Knowledge, attitudes and practices associated with oral rehydration therapy among caregivers of children two years or less with diarrhoea in Arua district, Uganda

Abstract

Diarrhea has been considered as a major cause of mortality in children aged less than five years old. It accounted for 526,000 (9%) of all deaths globally in 2015 and Uganda contributed nearly 7000 (8%). Most of these deaths are due to dehydration. Most of the diarrhea episodes are treated with oral rehydration therapy (ORT) and zinc in the home by caregivers. Only 47 % of children in Uganda however receive or use ORT. This study assessed and established caregiver knowledge, attitudes and practices associated with ORT use among caregivers of children two years or less with diarrhea in Arua district in Uganda. A descriptive community based cross-sectional study design was used. A total of 414 pairs of caregivers and their two-year-old or less children who reported having experienced diarrhea in the two weeks preceding the survey were consecutively recruited from Arua Municipality and Ayivu county in Arua district. Data was collected on demographic variables such as, knowledge, attitudes and practices associated with ORT use using a structured questionnaire. Odds ratios and their confidence intervals were used to measure associations between various exposures and the outcome variables. Multivariable logistic regression models were run to control for possible confounders. A total of 81 out of 414 (20%) of the caregivers had correct knowledge of ORT use and 382 out of 414 (92%) had negative attitude towards ORT. A total of 114 out of 414 (28%) diarrheal children were treated with ORS only, 126 out of 414 (30%), were treated with ORS and Zinc, and 36 out of 414 (9%) were treated with Zinc only within the first 24 hours of onset. 138 out of 414 (33%) were not treated. Urban caregivers were less likely to have their children use ORS compared to caregivers in rural areas. OR: 0.5, 95% CI: (0.294 - 0.754), p-value of 0.002, Caregivers with primary level education are less likely to give ORS to their diarrheal children compared to those with no education. OR: 0.574, 95% CI: (0.334 - 0.986), p-value of 0.044, while no significant association was found between caregivers with advanced and higher education compared to those with no education. OR: 1.505, 95% CI: (0.405 - 5.598) p-value of 0.542. Caregivers with income level between UGX 50,000/= to UGX 200,000/= per month are twice more likely to have their children use ORS compared those with less than 50,000/= per month. OR: 2.029, 95% CI: (1.192 - 3.452); p-value of 0.009. Caregivers with correct knowledge of diarrhea were twice more likely to have their children use ORS compared to caregivers who had incorrect knowledge. OR: 1.938, 95% CI: (1.236 - 3.04); p-value of 0.004. Caregivers had inadequate knowledge, negative attitude and practices about ORS in Arua. Factors associated with use of ORS were caregiver residence, education, household income and knowledge of diarrhea. There is need to improve caregiver education, household income and knowledge on diarrhea in order to promote ORS use in children of two years old or less with diarrhoea in Arua District.