early in the course of the illness (13). Recent studies suggest that rapid detection systems can decrease the costs associated with hospitalization and refine the application of antibiotic treatment (5).…”

Section: Discussionmentioning

confidence: 99%

Pentaplex PCR Assay for Detection of Hemorrhagic Bacteria from Stool Samples

2014

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Diarrheal diseases cause illness and death among children younger than 10 years in developing countries. Conventional testing for the detection of hemorrhagic bacteria takes 2 to 5 days to yield complete information on the organism and its antibiotic sensitivity pattern. Hence, in the present study, we developed a molecular-based diagnostic assay that identifies common hemorrhagic bacteria in stool samples. A set of specific primers were designed for the detection of Salmonella spp., Shigella spp., enterohemorrhagic Escherichia coli (EHEC), and Campylobacter spp., suitable for use in a one-tube PCR assay. The assay in the present study simultaneously detected five genes, namely, ompC for the Salmonella genus, virA for the Shigella genus, eaeA for EHEC, 16S rRNA for the Campylobacter genus, and hemA for an internal control. Specific primer pairs were successfully designed and simultaneously amplified the targeted genes. Validation with 20 Gram-negative and 17 Gram-positive strains yielded 100% specificity. The limit of detection of the multiplex PCR assay was 1 ؋ 10 3 CFU at the bacterial cell level and 100 pg at the genomic DNA level. Further evaluation of the multiplex PCR with 223 bacterium-spiked stool specimens revealed 100% sensitivity and specificity. We conclude that the developed multiplex PCR assay was rapid, giving results within 4 h, which is essential for the identification of hemorrhagic bacteria, and it might be useful as an additional diagnostic tool whenever time is important in the diagnosis of hemorrhagic bacteria that cause diarrhea. In addition, the presence of an internal control in the multiplex PCR assay is important for excluding false-negative cases.

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Why are there delays in seeking treatment for childhood diarrhoea in India?

Cited by 36 publications

References 17 publications

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Cross Sectional Survey of Care Seeking For Acute Respiratory Illness in Children Under 5 Years in Rural Kenya

Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level

Pentaplex PCR Assay for Detection of Hemorrhagic Bacteria from Stool Samples

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