Obstacle of putting knowledge into practice: Knowledge, attitude and practice of oral rehydration therapy during childhood diarrhea in Uganda

Oral Rehydration Therapy (ORT), including oral rehydration solution (ORS) and salt-sugar solution (SSS), is the primary intervention of diarrhea management. In spite of effective treatment, diarrhea remains one of the leading killers of young children. The aim of this study was to evaluate the knowledge, attitude and practice of ORT among caregivers in rural Uganda.

Questionnaire-based face-to-face interviews were conducted in Namutumba District, eastern Uganda. Caregivers were interviewed in their villages on childhood diarrhea and asked to mix ORT solutions under observation.

A majority of the respondents reported knowing how to prepare ORT solutions (ORS 94% and SSS 62%). However, upon preparation 36% of them did not mix an ORS sachet correctly, and 96% could not prepare SSS. More than half of the caretakers (66%) reported that ORT should begin immediately or within one day after the onset of diarrhea. However, among respondents with a child under five suffering from diarrhea during the past month, only 30% had started rehydration at home. In total 61% of the children received ORT, although the knowledge among caregivers on the dangers of diarrhea and the effects of ORT were generally high.

Our results show that the use of ORT is limited in spite of existing knowledge on recommended treatment among the caregivers. The preparation skills of ORT are poor, especially concerning SSS. Increased knowledge on preparation and use of ORT among caregivers is needed, as well as further studies to understand the underlying causes of the discrepancy between knowledge and practice.