ABSTRACT
Background: Diarrhea is second major killer disease for children less than 5 year of age; and maternal lack of sound knowledge and related correct practices inn this regard conflicts with WHO treatment guidelines for diarrhea. Objective: 1) to assess the level of maternal knowledge and practices regarding prevention and management of diarrhea at home; in children below five year of age 2) to identify association between maternal knowledge and practices regarding prevention and care of diarrhea at home. Materials & Methods: It was a cross sectional study conducted in three tertiary level hospitals of Lahore selected randomly. Study population was mothers having children less than 5 year of age coming to pediatric Outdoor in these hospitals. Calculated sample size was 296; and non-probability purposive sampling technique used to recruit the sample. Data was collected from 300 respondents; study instrument was KAP questionnaire adopted and modified and data was taken upon the variables of knowledge and practice. Data analysis plan was: descriptive statistics for all variables, Bivariate analysis upon knowledge and practice scores, Pearson Correlation upon the two variable scores. Results: 61.7% respondents had good knowledge score, whereas 32% and 6.3% had average and poor score respectively. 39.3% were found to have good practice score, whereas 54% and 6.7% were found to have average and poor practice level score. Highly significant association (P- 0.000) was found between knowledge and practice levels; and Pearson correlation of 43.8% was found between the two variables. Conclusion: Health education communication should be conducted by health care workers so as to give the right knowledge about ORS intake and its preparation; and adoption of correct dietary practices by the mothers during diarrheal episode of the child.
ABSTRACT
Aim:To determine possible factors associated with lethal outcome of pneumonia and to assess the accuracy of Pneumonia Severity Index (PSI) and Pediatric Risk of Mortality (PRISM) score in predicting mortality from pneumonia. Study Design: A retrospective analytical study Place and Duration of the Study: Pediatric Emergency Department (PED) of the pediatric hospital (Abu El-Reesh) Egypt, during a period from April 2010 to April 2012. Methodology: Children ≤5 years admitted to the PED diagnosed having pneumonia were included in the study (n=236). Data were retrieved from the electronic records and consisted of; hospital data, personal data, provisional and definite diagnosis, presenting clinical symptoms and signs, outcome and measurements of blood counts and serum biochemical markers. Results: Non-survivors constituted 26.7% of the studied group. Non-survivors significantly had a higher median PRISM score (18; IQR 11 for non-survivors compared to 8; IQR 6 for survivors, P =.000), have a longer median length of stay (8 days; IQR; 1 day for non-survivors compared to 4 days; IQR 2 days for survivors, P =.000), higher PSI score (61; IQR 39 for non-survivors compared to 41; IQR 20 for survivors, P =.000).Only longer LOS, higher PRISM score were independently associated with mortality. ROC curve analysis revealed area under the curve (AUC) of 0.857 for PRISM score (95% CI 0.80–0.91) and 0.73.6 for PSI score (95% CI 0.66–0.81). A PRISM score ≥ 12.5 is 81.4% sensitive and 73.3% specific in predicting mortality. Conclusion: Case fatality rate is quite high. PRISM scoring is accurate in predicting mortality among pneumonia pediatric patients and thus useful in decision making concerning management of these cases.