Diarrhoea management: An evaluation of the appropirateness of the home treatment given by caregivers

Abstract

Background: Diarrhoea often starts at home. Early and appropriate treatment by caregivers will go a long way towards reducing the morbidity and mortality from diarrhoea.

Aim: To document how acute diarrhoea is managed at home by caregivers and to determine the appropriateness of such treatment.

Methods: A prospective study of children less than 5 years with diarrhoea attending the Diarrhoea Training Unit (DTU) and Children Emergency Ward (CHEW) of the University of Port Harcourt Teaching Hospital (UPTH) was conducted using a structured questionnaire administered to the caregivers.

Results: A total number of 250 children were recruited for the study.  Twenty-four (9.6%) children had blood in stool (dysentery) while 226(90.4%) had acute watery diarrhoea. Thirty-six (14.4%) gave oral rehydration therapy (ORT) as the only home treatment, 60 (24.0%) gave both drugs and  ORT,  while  151 (60.4%) gave drugs alone and 3 (1.2%) children received no treatment.   The drugs given included antibiotics in 188 (89.1%), adsorbents in 53 (25.1%), antiemetic in 12 (5.7%), antispasmodic in 8 (3.8%), antihelminthics in 7 (3.3%), and antacid in 6 (2.8%).  None of the cases with blood in the stool (dysentery) received the appropriate antibiotics.  Parental education and social class did not seem to have an effect on the appropriateness of the care given to these children.

Conclusion: Diarrhoea management at home is inadequate in terms of low utilization of oral rehydration therapy, inappropriate administration of antibiotics for cases with bloody stool, and unnecessary use of antibiotics/antidiarrhoeals for acute watery diarrhoea.

Key words: Acute watery diarrhoea, Dysentery, Oral rehydration therapy (ORT), Drugs