Les maladies diarrhéiques chez les enfants au Centre Hospitalier Regional de Kara

Au terme d'une etude retrospective des affections admises en une annee dans le service de Pediatrie du Centre Hospitalier Regional (CHR) de Kara; les auteurs ont enregistre que 16;8 pour cent des enfants hospitalises avaient la diarrhee mais que le taux de letalite diarrheique etait de 11;4 pour cent. La prevalence diarrheique etait d'autant plus elevee que l'enfant etait age de 2 a 30 mois ou que l'on se trouvait en saison seche notamment de soudure. La solution des maladies diarrheiques residant dans la prevention; les auteurs ont recommande la creation d'une unite de formation au traitement de la diarrhee (UFD) dans les CHR et la poursuite des travaux d'assainissement et d'aduction d'eau dans les villages et campagnes du pays

Incidence et traitement de la diarrhee chez les enfants de moins de 5 ans en zones rurale et urbaine au Cameroun

Cette etude fait etat de l'incidence de la diarrhee chez 1348 enfants d'Edea-Ville et chez 1377 enfants du Departement du Nkam selon la technique d'echantillonnage aleatoire portant sur 30 grappes. L'etude montre en effet une augmentation de la frequence des episodes diarrheiques ville par rapport a la compagne. Les conduites therapeutiques sont elles aussi differentes car si en ville les parents preferent acheter des medicaments dans les villages les parents cherchent un traitement traditionnel. Les sels de rehydratation par voie orale sont presque inconnus et le faible pour centage des parents qui savent les preparer les utilise tres rarement. L'etude discute les raisons de cette faible utilisation et propose quelques solutions pour en augmenter l'emploi

Knowledge; attitudes and practices of mothers and health workers in relation to the use of sugar and salt solution in Masvingo Province

A total of 257 mothers out of 300 claimed that they knew about sugar and salt solution. Amongst the mothers who claimed that on a recalled episode of diarrhoea; they gave SSS 63 were from the urban areas; 81 from the rural areas and 71 from the farming compounds. More mothers than expected in the rural and farming areas claimed to have used SSS as the first line of action when a child had diarrhoea; than those in the urban areas. [abstract terminated]

The Use of Prelacteal Feeds in Uganda:Implications for Diarrhoeal Disease Control in Infancy

For a long time; clinical observation has indicated that many Ugandan Mothers offer artificial feeds to their newly delivered infants in the immediate post partum period; contrary to the recommendation by the World Health organisation. In an attempt to further document the use of these prelacteal feeds survey of 488 mothers was carried out at Mulago and Mbarara University teaching hospitals. Results show that 25.2 percent of mothers in this sample gave prelacteal feeds to their infants; confirming an earlier observation in the Uganda Breastfeeding Situation Analysis of 1991 that either there was no milk flow yet or that the babies were crying too much. The dangers associated with the use of prelacteal feeds are discussed. In conclusion; it is recommended that measures be taken to discourage this harmful practice among mothers delivering in our health facilities. The need is expressed to try and document the extent of prelacteal usage among mothers who deliver outside the formal health sector

The Influence of Home Administered Remedies/Fluids on Diarrhoea and Dehydration

As diarrhoea continues to be a daily problem in developing countries many a mother/child caretaker continues to devise knowledge and means of combating it and it's effects of dehydration or diarrhoeal malnutrition. Health workers are very aware that dehydration/starvation are the immediate and most worrying problem and therefore emphasise fluids and feeding as the key factors in instituting treatment of diarrhoea. It is true that many mothers are increasingly becoming aware of the principle. However; there is still a large number of them who vary in practice and harbour the notion that diarrhoea must be the first thing to be stopped. They seldom think of germs but accuse the foods and many unscientific ideas as causes. The home available remedies they give to the children before taking them to health units therefore reflect this mode of thinking or behaviour. Drugs; ORS; traditional herbs; special foods/fluids are often given. The results of this practice may sometimes be useful as when a child is given increased amounts of ORS; simple salt sugar solution (SSS) or increased breastfeeding; but others especially drugs and or herbs can be deleterious. The purpose of this study was to examine home management (feeding practices/use of drugs during an episode of diarrhoea); and its influence on the degree of dehydration when a child is first seen in a health facility

Diarrhoea case management experience from a specialised unit

The Ugandan Diarrhoeal training unit was started in 1992 at Mulago Hospital; Makerere Medical School. The Unit provides a 24 hours service of inpatient and outpatient care and carries out daily routine immunization of its clients. The unit offers training in diarrhoea and lactation management to various categories of health workers and carries out research. In 1993 the unit took training and management of ARI as well as now known as the child survival training Unit (CSTU).The Unit focuses five major areas for training and management. 1. Understanding diarrhoea; ARI and breastfeeding . 2. Patient care with particular emphasis on ORT; feeding and breastfeeding. 3. Communication skills acquisition. 4. Supervisory skills acquisition; record keeping; interpretation and use. 5. Training skills. 6. Outreach service in the form of home visiting and clinical support supervision. This article focuses on the units's experience in the management of diarrhoea during a period of nearly 2 years between February 1992 and June 1994. Of the 6693 cases of diarrhoea; 131(2) had severe dehydration; 412(6.2) had some dehydration and the remainder 6150; (91.8) had none. These were 5731 first attendances and 1423 (26.6)re-attendances. Of the 6693 cases; 6049 (90.4) were cases of acute diarrhoea and persistent diarrhoea accounted for the rest (9.6) of 545 cases.The management is by assessment ; institution of correct treatment and giving an appropriate advice on home using the standard WHO plans; A; B; and C. The commonest associated problems which may be considered risk factors were; stopped or reduced breastfeeding before or during the diarrhoea episode under-weight or overt malnutrition; oral candiasis; malaria and ARI; Bloody diarrhoea (dysentry) either as acute or persistent accounted for 169(2.5) of cases. The mortality rate during this period was 144 out of 4242 cases (3.4). Persistent diarrhoea was a major contribution to the mortality rate of the 123 deaths. 34 were cases with persistent diarrhoea (PD). It is unusual that even in a specialised unit there is only diarrhoea to deal with. Many dehydrated children or even those with symptomatic diarrhoea are referred to this unit. The most common associated conditions were failure to thrive 425(6.3). Persistent diarrhoea was a major contribution to the mortality rate of the 123 deaths. 34 were cases with persistent diarrhoea (PD). It is unusual that even in a specialised unit there is only diarrhoea to deal with. Many dehydrated children or even those with symptomatic diarrhoea are referred to this unit. The most common associated conditions were failure to thrive 425(6.3); malnutrition 424(6.3); pneumonia 246(3.7); malaria 711(10.6). One hundred and seventy eight (2.7)had symptom complexes suggestive of HIV infection.Other problems accounted for 322 cases (4.8) and these included Acute Upper Respiratory Infection (AUR); oral thrush; skin sepsis and anemia. The oral thrush was seen most commonly in patients with persistent diarrhoea who had received many medications including antibiotics. The challenge and implications of these findings are discussed