Diarrhea remains to be a main cause of childhood mortality. Diarrhea case management indicators reflect the effectiveness of child survival interventions. We aimed to assess time trends and country-wise changes in diarrhea case management indicators among under-5 children in low-and-middle-income countries.
We analyzed aggregate data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys done from 1986 to 2012 in low-and-middle-income countries. Two-week prevalence rates of diarrhea, caregiver’s care seeking behavior and three case management indicators were analyzed. We assessed overall time trends across the countries using panel data analyses and country-level changes between two sequential surveys.
Overall, yearly increase in case management indicators ranged from 1 · 3 to 2 · 5%. In the year 2012, <50% of the children were given correct treatment (received oral rehydration and increased fluids) for diarrhea. Annually, an estimated 300 to 350 million children were not given oral rehydration solutions, or recommended home fluids or ‘increased fluids’ and 304 million children not taken to a healthcare provider during an episode of diarrhea. Overall, care seeking for diarrhea, increased from pre-2000 to post-2000, i.e. from 35 to 45%; oral rehydration rates increased by about 7% but the rate of ‘increased fluids’ decreased by 14%. Country-level trends showed that care seeking had decreased in 15 countries but increased in 33 countries. Care seeking from a healthcare provider increased by ≥10% in about 23 countries. Oral rehydration rates had increased by ≥10% in 15 countries and in 30 countries oral rehydration rates increased by <10%.
Very limited progress has been made in the case management of childhood diarrhea. A better understanding of caregiver’s care seeking behavior and health care provider’s case management practices is needed to improve diarrhea case management in low- and-middle-income countries.
Fund UNC’s. Levels & Trends in Child Mortality, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF; 2012.
United Nations. Transforming our world: the 2030 Agenda for SustainableDevelopment. New York: United Nations; 2016.
United Nation Children’s Fund. State of World’s Children 2013. New York: United Nation; 2013.
The World Health Organization. Programme for Control of Diarrhoeal Diseases: Seventh Programme Report 1988–1989. Geneva: The World Health Organization; 1990.
The World Health Organization. Programme for Control of Diarrhoeal Diseases: ninth programme report, 1992–1993. Geneva: The World Health Organization; 1994.
World Health Organisation. Integrated Management Of Childhood Illness (IMCI). Geneva: The World Health Organisation; 2008.
United Nations Childrens Fund. Committing to Child Survival: A Promise Renewed, Progress Report 2013. New York: UNICEF; 2013.
Colvin CJ, Smith HJ, Swartz A, Ahs JW, De HJ, Opiyo N, et al. Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Soc Sci Med. 2013;86:66–78. CrossRefPubMed
MEASUREDHS: Demographic and health surveys. Calverton, MD: Macro International. Inc, available: http://www.measuredhs com. 2014.
United Nation Children’s Fund. Multiple indicator cluster surveys (MICS). New York: UNICEF; 1995.
US Census Bureau. International Data Base. In http://www.census gov/population/international/data/idb/informationGateway php. 2015.
Ryland S, Raggers H. Childhood morbidity and treatment patterns. Calverton: Macro International Demographic and Health Surveys [DHS]; 1998.
Ahs JW, Tao W, Lfgren J, Forsberg BC. Diarrheal diseases in low-and middle-income countries: incidence, prevention and management. Open Infectious Diseases Journal. 2010;4:113–24.
Sood N, Wagner Z. Private sector provision of oral rehydration therapy for child diarrhea in Sub-Saharan Africa. AmJTrop Med Hyg. 2014;90:939–44. CrossRef
Forsberg BC, Gwatkin D, Tomson G, Allebeck P, Petzold MG. Socioeconomic inequalities in the prevalence and management of childhood diarrhoea: potential health gains to be achieved. The Open Infectious Diseases Journal. 2009;3:44–9. CrossRef
Kalyango JN, Rutebemberwa E, Alfven T, Ssali S, Peterson S, Karamagi C. Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda. Malar J. 2012;11:10–1186. CrossRef
United Nation children’s Education Fund: Diarrhoea: why children are still dying and what can be done. https://www.unicef.org/media/files/Final_Diarrhoea_Report_October_2009_final.pdf. 2010.
Walker CLF, Fontaine O, Black RE. Measuring coverage in MNCH: Current indicators for measuring coverage of diarrhea treatment interventions and opportunities for improvement. PLoS Med. 2013;10, e1001385. CrossRef
- Slow progress in diarrhea case management in low and middle income countries: evidence from cross-sectional national surveys, 1985–2012
Chandrashekhar T. Sreeramareddy
Birger Carl Forsberg
- BioMed Central
Neu im Fachgebiet Pädiatrie
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II