Volume 85, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We sought to determine factors associated with appropriate diarrhea case management in Kenya. We conducted a cross-sectional survey of caregivers of children < 5 years of age with diarrhea in rural Asembo and urban Kibera. In Asembo, 61% of respondents provided oral rehydration therapy (ORT), 45% oral rehydration solution (ORS), and 64% continued feeding. In Kibera, 75% provided ORT, 43% ORS, and 46% continued feeding. Seeking care at a health facility, risk perception regarding death from diarrhea, and treating a child with oral medications were associated with ORT and ORS use. Availability of oral medication was negatively associated. A minority of caregivers reported that ORS is available in nearby shops. In Kenya, household case management of diarrhea remains inadequate for a substantial proportion of children. Health workers have a critical role in empowering caregivers regarding early treatment with ORT and continued feeding. Increasing community ORS availability is essential to improving diarrhea management.


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  1. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, , Bellagio Child Survival Study Group, 2003. How many child deaths can we prevent this year? Lancet 362: 6571.[Crossref] [Google Scholar]
  2. Boschi-Pinto C, Velebit L, Shibuya K, , 2008. Estimating child mortality due to diarrhea in developing countries. Bull World Health Organ 86: 710717.[Crossref] [Google Scholar]
  3. WHO, 2005. Handbook: IMCI Integrated Management of Childhood Illness. Geneva: WHO. [Google Scholar]
  4. UNICEF, 2009. State of the World's Children 2008. New York: UNICEF. [Google Scholar]
  5. Forsberg BC, Petzold MG, Tomson G, Allebeck P, , 2007. Diarrhea case management in low- and middle-income countries–an unfinished agenda. Bull World Health Organ 85: 4248.[Crossref] [Google Scholar]
  6. Ram PK, Choi M, Blum LS, Wamae AW, Mintz ED, Bartlett AV, , 2008. Declines in case management of diarrhea among children less than five years old. Bull World Health Organ 86(3): EF. [Google Scholar]
  7. Bureau of Statistics, Ministry of Health, and ORC Macro, 1998. Kenya Demographic and Health Survey 1998. Nairobi, Kenya: Kenya National Bureau of Statistics. [Google Scholar]
  8. Bureau of Statistics, Ministry of Health, and ORC Macro, 2004. Kenya Demographic and Health Survey 2003. Nairobi, Kenya: Kenya National Bureau of Statistics. [Google Scholar]
  9. Ngongo CJ, Mathingau FA, Burke H, Brieger W, Frick K, Chapman K, Breiman R, , 2007. Community participation to refine measures of socio-economic status in urban slum settings in Kenya. Int Q Community Health Educ 28: 3349.[Crossref] [Google Scholar]
  10. Bentley ME, , 1988. The household management of childhood diarrhea in rural north India. Soc Sci Med 27: 7585.[Crossref] [Google Scholar]
  11. De Zoysa I, Carson D, Feachem R, Kirkwood B, Lindsay-Smith E, Loewenson R, , 1984. Home-based oral rehydration therapy in rural Zimbabwe. Trans R Soc Trop Med Hyg 78: 102105.[Crossref] [Google Scholar]
  12. Yoder PS, , 1995. Examining ethnomedical diagnoses and treatment choices for diarrheal disorders in Lubumbashi Swahili. Med Anthropol 16: 211247.[Crossref] [Google Scholar]
  13. Vyas S, Kumaranayake L, , 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459468.[Crossref] [Google Scholar]
  14. Adazu K, Lindblade KA, Rosen DH, Odhiambo F, Ofware P, Kwach J, Van Eijk AM, Decock KM, Amornkul P, Karanja D, Vulule JM, Slutsker L, , 2005. Health and demographic surveillance in rural western Kenya: a platform for evaluating interventions to reduce morbidity and mortality from infectious diseases. Am J Trop Med Hyg 73: 11511158. [Google Scholar]
  15. Kenya National Bureau of Statistics and ICF Macro, 2010. Kenya Demographic and Health Survey 2008–09. Calverton, MD: KNBS and ICF Macro. [Google Scholar]
  16. Kenya Ministry of Public Health and Sanitation, 2010. Policy Guidelines on Control and Management of Diarrhoea Diseases in Children below Five Years in Kenya. Nairobi, Kenya: Kenya Ministry of Public Health and Sanitation, Division of Child and Adolescent Health. [Google Scholar]
  17. Coreil J, Genece E, , 1988. Adoption of oral rehydration therapy among Haitian mothers. Soc Sci Med 27: 8796.[Crossref] [Google Scholar]
  18. Hudelson PM, , 1993. ORS and the treatment of childhood diarrhea in Managua, Nicaragua. Soc Sci Med 37: 97103.[Crossref] [Google Scholar]
  19. Ellis AA, Winch P, Daou Z, Gilroy KE, Swedberg E, , 2007. Home management of childhood diarrhea in southern Mali–implications for the introduction of zinc treatment. Soc Sci Med 64: 701712.[Crossref] [Google Scholar]
  20. Teti DM, Gelfand DM, , 1991. Behavioral competence among mothers of infants in the first year: the mediational role of maternal self-efficacy. Child Dev 62: 918929.[Crossref] [Google Scholar]
  21. Lazzerini M, Ronfani L, , 2008. Oral zinc for treating diarrhea in children. Cochrane Database Syst Rev CD005436. [Google Scholar]
  22. Fischer Walker CL, Fontaine O, Young MW, Black RE, , 2009. Zinc and low osmolarity oral rehydration salts for diarrhea: a renewed call to action. Bull World Health Organ 87: 780786.[Crossref] [Google Scholar]
  23. UNICEF/WHO, 2009. Diarrhea: why children are still dying and what can be done. [Google Scholar]
  24. Bhandari N, Mazumder S, Taneja S, Dube B, Agarwal RC, Mahalanabis D, Fontaine O, Black RE, Bhan MK, , 2008. Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial. Pediatrics 121: e1279e1285.[Crossref] [Google Scholar]
  25. Gupta DN, SenGupta PG, Sircar BK, Mondal S, Sarkar S, Deb BC, , 1994. Implementation of ORT: some problems encountered in training of health workers during an operational research programme. Indian J Public Health 38: 6972. [Google Scholar]
  26. Rohde J, Northrup RS, , 1985. Diarrhea is a nutritional disease. Second International Conference on Oral Rehydration Therapy, December 10–13, 1985, Washington, DC: U.S. Agency for International Development. [Google Scholar]
  27. Sandhu BK, , 2001. Rationale for early feeding in childhood gastroenteritis. J Pediatr Gastroenterol Nutr 33 (Suppl 2): S13S16.[Crossref] [Google Scholar]
  28. Sullivan PB, , 1998. Nutritional management of acute diarrhea. Nutrition 14: 758762.[Crossref] [Google Scholar]

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  • Received : 25 Mar 2011
  • Accepted : 12 Jul 2011
  • Published online : 01 Dec 2011

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