208142 Obstacle of putting knowledge into practice: Knowledge, attitude and practice of oral rehydration therapy during childhood diarrhea in Uganda

Wednesday, November 11, 2009

Wenjing Tao , Division of International Health, Karolinska Institutet, Stockholm, Sweden
Jenny Löfgren , Division of International Health, Karolinska Institutet, Stockholm, Sweden
Elin Larsson , Division of International Health, Karolinska Institutet, Stockholm, Sweden
Francis Kyakulaga , Department of Health Sciences, Uganda Christian University, Mukono Town, Uganda
Birger Forsberg , Division of International Health, Karolinska Institutet, Stockholm, Sweden
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.

Learning Objectives:
1. Describe the pattern of childhood diarrhea management in a rural setting in Uganda 2. Identify some of the problems influencing correct treatment of childhood diarrhea in a low-income country 3. Discuss ways of overcoming these problems to develop suggestions of concrete action

Keywords: Diarrhea, Developing Countries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Graduate studies in medicine, final year at Karolinska Institutet, Sweden. Elective course in Global Health. Planned, conducted and analysed the data of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.