Assessment of mothers' knowledge and use of oral rehydration therapy for diarrhoea in children under 5 years in Ife, Nigeria

Diarrhoeadisease is the second leading cause of death in children under 5 years old, and is responsible for killing about 300, 000 children annually in Nigeria. Oral rehydration therapy (ORT) is the preferred treatment for fluid and electrolyte losses due to diarrhoea in children with mild to moderate dehydration. This study aimed to assess the knowledge and use of ORT in the management of diarrhoea in children under 5 years at Seventh Day Adventist Hospital (SDAH, Ife).Method: A structured questionnaire was adopted for this study design and data was collected using a self-structured questionnaire both self-administered and interviewer administered.Results: Of 80 participants, 44 (55%) of the respondents had heard of ORT before this study, while 36 (45%) had not. 48 (60%) responded that they use oral rehydration solution while 32 (40%) of mothers said they had not used ORT. There was significant difference in both outcomes. The result revealed that there was significant difference in morbidity and mortality between mothers who use ORT and those who do not. But there was no significant difference between the knowledge of ORT compared with its use.Conclusion:Appropriate knowledge of the therapy will positively influence its use which will drastically prevent morbidity associated with diarrhoea as well as contain the incidence of mortality

Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa

Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization's child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative. Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children's growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.

Socio-demographic determinants of diarrhoeal diseases among under five years old children in Rwanda

Background Diarrhoeal disease is a worldwide public health issue and remains a major cause of mortality and morbidity in children under five years old. Low and middle income countries (LMIC) of Africa and part of Asia are more affected by diarrhoeal diseases. Objectives To measure the prevalence of Diarrhoeal Diseases and to assess Socio-demographic determinants among Under Five Years Old Children in Rwanda. Methods A cross-sectional design was used. Secondary data analysis was carried out on a sample of 7474 drawn from Rwanda Demographic and Health Survey (RDHS). RDHS used multistage sampling technique. Results After running multiple logistic regression, Sociodemographic determinants associated with diarrhoeal included age of children, wealth index category, mother education, husband/partner education, types of place of residence (P-Value) Conclusion The results of the study showed that diarrhoeal remains an important health issue in Rwanda. Occurrence of diarrhoeal was statistically associated with child age, wealth index, education of parents, types of place of residence.

Accès à l'assainissement, eau et maladies diarrhéiques des enfants dans les ménages de Bamendjou, Cameroun

Introduction : Les maladies diarrhéiques sont une importante cause de morbidité et mortalité chez les nourrissons et les jeunes enfants dans les pays en voie de développement. Le district de santé de Bamendjou, à l'ouest Cameroun, n'en est pas épargné.Objectif : Principalement, il était question de mesurer l'association entre la qualité de l'eau de boisson, assainissement dans les ménages et les cas de diarrhées chez les enfants de moins de cinq ans.Matériel et méthode : Il s'agissait d'une étude cas-témoins. La population cible était les enfants de moins cinq ans résidant dans le district de santé de Bamendjou. Une approche adaptée de l'autopsie verbale en communauté était utilisée pour diagnostiquer les cas de diarrhées. Chaque cas était apparié à deux témoins. L'analyse des données s'est faite par régression et test de Khi2 à l'aide de l'outil Epi-info 7.1.4.0. Une valeur de P inférieure à 5% était considérée comme significative.Résultats : Sur 99 enfants (33 cas et 66 témoins), 38,71% des cas de maladies diarrhéiques, issus des ménages n'utilisant pas une source d'eau améliorée contre 30,8% des ménages utilisant une source d'eau améliorée (OR = 1.4535 ; IC = 0,582- 3,432). Sur les 33 cas diarrhéiques, 63,6% étaient issus des ménages n'utilisant pas de toilettes améliorées contre 36,3% issus ménages utilisant les toilettes améliorées (OR = 7,1346 ; CI = 2,805- 18,142).Conclusion : Les cas diarrhéiques sont attribuables à un accès limité à l'assainissement. Nous recommandons la mise en place d'un projet de promotion d'hygiène et assainissement dans le district de santé de Bamendjou

Poor utilization and wrong preparation of oral rehydration salt solution during childhood diarrhea in Ilesa, Nigeria

Background and Aim: Diarrheal deaths are largely preventable with the use of oral rehydration salt (ORS) solution. The aim of this study was to investigate the preparation and use of ORS for the treatment of childhood diarrhea in Ilesa, Nigeria. Materials and Methods: The characteristics of the present diarrheal illness as well as biodata, social class, use of ORS solution, and the method of preparation were documented in 250 children with diarrhea at the Wesley Guild Hospital, Ilesa, Nigeria. Data were analyzed using the statistical program for the social sciences (SPSS) version 16.0. Results: A total of 151 (60.4%) of the children had been given ORS before the presentation. The ORS was correctly prepared in 38 (25.2%) of them, whereas hypertonic ORS solution was mostly given to the others. A significantly higher proportion (66.7%) of those from high social class had their ORS correctly prepared, compared with 16.1% of those from low social class (P = 0.000). The use of ORS was more prevalent among children with longer duration of diarrhea (P = 0.004). A significantly higher proportion of children who were still breastfeeding were given ORS, compared with those who had stopped breastfeeding (P = 0.007). Conclusion: Teachings on the use and correct preparation of ORS should not be limited to diarrhea treatment units, but should rather be included in the routine health talks given to mothers at antenatal and immunization clinics. The provision of a 1 L measure to be used for measuring water for ORS preparation should be seriously considered to combat the problem of hypertonic ORS preparations

Epidemiology of rotavirus and astrovirus infections in children in Northwestern Nigeria

Background: Recent estimates attribute 527 000 deaths in children less than five years of age to rotavirus diarrhea annually, with 145 000 occurring in sub-Saharan Africa. Human astroviruses have been identified as one of the most frequent causes of infantile diarrhea, second in incidence only to rotavirus. This study was conducted to determine the prevalence of rotavirus and astrovirus and also to establish the circulating strains of rotavirus in a community in Nigeria where most diarrheic patients do not visit clinics or health care centers. Methods: A total of 154 stool samples (134 diarrheic and 20 non-diarrheic) were collected from infants and young children less than 5 years of age from January-March 2002. Samples were obtained by house-to-house visit in randomly selected districts in Zaria, Northwestern Nigeria. The samples were screened for rotavirus and astrovirus antigens using commercially available Enzyme Linked Immunosorbent Assay (ELISA) kits. All positive group A rotavirus samples were further subjected to VP6 sub-group ELISA, Polyacrylamide gel electrophoresis (PAGE) to determine their RNA electropherotypes and Reverse transcription polymerase chain reaction (RT-PCR) to determine their VP7 and VP4 genotypes. Results: Rotavirus and astrovirus antigens were detected in 9% (12) and 5% (7) of the 134 diarrheic stool samples respectively. No viral antigen was detected in the non-diarrheic stools. Rotavirus infection was more common in younger children than astrovirus infection. VP6 sub-group II specificity (58.3%), long RNA electropherotypes (41.6%), VP7 genotype G1 (33.3%) and VP4 genotype P [6] (33.3%) were the most common strains in circulation at that time in the community. Of significance is the fact that a large proportion of the rotavirus strains in circulation could not be assigned either a VP6 subgroup or RNA electrophoretic pattern probably as a result of low viral load. Conclusion: In this community-based study, rotavirus and astrovirus were significantly associated with diarrhea. However, the prevalence of rotavirus infection among children appears to be low while that of astrovirus falls in the range seen in hospital-based studies around the continent

Etude epidemio-clinique des diarrhees aigues a rotavirus chez les nourrissons a l'hopital Jason Sendwe de Lubumbashi; Republique Democratique du Congo

Introduction: le rotavirus est un probleme de sante publique; non seulement dans les pays en developpement ou tous les enfants sont infectes avant l'age de deux a trois ans mais aussi dans les pays developpes ou les conditions d'hygiene sont bonnes. La presente etude est la premiere a fournir des informations sur la prevalence de l'infection a rotavirus dans les diarrhees aigues des nourrissons dans la ville de Lubumbashi. Elle s'est fixee comme objectifs de determiner la frequence hospitaliere ainsi que la saisonnalite; les caracteristiques sociodemographiques; cliniques et evolutives de l'infection a Rotavirus chez les nourrissons admis a l'hopital Jason Sendwe de Lubumbashi pour une diarrhee aigue. Methodes: il s'agit d'une etude descriptive et transversale menee pendant la periode allant du 1er janvier au 31 decembre 2012. Les parametres epidemio-cliniques et evolutifs (age; sexe; saison; signes cliniques; nombre journalier de selles et evolution) des enfants diagnostiques positifs au rotavirus ont ete compares a ceux des enfants dont le test au rotavirus etait negatif. Le degre de signification etait de 5%. Resultats: nous avons recolte 193 cas de diarrhees aigues dont 104 nourrissons etaient infectes par le rotavirus soit 53;8%. Des taux eleves des diarrhees a rotavirus sont enregistres au cours de la saison seche comparativement a la saison des pluies (p0;05). La comparaison des moyennes d'age et celle des proportions d'enfants d'age inferieur ou egal a 12 mois sont statistiquement significatives entre le groupe de diarrhees a rotavirus et celui de diarrhees dues aux autres micro-organismes (p0;05). Le sexe feminin ainsi que les signes d'accompagnement de la diarrhee (vomissements; fievre et lethargie) ne donnent pas de difference statistique entre les deux groupes (p0;05). Par ailleurs; les enfants infectes par le rotavirus etaient 6 fois plus susceptibles de presenter une deshydratation moderee/severe (p0;02). Nous avons enregistre un deces (1% des cas) chez les enfants infectes par le rotavirus et aucun deces chez ceux non infectes par le rotavirus (p0;05). Conclusion: le rotavirus est confirme dans la ville de Lubumbashi et touche souvent les enfants d'age ?12 mois; pendant la saison seche sans distinction de sexe et conduit rapidement a une deshydratation moderee/severe. Une prise en charge adaptee et precoce permet d'eviter les deces et l'assainissement du milieu; le lavage des mains; la prise d'eau potable et la vaccination contre le rotavirus sont les mesures preventives les plus efficaces contre les rotavirus et a conseiller dans notre communaute

The prevalence of intestinal parasites in paediatric diarrhoeal and no-diarrhoeal patients in Addis Ababa hospitals; with special emphasis on opportunistic parasitic infections and with insight into the demographic and socio-economic factors

Background: Opportunistic intestinal parasitic infections cause severe diarrhoea specially in infants and in immunocompromised people world wide Objective: The objective of this study was to assess and determine the prevalence of opportunistic intestinal parasites in paediatric patients with and without diarrhoea in selected hospitals in Addis Ababa. Methods: A cross-sectional study was conducted on 222 children under five years of age who had diarrhoea and on 74 children who had no diarrhoea in selected Hospitals in Addis Ababa. Single stool specimens were collected and screened for intestinal parasitic infections by using direct and concentrated methods. The Modified Ziehl-Neelsen Staining and Modified Water-Ether Sendimentaion methods were used for detecting Coccidial parasites.Results: Of the 222 paediatric diarrhoeal patients, 61(27.5%) were found to be infected with a variety of intestinal parasites and out of 74 children without diarrhoea 11(14.9%) were found to be infected. Among the emerging opportunistic parasites detected in diarrhoeal children were Cryptosporidium parvum (8.1%), Isospora belli (2.3%) and Enterocytozoon bieneusi/ Encephalitozoon intestinalis (0.5%). Other common intestinal parasites detected were Ascaris lumbricoides (0.5%), Trichuris trichiura (0.9%), Giardia lamblia (6.3%), Entamoeba histolytica/ E. dispar (1.4%), Blastocystis hominis (5.9%) and Hymnolepis nana (0.5%). Opportunistic parasites were found to be significantly associated with diarrhoeal and non-breastfed children (p<0.001). C. parvum and I. belli respectively were isolated from 83.3% and 80% of diarrhoeal children aged less than 12 months. C. paravum and I. belli infections were also higher in male children, with a prevalence of 72.2% for C. paravum and 80% for I. belli.Conclusion: This study re-affirms and confirms the previously held view that opportunistic parasites can cause diarrhoea in paediatric patients and that it is more prevalent in male, non-breastfed children. The cause of diarrhoea in paediatrics in the absence of identifiable parasitic infections suggests that other infectious agents might be responsible for the diarrhoea

SIDA de l'enfant dans le service de pédiatrie du CHU-Tokoin, Lomé (Togo): aspects cliniques et épidémiologiques

51 enfants souffrant de SIDA; hospitalises entre janvier 1991 et septembre 1992 dans le service de pediatrie du CHU-Tokoin (Lome); ont fait l'objet d'une analyse retrospective epidemiologique et clinique. Le sex-ratio a ete de 0;8 et l'age moyen de 25;64 mois (extremes: 2 mois et 15 ans). L'infection a HIV 1 s'est averee predominante (100 pour cent des cas). Sept enfants avaient un double profil serologique HIV1-HIV2. Diarrhee trainante; candidose oropharyngee; adenopathies; malnutrition proteino-energetique de type marasme et infections respiratoires (a germes banals et tuberculose pulmonaire) ont ete les dominantes pathologiques observees