Fluid curtailment during childhood diarrhea: a countdown analysis

BMC Public Health

Research Article

Holly Newby¹  Liliana Carvajal-Velez¹  Emily Carter²  Jennifer Bryce²  Jamie Perin² 

[1] Division of Data, Research and Policy, Data and Analytics Section UNICEF, UNICEF, 3 UN Plaza, 10017, New York, NY, USA;Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, 21205, Baltimore, MD, USA;

关键词: Diarrhea;    Behavior Change Intervention;    Oral Rehydration Salt;    Childhood Diarrhea;    Multiple Indicator Cluster Survey;   

DOI  :  10.1186/s12889-015-1878-z

 received in 2014-10-10, accepted in 2015-05-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe foundation of recommended diarrhea management in young children is increased fluids and continued feeding. This increase in fluids is necessary to replace those lost during diarrhea and ultimately prevent dehydration. There may be an opportunity to prevent deaths in children under five by discouraging the practice of reducing or curtailing fluids during diarrhea episodes across different settings worldwide.MethodsWe quantify and describe the extent of fluid curtailment in children with diarrhea in a selection of countries (Burkina Faso, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania, and Uganda) with high burden of diarrhea-related mortality with national cross sectional survey data. We examine the practice of fluid curtailment in these countries and its relationship to child and household traits and to characteristics of diarrhea management.ResultsThe prevalence of fluid curtailment among children under five with diarrhea is strikingly high in these countries: 55 % in Nigeria, 49 % in Ethiopia, 44 % in Uganda, 37 % in Tanzania, 36 % in DR Congo and 32 % in Burkina Faso. Fluid curtailment is associated with giving less food, potentially worsening the impact of this harmful practice. Children who were reported to have had fluids curtailed during diarrhea episodes were also 3.51 (95 % confidence, 2.66 - 4.64) times more likely to be reported to have food withheld (α = 0.05; p < 0.001). Children who received care from non-governmental providers, and those who were breastfed were more likely to have their fluids curtailed, as were children with an unimproved water source. Children of poorer or less educated mothers and those living in rural areas are more likely to have curtailed fluids, compared to children of less poor or more educated mothers, or those living in urban areas.ConclusionsThe harmful practice of curtailing fluids for a child with diarrhea is highly prevalent, representing an increased risk of dehydration and complications due to diarrhea, including death, especially for children in specific subgroups.

【 授权许可】

CC BY   
© Perin et al. 2015