Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

Yeshaw, Yigizie; Worku, Misganaw Gebrie; Tessema, Zemenu Tadesse; Teshale, Achamyeleh Birhanu; Tesema, Getayeneh Antehunegn

doi:10.1371/journal.pone.0243245

Cited by 13 publications

(30 citation statements)

References 20 publications

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“…We even found a claim that zinc was not recommended in the Thai guideline. However, Thai guidelines for the treatment of acute diarrhea list zinc as one of the treatments [ 18 19 ], Our finding was agreed with the finding that zinc was not generally given to patients [ 15 20 ] and inadequate knowledge and clinical training were the reason for inappropriate drug prescription [ 21 ].…”

Section: Discussionsupporting

confidence: 84%

Medication selection for the treatment of acute infective diarrhea in Thai pharmacies: a qualitative study

Leelakanok

Petchsomrit

Methaneethorn

et al. 2021

Transl Clin Pharmacol

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World Health Organization (WHO) released the treatment manual of diarrhea in 2005. We aimed to investigate the rationale for selecting medications for acute infective diarrhea in Thai community pharmacies and to see if the selection complied with the WHO manual. A theoretical 18-year-old patient with acute infective diarrhea was used for interviews. The protocol and materials for the research were approved by Institutional Review Board. A total of 30 drugstore personnel were selected by convenience sampling and included. The first author manually coded, extracted for themes, and translated the transcript. Participants did not dispense oral rehydration salt because of the feeling that diarrhea was not severe. Absorbents were dispensed because they were perceived as the first-line medication for noninfective or mild diarrhea. Antibiotics were dispensed because of the concerns for the prognosis and the expected patient pressure. None provided zinc to the patient because of the lack of knowledge of the indication of zinc. We found that dispensing for acute infective diarrhea in Thai drugstores deviated from the WHO treatment guideline. The reasons were that the pharmacy personnel were not practicing evidence-based medicine, the lack of knowledge, the patient pressure, the unavailability of products, and the perceived availability of information in local guidelines.

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Section: Discussionsupporting

confidence: 84%

Medication selection for the treatment of acute infective diarrhea in Thai pharmacies: a qualitative study

Leelakanok

Petchsomrit

Methaneethorn

et al. 2021

Transl Clin Pharmacol

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“…Contrary to recent findings from Ethiopia, our results suggest that maternal education, media exposure, and the number of under-5 children in a household were not associated with zinc supplementation. 28 More than 40% of women in the current study had no media exposure; hence, this may be a possible reason for our findings. Nonetheless, these results warrant further investigation.…”

Section: Discussionmentioning

confidence: 71%

Association Between Source of Treatment and Quality of Childhood Diarrhea Management Among Under-Five Children in Nigeria

Olorunsaiye

Degge

Saigh

2021

Int. J. Transl Med Res Public Health

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Background and Objective: Despite the availability of low-cost and effective interventions, diarrhea remains one of the leading causes of under-five morbidity and mortality in Nigeria. We assessed the relationships between the source and quality of treatment for children with diarrhea in Nigeria. Methods: We analyzed cross-sectional data on 3,956 under-five children with a recent diarrheal episode, from the 2018 Nigeria Demographic and Health Survey. The outcome was quality of diarrhea management based on the administration of the following treatment recommendations: oral rehydration salt (ORS), zinc supplementation, increased oral fluids, and continued feeding. The exposure was the source of treatment (none; traditional/informal; public hospitals/health centers; private hospitals/clinics; and community-based services). Using adjusted, multivariable logistic regression, we estimated the odds ratio (OR) and 95% confidence intervals (CI) to predict the factors related to the quality of diarrhea management. Results: In all, only 1 in 5 children received all the four recommended diarrhea interventions. The odds of good quality diarrhea management were higher among children who received treatment in public hospitals/health centers, private hospitals/clinics, and community-based services compared to those of children who did not receive treatment (OR=2.52, 95% CI=1.89-3.34; OR=2.46, 95% CI=1.90-3.16; and OR=1.91, 95% CI=1.40-2.59, respectively). Compared to children whose parents did not seek treatment, the odds of receiving ORS ranged from 2.1 times (OR: 2.11, 95% CI=1.44-3.11) for seeking care in traditional/informal sources to 12.3 times (95% CI=8.81-17.15) in public hospitals/health centers. We observed similar trends for zinc supplementation. The odds of increased oral fluids were higher in public and private hospitals/clinics (OR=1.44, 95% CI=1.03-2.01 and OR=2.08, 95% CI=1.57-2.76, respectively). Across all settings, the odds of continued feeding were significantly lower among children who received treatment compared to children who did not receive treatment. Conclusion and Implications for Translation: Our findings indicate poor quality diarrhea management across various treatment settings. Policies and programs that encourage caregivers to seek treatment and improve the quality of care may contribute to reducing childhood diarrhea-related morbidity and mortality in Nigeria. Copyright © 2021 Olorunsaiye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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Section: Introductionmentioning

confidence: 99%

“…The prescription and intent to give therapeutic zinc for diminutions of acute diarrhea varied across the world, 49% in Bangladesh, 18% in Tanzania, 10% in Nigeria, 15% in Sudan, and 21.54% in Ethiopia [ 1 ]. Of the East African countries, Uganda had the highest (40.51%) and Comoros was the lowest (0.44%) ever reported countries [ 1 , 4 ]. The recommended dosage of therapeutic zinc for the treatment of acute diarrhea is 20 mg per day for above six and 10 mg per day for under six months of children until 10–14 days were prescribed [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Of the East African countries, Uganda had the highest (40.51%) and Comoros was the lowest (0.44%) ever reported countries [ 1 , 4 ]. The recommended dosage of therapeutic zinc for the treatment of acute diarrhea is 20 mg per day for above six and 10 mg per day for under six months of children until 10–14 days were prescribed [ 1 ]. The low level of zinc in serum is estimated to be responsible for 21% of worldwide deaths for under-five age children [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Does Therapeutic Zinc Level of Supplementation for Diminutions of Acute Diarrheal Morbidity Varied in Public and Private Health Institutions in Ethiopia, Data from EDHS 2016?

Kebede

Markos

2022

International Journal of Pediatrics

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Background. Supplementation of zinc is a therapeutic medication for under-five children diminution incidence, severity, duration, and intensity of acute diarrhea morbidity. Nevertheless, levels of therapeutic zinc supplementation varied across public and private health institutions in Ethiopia. Thus, this study was aimed at estimating the levels of therapeutic zinc supplementation and factors associated for intent to be utilized among caregivers with their dyads, data from Ethiopia Demographic and Health Survey (EDHS 2016). Methods. The data used were from a secondary analysis of the Ethiopia Demographic and Health Survey in 2016 (EDHS). Overall, 1090 under-five children with acute diarrheal cases of two weeks before the EDHS 2016 were included. After cleaning, editing, and coding variables, the result was presented with frequency, tables, and graphs. Bivariable and multivariable logistic regression was conducted to identify and determine factors associated after zinc is prescribed for utilizations by caregivers. Result. The mean (±SD) age of participant children was found to be 36.4(±7.07) month. The overall levels of therapeutic zinc supplementation were 38.7% (95% CI: 35.8, 41.6) in public (29.08%) and private 138 (12.66%), respectively. The prescribed therapeutic zinc was influenced for utilization through maternal educational status ( AOR = 2.55 ; 95% CI: 1.95, 3.47; P = 0.001 ), availability of health insurance ( AOR = 10.7 ; 95% CI: 7.2, 16; P = 0.001 ), media exposure status ( AOR = 2.1 ; 95% CI: 1.7, 3.6; P = 0.001 ). Conclusion. More than twofold time therapeutic zinc was prescribed in public than in private health institutions. Health care workers should be encouraged both in public and private health institutions for zinc prescription.

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Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

Cited by 13 publications

References 20 publications

Medication selection for the treatment of acute infective diarrhea in Thai pharmacies: a qualitative study

Medication selection for the treatment of acute infective diarrhea in Thai pharmacies: a qualitative study

Association Between Source of Treatment and Quality of Childhood Diarrhea Management Among Under-Five Children in Nigeria

Does Therapeutic Zinc Level of Supplementation for Diminutions of Acute Diarrheal Morbidity Varied in Public and Private Health Institutions in Ethiopia, Data from EDHS 2016?

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