Management of acute diarrhoea among children aged 6 - 59 months admitted at Juba Teaching Hospital

Abstract

Introduction: Diarrhoea is a leading cause of mortality and morbidity in  children under five worldwide and accounts for 42.9% of under-5 mortality in South Sudan. Clinical outcomes for diarrhoea correlate with the quality of hospital care.

Methodology: The standard WHO/IMCI for assessment of health workers’  performance in the management of illnesses in children under 5years was adapted and used in the study. Questionnaires and interviews were used to collect data on health workers’ knowledge and practice in the management of acute diarrhoea. Descriptive analysis was used to determine the means, frequencies and proportions of the variables.

Results: Thirty nine health workers were interviewed and 202 medical records of children admitted with acute diarrhoea between March and June 2014 were  examined. The majority (75.74%) of the children were 6-24 months old. Most assessments were incomplete; the commonest sign assessed was sunken eyes (75.12%) and the least assessed was ability to drink/breastfeed (34.32%). Seventy five percent of patients were classified correctly according to WHO guidelines and 61% of health workers administered fluid therapy correctly. Health workers’ knowledge of how to assess the hydration state was poor (below 50%).

Conclusion: There was inadequate assessment and documentation of the signs and symptoms of dehydration and inappropriate use of rehydration fluid therapy in the children admitted with acute watery diarrhoea. Regular in-house training and feedback and provision of supplies should be given to the clinicians in order to improve the quality of care.

Key words: acute diarrhoea, assessment, South Sudan