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Pre-hospital management of diarrhoea among caregivers presenting at a tertiary health institution: implications for practice and health education

Diarrhoeal diseases cause significant childhood morbidity and mortality worldwide. The effectiveness of home management of diarrhoeal diseases is achievable only if caregivers have appropriate information despite varying recommendations on the strategies for diarrhoea therapy.  The objective of this study is to evaluate caregivers’ perception and use of ORT fluids for management of diarrhoea in under-five age children in the face of varying phases of recommendations, as an indicator of home treatment. Caregivers of U5 children presenting with acute watery diarrhoea to different Paediatrics clinics/wards of the University of Nigeria Teaching Hospital (U.N.T.H.), Enugu between October 2006 and February 2007 were interviewed with a structured questionnaire. Caregivers of 156 under-five children who met the inclusion criteria were recruited. Access to ORT fluids was high with 73.1% of all children with diarrhoea being offered an ORT fluid at home. However, the method of preparation and administration of fluids was quite unsatisfactory. Previous experience with ORT fluids, higher educational or socioeconomic status did not correlate significantly with better performance. Despite high level of knowledge and acceptance of ORT among the study population actual practice was not satisfactory. Diverse practices by caregivers which represent the various phases of evolution in the types of fluids promoted for oral rehydration reflect some confusion that require urgent attention. Knowledge and skills of ORT need to be widely promoted on a continuing basis with the need for health workers to ensure that caregivers are taught and adhere to the correct recommendations on oral rehydration therapy.