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Home based management of acute diarrhoeal disease in an urban slum of Aligarh- an appraisal
N.Faizi,M.S.Shah1, A.Ahmad1, N.Khalique3,S.Afzal4,M.A.Ansari2, Z Khan3
Dr. M. Salman ShahAssistant Professor
Department of Community MedicineJawaharlal Nehru Medical College
Aligarh Muslim University, Aligarh.
Introduction Globally, Diarrhoeal diseases are a
major cause of morbidity and mortality accounting for 4 billion cases and 2 million deaths annually.
According to the recent estimates for 2004 diarrhoeal diseases accounted for about 17% of under-five mortality and 3% of neonatal deaths.
17%
19%
4%8%3%3%
10%
37% Diarrhoeal Diseases
ARI
Measles
Malaria
HIV/AIDS
Injuries
Non communicable ds
Neonatal causes
Causes of Death of Children under- five years of age
Source :WHO- 2003
Use of ORT became the highest priority in diarrheal disease control efforts.
1.07 million cases in 2005 . (4.07 m in 1980)
Objective To know the knowledge, attitude,
practice regarding diarrhoea in children under-five years of age.
Methodology
The study was undertaken in urban slum (Shahenshabad) of Aligarh District in June & July 2009.
Aligarh DistrictShahenshabad
Households 300
Total Population (2100)
Children (upto 60 months)
(280)
101
The mothers of all the 250 children uptill the age of 60 months, suffering from diarrhoea with atleast one episode in the last 2 weeks prior to the day of interview were included in the study.
Tool of Study: Information was gathered on a predesigned and pretested questionnaire.
Mothers of the child were interviewed for :
Danger Signs Home available fluids preparation of ORS feeding pattern health seeking behaviour during
diarrhoeal illness. Case of diarrhoea: Children up to the age
of 60 months having passed 3 or more loose stools in a day or passed blood or mucous even once over a period of 2 weeks preceding the date of interview.
Consent & Ethical Consideration Only those mothers who gave
consent were included in the study Wherever known that there is
deficiency in the knowledge and practice and the behaviour, it was overcome by behavioural change communication
Results
Socio-demographic profile of mothers
• Approximately 80% of the mothers were illiterate.
• Per capita income was less than Rs.1500.
• Availability of safe water was poor. • Water was stored in buckets which
remained open. • Practice of defecation in fields was
near universal.
Prevalence of Diarrhoea cases in under-five children
Age group No. of diarrhoea cases Prevalence (%)
0-365 days
(n=84)
37 44%
365dys – 60 months (n=196)
59 30%
Total
(280)
101 36%
Aware of Danger Signs?
Many watery stools
Repeated vomiting
Fever lethargy Blood in stools
Marked thirst/ Poor feeding
Reduced urine output
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
DO YOU KNOW ABOUT ORS? HOW TO PREPARE ORS?
46.5
53.5
Yes
No
Correct method Incorrect method0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
KNOWLEDGE ABOUT HAF ? WHAT CAN BE GIVEN ?
38.7
61.3
Present
Absent
Salt
suga
r sol
utio
n
Daal k
a pa
ni
Dalia
Khich
di
Rice
wat
er0.00
10.00
20.00
30.00
40.00
50.00
60.00
Feeding pattern during diarrhoea
Babies on exclusive breast feeding (n= 25)
Continued 18(72%)
Interrupted 7 (28%)
Feeding pattern during illness (n=225)
Continued 128(57%)
Withheld 97(43%)
Health Seeking BehaviorUse of Medical Services
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
Types of Medical Services availed
Nearb
y che
mist
Vaidh
/ Hak
eem
Quack
Use o
f lef
t ove
r dru
gs p
resc
ribed
ear
lier
Gener
al p
ract
ition
er
Child
spe
cialis
t
Gover
nmen
t hea
lth w
orke
r (RHTC
)
No Tr
eatm
ent
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
Conclusion &
Recommendations
The study highlights that the knowledge and practice of mothers is not adequate.
If health education is correctly provided to the specific target group (mothers and health care providers) regarding early home based case management of childhood diarrhoea, things would improve.
Serious analysis of the reasons for a this disappointing situation should be done, although the significant efforts made over the past 25 years to promote proper home base management of diarrhoea in children.
Thank You!