Diarrhoea among children in rural Somalia. Maternal perceptions, management and mortality.

Diarrhoea was the second most common symptom of disease in a longitudinal study of 431 children under 5 years of age in rural Somalia. Most mothers perceived diarrhoea as a condition in which oral rehydration therapy (ORT) and feeding were logical parts of its management. During 1 year of observation, ORT was used in the household in one-third of the episodes of diarrhoea, mostly by non-farming, young and literate mothers. Infants were treated more often than older children, as were also children in smaller households. In a 3-year demographic surveillance in the same area (1219 person years), the under-5 mortality from diarrhoea in children of literature and illiterate mothers was 43 per 1000 (95% CI 0-84) and 93 per 1000 (95% CI 60-101), respectively. The findings suggest that the use of ORT is associated with a mother's ability to allocate time to health care and her general position in the household.