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Seifu BL, Legesse BT, Yehuala TZ, Kase BF, Asmare ZA, Mulaw GF, Tebeje TM, Mare KU. Factors associated with the co-utilization of oral rehydration solution and zinc for treating diarrhea among under-five children in 35 sub-saharan Africa countries: a generalized linear mixed effect modeling with robust error variance. BMC Public Health 2024; 24:1329. [PMID: 38755544 PMCID: PMC11100298 DOI: 10.1186/s12889-024-18827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Even though childhood diarrhea is treated with a simple treatment solution, it continues to be one of the leading causes of under-five child mortality and malnutrition globally. In resource-limited settings such as Sub-Saharan Africa (SSA), the combination of oral rehydration salts (ORS) and zinc is regarded as an effective treatment for diarrhea; however, its utilization is very low. The purpose of this study was to determine the proportion and associated factors of co-utilization of ORS and zinc among under-five children with diarrhea in SSA. METHODS The proportion and associated factors of co-utilization of ORS and zinc among under-five children with diarrhea in SSA were determined using secondary data analysis of recent Demographic and Health Surveys (DHS) of 35 SSA countries. The study included a total of 44,341 under-five children with diarrhea in weighted samples. A generalized linear mixed-effects model with robust error variance was used. For the variables included in the final model, adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were estimated. A model with the lowest deviance value were considered as the best-fitted model. RESULT The pooled proportion of co-utilization of ORS and zinc for the treatment of diarrhea among under five children in SSA countries was 43.58% with a 95% CI (43.15%, 44.01%). Sex of the child, maternal age, residence, maternal educational and employment status, wealth index, media exposure, perceived distance to health facility and insurance coverage were statistically significant determinants of ORS and Zinc co-utilization for treating diarrhea among under five children in SSA. CONCLUSION Only less than half of under-five children with diarrhea in SSA were treated with a combination of ORS and zinc. Thus, strengthening information dissemination through mass media, and community-level health education programs are important to scale up the utilization of the recommended combination treatment. Furthermore, increasing health insurance coverage, and establishing strategies to address the community with difficulty in accessing health facilities is also crucial in improving the use of the treatment.
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Affiliation(s)
- Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Bruck Tesfaye Legesse
- Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, Institutes of Health Science, Wollega University, Nekemte, Ethiopia
| | - Tirualem Zeleke Yehuala
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Bizunesh Fantahun Kase
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getahun Fentaw Mulaw
- School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Achiro E, Okidi L, Echodu R, Alarakol SP, Nassanga P, Ongeng D. Status of food safety knowledge, attitude, and practices of caregivers of children in northern Uganda. Food Sci Nutr 2023; 11:5472-5491. [PMID: 37701219 PMCID: PMC10494620 DOI: 10.1002/fsn3.3504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/04/2023] [Accepted: 05/31/2023] [Indexed: 09/14/2023] Open
Abstract
The safety of homemade weaning foods in low- and middle-income countries is of great concern as rural households have limited access to standardized commercial weaning foods. In the Acholi subregion of Uganda, complementary foods are locally produced. However, there is limited information on the Food safety knowledge (FSK), food safety attitude (FSA), and food hygiene practices (FHP) of the caregivers. This study examined food safety knowledge, attitude, and practices of the caregivers of children 6-23 months of age in Amuru and Nwoya districts, Northern Uganda, between March 2019 and June 2019. A cross-sectional study was conducted involving 180 caregivers. Data were collected using semi-structured questionnaires and focus group discussions and analyzed using descriptive statistics, multivariate binary logistic regression, and thematic content analysis. Caregivers had sufficient FSK (74.1%) and positive FSA (68.1%). However, only 17.6% of them adhered to FHP. Frequency of food safety training (p = .041) and households with children who suffered from foodborne illness (p = .001) significantly predicted FSK. Conversely, both FSK and FSA were significantly predicted by gender roles in decision-making on household income (p = .006) and households with older children (p = .041). A significant positive correlation was observed between FSK and FSA (r = .406, p = .000). However, major barriers to adherence to FHP were inadequate sanitation facilities and caregiver's workload. The overall nontranslation of sufficient FSK and positive FSA into proper FHP calls for future intervention to harness the sociodemographic factors that influence FSK and FSA and address the barriers to FHP among caregivers.
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Affiliation(s)
- Eunice Achiro
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and EnvironmentGulu UniversityGuluUganda
| | - Lawrence Okidi
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and EnvironmentGulu UniversityGuluUganda
| | - Richard Echodu
- Department of Biology, Faculty of ScienceGulu UniversityGuluUganda
| | - Simon Peter Alarakol
- Department of Medical Biochemistry, Faculty of MedicineGulu UniversityGuluUganda
| | - Prossy Nassanga
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and EnvironmentGulu UniversityGuluUganda
| | - Duncan Ongeng
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and EnvironmentGulu UniversityGuluUganda
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Kajungu D, Nabukeera B, Muhoozi M, Ndyomugyenyi DB, Akello MC, Gyezaho C, Waako J, Kasirye R. Factors associated with caretakers' knowledge, attitude, and practices in the management of pneumonia for children aged five years and below in rural Uganda. BMC Health Serv Res 2023; 23:700. [PMID: 37370154 DOI: 10.1186/s12913-023-09713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Efforts aimed at reducing morbidity and mortality associated with pneumonia in children aged five years and below largely depend on caretakers. This study aimed to assess the factors associated with knowledge, attitudes, and practices of caretakers regarding pneumonia. METHODS This was a cross-sectional study carried out within Iganga and Mayuge health and demographic surveillance site (IMHDSS) cohort in Eastern Uganda. Caretakers of children under the age of five years were assessed for knowledge, attitudes, and practices using a set of indicators. The caretaker characteristics as determinants for knowledge, attitude, and practices in relation to pneumonia management were assessed for association. Logistic regression was used to assess the factors associated with caretaker knowledge, attitudes and practices. RESULTS A total of 649 caretakers of children five years and below of age were interviewed. Caretakers knew pneumonia as one of the childhood diseases, but were less knowledgeable about its transmission, signs and symptoms, risk factors and treatment. Overall, 28% had good knowledge, 36% had moderate knowledge and 35% had poor knowledge. The caretaker attitude was good for more than a half of the respondents (57%), while majority reported good practices (74.1%). Older age (OR = 1.63, 95% CI (1.05-2.51)), Tertiary education (OR = 4.92, 95% CI (2.5-9.65)), being married (OR = 1.82, 95% CI (1.05-3.15)) were associated with having good knowledge. Age above 35 years (aOR = 1.48, 95% CI (1.03-2.11)), and main source of livelihood were associated with good attitude and lastly being female (OR = 2.3, 95% CI (1.23-4.37)), being a Muslim (aOR = 0.5, 95% CI (0.35-0.75)), and being a farmer (OR = 0.5, 95% CI (0.33-0.85)) were associated with being a good caretaker practice. CONCLUSIONS The caretakers of children five years and below, have relatively adequate knowledge about the signs and symptoms of pneumonia, risk factors and treatment measures. Higher education, being married, and being a salary earner were associated with better knowledge about pneumonia, while being female, being a Muslim, and being a peasant farmer were associated with good practice. Targeted interventions to equip caretakers with relevant and adequate skills and knowledge for lower-income and less educated caretakers, considering cultural and religious beliefs about childhood pneumonia identification and management are required.
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Affiliation(s)
- Dan Kajungu
- Makerere University Centre for Health and Population Research (MUCHAP), Kampala, Uganda.
- Department of Global Health, Stellenbosch University, Stellenbosch, 7602, South Africa.
| | - Betty Nabukeera
- Makerere University Centre for Health and Population Research (MUCHAP), Kampala, Uganda
| | - Michael Muhoozi
- Makerere University Centre for Health and Population Research (MUCHAP), Kampala, Uganda
| | | | | | - Collins Gyezaho
- Makerere University Centre for Health and Population Research (MUCHAP), Kampala, Uganda
| | - James Waako
- Iganga General Hospital and Kamuli District, Kampala, Uganda
| | - Ronnie Kasirye
- Makerere University Centre for Health and Population Research (MUCHAP), Kampala, Uganda
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Negesse Y, Fetene Abebe G, Addisu A, Setegn Alie M, Alemayehu D. The magnitude of oral rehydration salt utilization in diarrhea hot spot regions of Ethiopia and its associated factors among under-five children: A multilevel analysis based on Bayesian approach. Front Public Health 2022; 10:960627. [PMID: 36438299 PMCID: PMC9686366 DOI: 10.3389/fpubh.2022.960627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022] Open
Abstract
Background Diarrhea leads the children to severe dehydration or death as a result of the loss of water and electrolytes (namely, potassium, chloride, sodium, and bicarbonate). To compensate for the losses, ORS is given to children who experienced diarrhea. Objective To estimate the magnitude of ORS utilization in diarrhea hotspot regions of Ethiopia and to assess its associated factors among under-five children. Methods To conduct this study, we used the 2016 Ethiopian demographic and health survey data. A total of 1,079 weighted sample children were selected. Each sample was selected randomly. Then, to identify factors associated with ORS utilization in diarrhea hotspot regions of Ethiopia, a multilevel analysis based on the Bayesian approach was applied. Finally, the credible interval of AOR that does not include 1 was considered statistically significant. Results The magnitude of ORS utilization for children in diarrhea hotspot regions of Ethiopia was 28%. Being urban resident (AOR = 1.92; 95% CrI: 1.13-3.3), woman household head (AOR = 2.11; 95% CrI: 1.3-3.9), having higher educational level (AOR = 1.52; 95% CrI: 1.04-2.22), member of health insurance (AOR = 1.73; 95% CrI: 1.14-2.43), and being exposed for media (AOR = 1.43; 95% CrI: 1.18-2.5) increases ORS utilization for diarrhea management. Conclusion Residence, educational level, health insurance, and media exposure were the factors of ORS utilization. So, to increase the practice of ORS utilization for diarrhea management in Ethiopia, the Ministry of Health and the Government of Ethiopia should consider those factors when they design diarrhea prevention and control strategies.
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Affiliation(s)
- Yilkal Negesse
- College of Health Science, Debre-Markos University, Debre-Markos, Ethiopia,*Correspondence: Yilkal Negesse
| | - Gossa Fetene Abebe
- College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Abebaw Addisu
- College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Melsew Setegn Alie
- College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dereje Alemayehu
- College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Kassa SF, Alemu TG, Techane MA, Wubneh CA, Assimamaw NT, Belay GM, Tamir TT, Muhye AB, Kassie DG, Wondim A, Terefe B, Tarekegn BT, Ali MS, Fentie B, Gonete AT, Tekeba B, Desta BK, Ayele AD, Dessie MT, Atalell KA. The Co-Utilization of Oral Rehydration Solution and Zinc for Treating Diarrhea and Its Associated Factors Among Under-Five Children in Ethiopia: Further Analysis of EDHS 2016. Patient Prefer Adherence 2022; 16:1713-1721. [PMID: 35903082 PMCID: PMC9314449 DOI: 10.2147/ppa.s356557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Diarrhea causes a loss of body water and salt, which can lead to dehydration and death. The use of oral rehydration salts and zinc together is regarded as an effective treatment for diarrhea in resource-poor settings like Ethiopia. However, studies that examine the co-utilization of oral rehydration solution and zinc in the treatment of diarrhea are limited Ethiopia. OBJECTIVE To assess the prevalence and associated factors of oral rehydration solution and zinc co-utilization to treat diarrhea in children under the age of five in Ethiopia, EDHS 2016. METHODS Secondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used to investigate the prevalence and factors associated with the co-utilization of ORS and zinc to treat diarrhea in under-five children. A multilevel binary logistic regression model was fitted to identify factors associated with the co-utilization of ORS and zinc. Adjusted odds ratios (AOR) with 95% CI were calculated and used as a measure of associations, and variables having a p-value of less than 0.05 were declared as statistically significant. RESULTS The national prevalence of ORS and zinc co-utilization was 16.65% (14.66%, 18.84%). Maternal educational status (AOR = 1.45; 95% CI; (1.01, 2.09)), household size (AOR = 1.53; 95% CI; 1.09, 2.16) and distance to health facilities at the community level (AOR = 1.60, 95% CI = 1.02, 2.58) were variables significantly associated with the co-use of ORS and zinc. CONCLUSION The co-utilization of ORS and zinc for the management of diarrhea was low in Ethiopia. Education, household size, and distance to health facilities at the community level were significantly associated with the co-utilization of ORS and zinc in Ethiopia.
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Affiliation(s)
- Selam Fisiha Kassa
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Selam Fisiha Kassa, Email
| | - Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masresha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chalachew Adugna Wubneh
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Mulualem Belay
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addis Bilal Muhye
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaye Guadie Kassie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Wondim
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bethelihem Tigabu Tarekegn
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Beletech Fentie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bogale Kassahun Desta
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Demsie Ayele
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tilahun Dessie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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