Knowledge and usage of Oral Rehydration Therapy by Caretakers as First-Line management of Diarrhoea in children under five years in Lusaka, Zambia

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Milambo, Annah
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In Zambia, diarrhoea has been and remains a public health problem. Z.D.H.S, (2002) indicated that in Zambia, the prevalence of diarrhoea in children under five years was 21 percent. A child with diarrhoea dies from dehydration through loss of fluids and electrolytes. Use of Oral Rehydration Solution (ORS) by mothers is an effective tool for decreasing deaths due to diarrhoeal dehydration. The success of such a programme depends on the ability of the health workers to educate mothers on the importance of Oral Rehydration Therapy (ORT). The purpose of this study was to determine the caretaker's knowledge about diarrhoea and usage of ORT as first line management of diarrhoea in children under five years. This was a cross-sectional study design conducted at Kanyama and Chawama health centers, in Lusaka. The target population was caretaker-child pairs. The children were under five years with diarrhoea. A total sample size of 232 caretakers-child pairs and 10 nurses were systematically sampled. An interview schedule and questionnaire were used to collect data from caretakers and nurses,respectively.Data was analyzed using EPI-INFO statistical package. Most of the caretakers did not breastfeed their children up to two years. Out of the 129 children who were not breast-feeding, 96 (74.4percent) stopped breast-feeding before two years. Almost all the children 226 (97.4percent) were fully immunized according to age, except 6 (2.6percent) of the children. Under five attendance was generally good with 228 (98.3percent) attending regularly. All the 232 (lOO percent) caretakers had universal knowledge on what diarrhoea is and the majority 217 (94.3percent) had the health facilities as the source of information, while 13 (5.7percent) had heard about diarrhoea from friends/relatives. When respondents were asked on what ORS / Manzi a Moyo is used for, 229 (98.7percent) knew the use, while 3 (1.3percent) did not know. About 149 (64.2percent) of the caretakers knew how to make ORS / Manzi a Moyo sachets, while 83 (35.8percent) did not.A large number of the caretakers 219 (94.8percent) use ORT as first line management of diarrhoea in children under five years although this is mainly done at the health facilities and not at home when the child just develops diarrhoea. While sugar-salt solution is being discouraged because of the wrong measurements where too much salt leads to hypernatraemia and too much sugar worsens the diarrhoea, this study revealed that 207 (89.2percent) of the caretakers would use the sugar-salt solution if they had no ORS sachets. There was generally low knowledge on the other types of fluids that can be used when a child has diarrhoea. Guava leaves are widely used as traditional medicine for diarrhoea 21 (9.1 percent), while flagyl 74 (31.9percent) is the common known drug that can cure diarrhoea. Only 2 (20percent) nurses interviewed were trained in diarrhoea management under IMCI. All the 10 (lOO percent) nurses interviewed acknowledged giving health talks on diarrhoea and the use of ORS during under five clinics and they all considered ORS as being effective in diarrhoea management, and that they would use it if their children had diarrhoea.
Oral rehydration therapy for children - Zambia , Diarrhoea in children -Zambia , Diarrhoea - Zambia