Factors associated with appropriate diarrhea case management in hospitalized children under five in Nyanza Province, Kenya
Weaver, Anne Marie
MetadataShow full item record
Diarrheal disease is a major source of morbidity and mortality for children under five years old in Nyanza Province, Kenya. Oral Rehydration Therapy (ORT) is a simple, inexpensive, and effective treatment for acute diarrhea in children. However, according to recent surveys, ORT use is low in Nyanza Province, Kenya. The goal of this study was to determine modifiable factors associated with ORT use in this population. A cross-sectional study of primary caregivers of hospitalized children under five was conducted in Nyanza Province. In the study, caregivers were asked about diarrhea case management, clinical features of their children's illnesses, beliefs about diarrhea and treatment, self efficacy, social support, demographic factors, and other potential factors that may influence ORT use. These factors were grouped into behavioral constructs. A logistic regression model was created within each construct, in order to determine which factors in that construct were associated with ORT use independently of other factors in that construct. Then, a final cross-construct logistic regression model was created, testing together the factors that were independently associated with ORT use in each construct-specific model. In the final cross-construct model, a caregiver feeling a child could die (OR adj 4.2 95% CI 1.4-12.8, p = 0.01), a caregiver feeling she knows how to prepare Oral Rehydration Solution (ORS) (OR adj 3.4, 95% CI 1.2-9.8, p = 0.03), and advisors to the caregiver recommending ORS and/or increased fluids (OR adj 3.8 95% CI 1.3-11.1, p = 0.01) were independently significantly associated with ORT use. This indicates that risk perception, self efficacy, and social support are important determinants of ORT use in this population. These factors are all potentially modifiable by designing and implementing interventions.