title: Community case management of childhood diarrhea in a setting with declining use of oral rehydration therapy: findings from cross-sectional studies among primary household caregivers, Kenya, 2007.
abstract: We sought to determine factors associated with appropriate diarrhea case management in Kenya. We conducted a cross-sectional survey of caregivers of children < 5 years of age with diarrhea in rural Asembo and urban Kibera. In Asembo, 61% of respondents provided oral rehydration therapy (ORT), 45% oral rehydration solution (ORS), and 64% continued feeding. In Kibera, 75% provided ORT, 43% ORS, and 46% continued feeding. Seeking care at a health facility, risk perception regarding death from diarrhea, and treating a child with oral medications were associated with ORT and ORS use. Availability of oral medication was negatively associated. A minority of caregivers reported that ORS is available in nearby shops. In Kenya, household case management of diarrhea remains inadequate for a substantial proportion of children. Health workers have a critical role in empowering caregivers regarding early treatment with ORT and continued feeding. Increasing community ORS availability is essential to improving diarrhea management.
authors.affiliation: Epidemic Intelligence Service and Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, USA. colson@cdc.gov
authors.forename: Christine K
authors.initials: CK
authors.lastname: Olson
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Blum
authors.forename: Kinnery N
authors.initials: KN
authors.lastname: Patel
authors.forename: Prisca A
authors.initials: PA
authors.lastname: Oria
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Kayla F
authors.initials: KF
authors.lastname: Laserson
authors.forename: Annah W
authors.initials: AW
authors.lastname: Wamae
authors.forename: Alfred V
authors.initials: AV
authors.lastname: Bartlett
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Pavani K
authors.initials: PK
authors.lastname: Ram
mesh_terms: D000328:Adult; D001942:Breast Feeding; D017028:Caregivers / Q000706:statistics & numerical data*; D019090:Case Management / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003681:Dehydration / Q000209:etiology / Q000628:therapy; D003968:Diarrhea, Infantile / Q000150:complications / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D015999:Multivariate Analysis