1921
Volume 60, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In a household survey in Guinea-Bissau, 319 episodes of diarrhea in children were followed by interviews every second day with the aim of investigating perceived morbidity and subsequent actions taken. The majority of the mothers had good knowledge of oral rehydration salts (ORS). However, only 58% of the episodes were treated with ORS and the amount given was insufficient. Mothers with no knowledge of ORS did not use it during the observed attack of diarrhea regardless of contact with a health center, which suggests that maternal knowledge is an important determinant of whether health personnel provide ORS. Children with diarrhea considered to be caused by teething were less likely to receive ORS in the acute phase (risk ratio = 0.6, 95% confidence interval [CI] = 0.5-0.9). Univariate analyses showed that the use of ORS was related to number of reported symptoms, the mother being the care taker, consultations, previous use of ORS, good knowledge of ORS, and having ORS sachets at home. Multivariate Cox regression analyses showed that the presence of ORS sachets at home at the onset of diarrhea was the strongest predictor of use (hazard ratio = 3.3, 95% CI = 1.9-3.6). Improved health education should focus more on the quantity of ORS needed, early signs of dehydration, treatment of teething diarrhea, and breast feeding, and address mothers who have no prior knowledge of ORS. Management of diarrhea may be improved by a more liberal distribution of ORS sachets.

In a household survey in Bandim, Guinea-Bissau, 319 episodes of diarrhea in children of mean age 10.5 months were followed by interviews every second day of the episode until the mother reported that the diarrhea had stopped, the child was hospitalized, or 14 days had elapsed. Although most mothers knew about oral rehydration salts (ORS), only 58% of diarrhea episodes were treated with ORS and an inadequate amount was given to the child. Mothers who did not know about ORS failed to use it during the episode of diarrhea regardless of contact with a health center, suggesting that maternal knowledge is an important determinant of whether health personnel provide ORS. Children with diarrhea considered to be caused by teething were less likely to receive ORS during the acute phase. Univariate analysis found the use of ORS to be related to the number of reported symptoms, the mother being the caretaker, consultations, previous ORS use, good knowledge of ORS, and having ORS sachets at home. Multivariate Cox regression found the presence of ORS sachets at home at the onset of diarrhea to most strongly predict use. Improved health education should focus more upon the quantity of ORS needed, early signs of dehydration, the treatment of teething diarrhea, and breast-feeding, and reach out to mothers with no prior knowledge of ORS. Moreover, the management of diarrhea could be improved through the more liberal distribution of ORS sachets.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.1999.60.167
1999-01-01
2017-09-26
Loading full text...

Full text loading...

http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.1999.60.167
Loading

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error