Dear HIFA and CHIFA colleagues,
Citation, abstract and a comment from me below.
CITATION: Assessment of care givers’ pre-hospital management of gastroenteritis among children in a tertiary referral hospital
R. W. Kung’u et al. East Africa Medical Journal 2022
https://www.ajol.info/index.php/eamj/article/view/228253
ABSTRACT
Objective: The current study sought to determine the caregivers’ pre-hospital management and treatment outcomes of GE among children under five years admitted at Kenyatta National Hospital. Design: Analytical cross-sectional study design was utilized in this study. Setting: The study was conducted in Kenyatta National Hospital in Nairobi.
Participants: The study population included caregivers and children under five years with acute gastroenteritis presenting at pediatric emergency unit (PEU) Kenyatta National Hospital and their caregivers. A total of 102 respondents participated in the study.
Data Sources: Questionnaires and clinical examination tools were used to collect data. The data collected quantitatively from clinical examinations was analyzed using R Studio Version 2.0 statistical software.
Results: The study results revealed that 57.8% administered remedies, 15.6% administered oral rehydration salts, 14.7% took their children to the herbalist while 11.8% took no step before taking their children to hospital. The results also showed that 65% of the children recovered. There was a significant relationship between pre-hospital management and the treatment outcomes of the children, whereby the children who received ORS at home were 40% less likely to succumb to diarrheal related complications (OR=0.6, CI95%=0.5-0.9, P=0.121).
Conclusion: There was a significant relationship between caregivers’ pre-hospital management and treatment outcomes of children with GE. Therefore, there is need for all county governments to enhance health education in the community to promote positive approaches in the management of children suffering from diarrhea at home.
COMMENTS (NPW):
1. Children with diarrhoea are dying needlessly every day in low- and middle-income countries because of gross failures in proviging simple, life-saving treatment. The death in 1987 of a child with diarrhoea was the seed for my commitment to healthcare information for all, and you can listen to my story here (starting at 2mins 27secs): https://www.youtube.com/watch?v=Ax4iS4-AuO0&t=19s That child died from dehydration before the mother reached my medical hut in rural Peru, and the reason was that the parents believed that they should *stop* giving fluids to a child with diarrhoea.
2. This false belief is common across the world, in Latin America, Africa and South Asia. Our collective failure to empower parents with basic life-saving information is an indictment of the global healthcare inforamtion system. The most recent figures I have, from the DHS Survey in India, show that '57 percent of children with diarrhoea were given less to drink and 5 percent were not given anything to drink'. It is because of failures like these that we need a stepchange in high-level commitment, as described in the HIFA Strategy 2022-2024.
3. The paper from Kenya is unfortunately restricted-access, so most of us cannot read the full text. The East Africa Medical Journal is a flagship medical journal for Africa, and is increasingly alone among African journals (many if not most of which are now open access). More debate is needed on how to support LMIC journals to become open-access.
Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org
Working in official relations with WHO
