Perception and Practices of Home Management of Acute Watery Diarrhoea and Its Impact on Dehydration
M. Z. Uddin
Paediatrics, 250 Bedded General Hospital, Jamalpur, Bangladesh.
K. Fatema *
Department of Pediatric Neurology, BSMMU, Bangladesh.
R. S. Begum
Kurmitola General Hospital, Kurmitola, Dhaka, Bangladesh.
T. Saad
Department of Pediatrics, Dhaka Medical College Hospital, Dhaka, Bangladesh.
M. M. Hossain
Pediatric Neurology, National Institute of Neuroscience, Dhaka, Bangladesh.
A. R. M. S. H. Khan
Department of Pediatric Neurology, BSMMU, Bangladesh.
M. Mohsin
Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Diarrhoea is one of the commonest causes of death in children in developing countries. Proper home management can reduce morbidity and mortality. High rates of dietary restriction, poor knowledge of preparation of ORS solutions and low attention given to clinical indicators are causes for seeking hospital management. This study was done to observe the knowledge of caregivers regarding home management of acute watery diarrhoea and to assess the impact of home management on severity of dehydration.
Methods: This study was a prospective study carried out on children with acute diarrhea who attended outpatient department (OPD) of Rangpur Medical College Hospital and duration of the study was 6 months. A total of 100 cases were included in this study who fulfilled the definition of acute diarrhea by WHO. The investigator questioned each mother with the help of a preformed questionnaire.
Results: In 85% of cases, caregivers perception about diarrhea was an increase in the frequency and fluidity of stool. About 95% of cases were initially treated at home; treatment was given at home with ORS (95%). There was change in feeding pattern and modified food was given (24%). Perception about ORS preparation was appropriate in 64% and inappropriate in 31% of cases. Inadequate amount of ORS was given in 74% cases. There was no interruption of breast feeding; dietary restriction during diarrhoea was observed only in 2% cases. Most of the parents did not know when to return immediately to hospital. Dehydration status of diarrhoeal cases was no dehydration (81%), some dehydration (18%) and severe dehydration (1%). In majority of the cases different drugs were used.
Conclusion: Most of the caregivers’ decided to treat diarrhoea at home. Many of them had wrong perception about preparation of ORS and some of them did not know how to make ORS solution. Inadequate amount of ORS was given in most of the cases. Thus to lessen hospital burden and to prevent dehydration increased emphasis should be given to health education of home management of diarrhea.
Keywords: Diarrhoea, ORS, home management; breast feeding, dehydration.