Department of Pediatrics, R. D. Gardi Medical College, Ujjain 456006, India.
Global Health-Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
Int J Environ Res Public Health. 2019 May 11;16(9):1646. doi: 10.3390/ijerph16091646.
Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation and drug utilization research to improve diarrheal case management. The mean age was 2.08 years, with 297 (19%), children living in high diarrheal index households. Most mothers (70%) considered stale food, teething (62%), and hot weather (55%) as causes of diarrhea. Water, sanitation, and hygiene (WASH)-related characteristics revealed that most (93%) households had toilets, but only 23% of the children used them. The study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on the streets (89%). The results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; littering around the household, 15%) and of correct diarrhea treatment (oral rehydration solution (ORS) and zinc use, 29% and 11%, respectively) and a high antibiotic prescription rate by healthcare providers (83%). Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented.
儿童腹泻仍然是全球和印度五岁以下儿童（U-5）死亡的主要原因。本研究纳入了印度乌贾因市的 9 个农村村庄和 4 个城市贫民窟的 1571 名 U-5 儿童，旨在利用社区参与和药物利用研究来改善腹泻病例管理。平均年龄为 2.08 岁，有 297 名（19%）儿童生活在高腹泻指数家庭中。大多数母亲（70%）认为变质食物、出牙（62%）和炎热天气（55%）是腹泻的原因。与水、环境卫生和个人卫生（WASH）相关的特征表明，大多数（93%）家庭都有厕所，但只有 23%的儿童使用。研究发现，大多数家庭（93%）通过布过滤对家庭用水进行了无效处理，且将家庭垃圾倾倒在街道上（89%）。研究结果表明，社区对正确腹泻原因（手卫生不当，21%；乱扔垃圾，15%）和正确腹泻治疗（口服补液盐（ORS）和锌的使用，分别为 29%和 11%）的认识不足，而且卫生保健提供者开具抗生素处方的比例很高（83%）。基于本研究的结果，将设计并实施针对特定环境的逐户干预措施。
