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ISSN: 2315 6562 E-ISSN: 2384 - 6828

CARE GIVERS KNOWLEDGE ABOUT CHILDHOOD DIARRHEAL

MANAGEMENT IN A RURAL COMMUNITY IN SOUTH-SOUTH NIGERIA
1
TOBIN, E.A. , 2ISAH, E.C. and 1ASOGUN, D.A.1
1
Institute of Lassa Fever Research and Control , Irrua Specialist Teaching Hospital, Irrua, Edo state, Nigeria
2
Department of Community Health, University of Benin Teaching Hospital, Benin-City. Edo state, Nigeria
Corresponding author: Dr. Ekaete Tobin; [email protected]; +2348037544369

ABSTRACT

This study was designed to determine the knowledge of mothers of under-five children of Oral Rehydration Solution
(ORS) and their child feeding/ drug use practices during diarrhea. This descriptive cross-sectional study was carried
out among 204 mothers of under-five years children in a community in Edo state, using researcher administered
structured questionnaires. Data was analyzed using SPSS, with statistical significance set as < 0.05. One hundred
and sixty (78.4%) mothers recognized the acronym ORS out of which 17 (10.6%) knew the full meaning, 143
(83.3%) knew correctly that ORS provided energy during diarrhea, 128 (80.0%) knew it replaced lost fluids.
Seventy-eight (38.2%) mothers acknowledged that children should be given more fluids than usual during diarrhea,
72 (35.3%) more breast milk than usual, and 94 (47.1%), more food than usual. One hundred and twenty (58.8%)
mothers were aware that antibiotics may be used during diarrhea. Overall, only 80 (39.2%) mothers were found to
have good knowledge of home management of diarrhea. Knowledge was significantly associated with age, marital
status, educational status and social class of mothers. Health education should be tailored to address the knowledge
gaps of mothers and target women who were more at risk of poor practice.

Keywords: Home management, Diarrhea, Child feeding practices

Received: 13th September, 2013 Accepted: 23rd October, 2014 Published: 31st October, 2014

INTRODUCTION 1998). Additionally, inappropriate feeding practices,

irrational use of antibiotics, anti-diarrheal
Globally, improved access to sanitation, clean preparations and other forms of drug, including
drinking water, and increased availability of ORS herbal remedies during diarrheal episodes by the
have significantly reduced diarrheal-related deaths in mothers, may contribute to worsen diarrheal
under five children by nearly half the figures morbidity and mortality (Ali et al., 2000; Curtis,
obtained in 1980- 1990 (Boschi-Pinto., et al 2006). 2003; Onyema et al., 2002; Onyema et al., 2004;
Despite this progress, diarrhea still poses a significant Seyal and Hanif, 2009).
threat to the health, wellbeing and survival of under-
fives in many developing countries today, especially As research into diarrheal incidence and home
in Africa and South East Asia, and accounts for as management practices has generally declined, there is
much as 16% of childhood deaths (Black, 2003; at present a dearth of published work on maternal
United Nations Childrens Education Fund, 2010). diarrheal related practices even in Nigeria. The study
The main complication with diarrhea is the aimed to investigate the current level of knowledge
development of dehydration with insufficient fluid of ORS and child feeding/ drug use practices of rural
intake, which can be prevented through the mothers with regard to home management of
appropriate use of ORS (Black et al., 2003). childhood diarrheal disease with a view to providing
recommendations that will be useful in enhancing the
However, there are indications that in some quality and content of health information so as to
developing countries, knowledge and use of oral ensure good practice and an overall success of
rehydration therapy to successfully manage diarrhea diarrheal control in Nigeria.
in under-fives, especially at home, may be declining,
irrespective of the fact that the majority of mothers MATERIALS AND METHODS
are reportedly reached by health education on oral
rehydration therapy (Ekanem and Benebo, 1988; Study area and design: This cross sectional study
Federal Ministry of Health, 2007). Even in areas was conducted in July 2011, in Edo State, in the
where ORS utilization is high, there is growing South-south geopolitical region of Nigeria. Edo State
concern that practice is inappropriate ( Rao et al., is located between latitudes 50 41 and 70 381 North

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and longitudes 50 41 and 6111 East of equator. The meaning of ORS, use of ORS, method of preparation
state has tropical climate characterized by rainy and preservation and frequency of administration was
season between April and October and dry season given a score of 1 each. An incorrect response was
lasting from November to March. The state has a scored zero (0). A positive response each in favour
mean rainfall of about 1300 to 2300 mm (Edo of continued breast feeding, increased fluid intake,
Agricultural Development Programme, EADP, increased quantity of food eaten during and after
1995). Through a multistage sampling technique, a diarrheal episodes, and non-use of drugs in the
representative local government area (Estako Central) absence of fever was given a score of one (1), while a
was selected from amongst 18 others, and a political score of zero (0) was given for negative responses.
ward from within 10 wards in the selected local Total possible score for knowledge of home
government area. The Afemai tribe is in the majority, management of diarrhea was 19. Good knowledge
and predominant occupation as farming. The ward is was described by an aggregate score 50% of the
home to one comprehensive and several Primary total, while poor knowledge, a score <50% of the
health care centers. total.

Sample size: Sample size was calculated as 184, Data analysis: Data was analyzed using the
obtained using the formula for prevalence study, N = Statistical Package for Social Sciences (SPSS) for
pq/(E/1.96)2 (Araoye, 2003), with p set as 14% Windows version 15.0 (SPSS Inc, Chicago IL 60606-
being the proportion of caregivers who could 6412). Categorical data were presented as frequency
correctly prepare the UNICEF ORS in a study carried tables, while continuous data were summarized as
out in Enugu, Nigeria (Adimora et al., 2011) and means with standard deviation. Chi-square test of
non-response rate of 10%. association was carried out where appropriate with
statistical significance set as p < 0.05.
Study population: Study population included
mothers of under-five children. Mothers who had Ethical Consideration: Institutional ethical approval
been resident in the study area for at least one year was obtained and verbal consent voluntarily given by
prior to the study and were present at home were respondents. Confidentiality of respondents was
eligible for the study. maintained.

Sampling technique and data collection: A RESULTS

preliminary survey carried out in the ward identified
eligible mothers, following which all were invited to Two hundred and eighty nine mothers were
participate. Consenting mothers were interviewed identified, of which 204 (70.6%) participated in the
using a structured questionnaire designed by the study. Mean age was 29.47 + 6.6 years as shown in
researchers after an extensive literature search, and table 1 alongside their socio-demographic profile.
with the objectives in mind. The questionnaire was
divided into two parts: Part A: socio-demographic A greater proportion of the mothers (146; 91.3%)
questions and part B ORS knowledge related obtained their health information on management of
questions focusing on knowledge of benefits of childhood diarrhea from the health centres. Other
ORS, preparation and frequency of use for feeding. sources of information were family (7; 4.4%), mass
Other questions sought to investigate child feeding media (5; 3.0%) and social club (2; 1.3%).
and drug practices during diarrhea. The questionnaire
was initially tested with 20 subjects in the pilot One hundred and sixty (78.4%) respondents were
phase. Thereafter, amendments were made to ensure familiar with the acronym ORS, though only 17
content and construct validity, including the addition (10.6%) respondents correctly knew the full meaning
of suitable options and modification in wordings of to be oral rehydration solution as against 143
some questions. The administered questionnaires (89.4%) who could not. Overall, 134 (83.8%)
were collated and responses coded. respondents knew correctly that ORS provided
energy during diarrhea, 128 (80.0%) knew it replaced
Maternal knowledge of home management of lost fluids, while 88 (55.0%) and 113 (70.6%) knew
childhood diarrhoea was determined by allotting that ORS increased appetite and cured diarrhea
scores to responses to questions on ORS, feeding and respectively.
drug use. A similar scoring system has been used in
a previous study carried out in Nepal (Rehan et al., A larger proportion (134; 83.8%), knew the correct
2003). A correct response to questions relating to ingredients (bowl, ladle, boiled clean water, ORS

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sachet) required to mix ORS [one ORS sachet to 1 As to the quantity of breast milk a child with diarrhea
litre of water (two 500ml sachet water packs)]. should receive, 72 (35.3%) respondents knew that
Seventy seven (58.3%) respondents knew correctly more breast milk than usual should be given.
that prepared ORS should be discarded after 24 hours However, 96 (47.1%) were of the opinion that the
same quantity of breast milk as usual should be
Table 1: Socio-demographic characteristics of given, while 36 (17.6%) opined breast feeding should
respondents (N = 204) be reduced.

Variable Frequency Ninety-four (47.1%) respondents opined that more

(%) food than usual should be given during diarrhea, 80
Age (Years) (39.2%) same amount as before diarrhea, and
< 24 46 (22.5) 38(18.6%) less food be given. During convalescence,
25 34 114 (55.9) 94 (46.1%) caregivers opined that food intake should
35 44 38 (18.6) be more than before diarrhea, 102 (50.0%) same as
> 45 6 (2.9) before, while only 8(3.9%) mentioned less than
Social Class before diarrhea episode.
Low 154 (75.5)
Middle 40 (19.6) Furthermore, twenty (9.8%) respo ndents knew that
High 10 (4.9) children with diarrhea should not be administered any
form of medication as part of home therapy, but 120
Ethnic Group
(58.8%) said antibiotics may be given. About 123
Estako 196 (96.1)
(60.3%), 96 (47.1%), 86 (42.2%) and 72(35.3%)
Others 8 (3.9)
stated that anti-diarrheal drugs, multivitamins,
Religion analgesics and antimalarials should be given
Christianity 76 (37.3) respectively. No mother had ever heard of the use of
Islam 128 (62.7) zinc tablets in the management of diarrhea.
Marital status
Single 4 (2.0) Overall, 124 (60.8%) respondents were graded as
Married (monogamy) 146 (71.6) having poor knowledge of home management of
Married ( polygamy) 54 (26.5) childhood diarrhoea while 80 (39.2%) had good
Educational status knowledge. Knowledge was significantly associated
None 36 (17.6) with age, educational level and socioeconomic status
Primary 94 (46.1) of mother (p = 0.00, 0.01 and 0.00 respectively).
Secondary 64 (31.4) Thus, unskilled mothers , those with no formal
Tertiary 10 (4.9) education and those aged >45 years and less than
24 years had poorer knowledge compared to others
groups (see table 2).
while 22 (16.7%) incorrectly mentioned 12 hours, 9
(6.8%) 72 hours, 7(5.3%) 168 hours, and 6 (4.5%) DISCUSSION
after 6 hours. Fifty six (35.0%) would discontinue
ORS if child refused to take or vomited, while 104 The familiarity of most mothers with ORS has
(65.0%) would encourage child to take ORS. similarly been reported in other studies carried
out within and outside the country ( Ahmed et al.,
One hundred and thirty two (82.5%) respondents 1994; Akpede et al., 1997; Chattopadhyay, 2008;
mentioned that ORS was the preferred fluid to be Datta et al., 2001). However, it appears that the
given at home during diarrhea. Other home based all-too- popular use of the acronym had resulted
fluids included coconut water 26(16.3%), rice water in the majority being unfamiliar with its full
14(10.6%), weak tea or beverage 12 (7.5%), soft meaning . The knowledge of the ability of ORS to
drinks 23 (14.4%) and herbal remedies 68 (42.5%). prevent dehydration and restore energy was known
to many, as was similarly reported in a study in
One hundred and eighty four (90.2%) respondents Rawalpindi (Sultana et al., 2010) and contrary to
were of the opinion that a child being weaned from what was reported in a study carried out in
breast milk should continue to receive same when Northern-Nigeria (Ogunrinde et al., 2012).
he/she has diarrhea, while 20 (9.8%) recommended
stopping breastfeeding altogether.

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Table 2: Socio-demographic determinants of maternal knowledge of home management of diarrhea

(N = 204)

Variable Knowledge Total (N; %) p value

Good (n; %) Poor (n; %)

Age (years)
< 24 26 (56.5) 20(43.5) 46 (100.0)
25 34 74 (64.9) 40 (35.1) 114 (100.0)
35 44 24 (63.2) 14 (36.8) 38 (100.0) 0.01*
> 45 0 (0.0) 6 (100.0) 6 (100.0)
< 24 26 (56.5) 20(43.5) 46 (100.0)
Social Class
Low 84 (56.0) 66 (44.0) 154 (100.0) 0.01*
Middle 32 (80.0) 8 (20.0) 40 (100.0)
High 8 (80.0) 2 (20.0) 10 (100.0)
Marital status
Single 0 (100.0) 4 (0.0) 4 (100.0) 0.00*
Married (monogamy) 38 (70.4) 16 (29.6) 146 (100.0)
Married ( polygamy) 82 (56.2) 64 (43.8) 54 (100.0)
Educational Status
None 10 (27.8) 26 (72.2) 36 (100.0) 0.01*
Primary 56 (59.6) 38 (40.4) 94 (100.0)
Secondary 36 (56.3) 28 (43.8) 64 (100.0)
Tertiary 6 (60.0) 4 (40.0) 10 (100.0)

Likewise, the wrong perception that ORS cures represent women whose children stand the risk of
diarrhea implies that the role of ORS in diarrheal dehydration from diarrhea, or ingestion of hyper-
management needs further emphasis. This latter or hypo osmolar ORS solutions with resultant
misconception has also been identified in other increased morbidly in the children. It is important
studies (Akpede et al., 1997). This misconception that health care workers seize every opportunity
may lead to mothers abandoning ORS if diarrhea during contacts with mothers at home or in health
persists or eventually subsides, even when facilities to deliver information of use of ORS,
dehydration is still present in the child as was irrespective of whether the child has diarrhea or
reported in a study carried out in rural north India not.
(Bently, 1988) .
The mention of herbal remedies by some mothers
The correct steps and ingredients for the may not be unrelated to traditional beliefs about
preparation of ORS was known to the majority, the cause of childhood diarrhea, mistrust of the
contrary to what was found in some other orthodox health system, or wrong counseling
studies (Adimora et al., 2011; MacDonald et al., from family members particularly elderly mothers
2005; Seyal and Hanif, 2009). The reason may (Adhikari et al., 2006, Ellis et al., 2007) . While
probably be because such would have been some herbs may find a place in the management
demonstrated in the health facilities during health of childhood diarrhea (Subbotina eta..,2003), the
talks or previous consultations for diarrhea , or danger use of herbs in this study site lies in the fact
because the materials needed for preparation are that they may be produced under hygienic
readily available, and come in measurements that conditions, nor subjected to any form of analysis
mothers can easily remember. . The minority who to determine content and efficacy. Thus, they may
missed out on the steps or ingredients represent a complicate the diarrheal process, and should be
group who may have been left out from health discouraged. Health educators need to reach not
information or may have never used ORS . They only mothers but other members of the family that

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ISSN: 2315 6562 E-ISSN: 2384 - 6828

are influential in taking decisions regarding care of making power and a reliance on alternative
the children with diarrhea. medicine. Interestingly, children of these women are
also more likely to suffer from diarrhea. It may be
Mothers were generally ignorant as to necessary to design messages that can be
appropriate feeding practices during diarrhea, with delivered through the use of posters and
the majority of the belief that food should be pictorials preferably delivered in the local
withheld or reduced. This finding was also reported language. Literacy level and occupation were
in other studies (Ogunbiyi and Akinyele, 2010) , associated with knowledge of ORS in a study in
and contrary to what was obtained in Pakistan ( Gulbarga (Dhadave et al., 2012). Knowledge of
Morisky et al., 2002) where over 80% continued to ORS was found to be higher among educated
provide adequate food and fluids for their children mothers belonging to the middle socioeconomic
with diarrhea. Withholding of food by mothers and class in Rawalpindi (Sultana et al., 2010) . Others
failure to compensate for decreased food intake by studies also associate better knowledge of ORS
increasing feeding during convalescence are major with higher educational levels in mothers (Datta
contributors to the adverse nutritional outcomes of et al., 2010; Rasania et al., 2005; Taha, 2002) On
diarrhoea. (Ogunbiyi and Akinyele, 2010). The the contrary, a study carried out among 24
practice of gut resting during diarrhea is based on mothers in Kamala found no significant
the belief that feeding could enhance the passage of association between demographic variables and
frequent watery stools, thus increasing the severity awareness of ORS ( Chattopadhyay, 2008) possibly
and prolonging the duration of diarrhea. Studies due to the small sample size. Though single
have however proven that the gut kept in a mothers and those in polygamous relationships in
resting state atrophies with a fall in the level of the present study had poorer knowledge compared
digestive enzymes , and a reduction in absorption to those in monogamous relationships, the finding
of nutrients ( Isolauri et al., 1986). was not significant.
The mention of anti-diarrheal drugs and
antibiotics by over 50% of mothers in this study CONCLUSION
may not be surprising as antibiotics are easily
obtained from markets and ambulatory vendors, and There is an urgent need for concerted and intensified
can be purchased individually or a few at a time to health education of mothers of under-five children, to
minimize the cost, a factor appealing to many address the identified knowledge gaps. Health
locals ( Ellis et al., 2007) . Drugs have no place in education should be delivered in a manner acceptable
diarrheal treatment except for dysentery or to them considering their socio-cultural and
cholera ( Dutta et al., 1990). Studies carried out in economic backgrounds. Sustaining the process will
Cambodia ( Saunders , 2005) , and Kenya ( Othero et ensure that new mothers are captured. Use of the
al., 2008) also found 58% and 45.3% of mothers mass media will ensure more mothers are reached
respectively to give anti-diarrheal medicines. This with information on ORS. Research on the
is an area health educators need to address, as impediments to use of ORS is recommended.
guidelines for home management of diarrhea have no
place for use of anti-diarrheal agents ( Dutta et al, ACKNOWLEDGMENT
1990). Moreover, indiscriminate use of antibiotics
can lead to microbial resistance, adverse reactions The authors would like to express their gratitude to
and increased treatment cost ( Gupta and Gupta, the research assistants who participated in data
2000). The ignorance of use of zinc is not collection, and to the study participants
surprising as the drug is yet to gain widespread
acceptance even among health workers. REFERENCES

Thus study has shown that mothers who were in Adhikari, K.P., Kunwar, L.S., MacDonald, V., and
dire need of health information on management Paudel, M. (2006). Qualitative Research for a Zinc
of childhood diarrhea at home were those who Treatment Program in Nepal: Findings and
were of low social class, those without formal Recommendations. [Cited 2012 February 20]
education and those who were less than 24 years Available from:
and older than 45 years of age . These are women http://www.pspnone.com/content/resource/detail/328
who may most likely have reduced access to, and 0/
contact with health professionals as a result of
inability to afford health care, low decision

Tobin, IJCR 2014; 3(4): 93 - 99. 97

International Journal of Community Research http://www.arpjournals.com
ISSN: 2315 6562 E-ISSN: 2384 - 6828

Adimora, G.N., Ikefuna AN, Ilechukwu G. 2011. Datta V, John R, Singh VP, Chaturvedi P. 2001.
Home management of childhood diarrhea: need to Maternal knowledge, attitude and practices
intensify campaign. Niger J Clin Pract. 14 (2): 237- towards diarrhea and oral rehydration therapy in
41 rural Maharashtra. Indian J Pediatr. 68 (11):
1035-1037
Ali M, Atkinson D. Underwood P. 2000.
Determinants of use rate of oral rehydration therapy Dhadave, M.M., Kumar, G.A., Reddy, S.,
for management of childhood diarrhea in rural Vijayanath, V. 2012. A study on diarrhea related
Bangladesh. Journal of Health Population and practices awareness of ORS among mothers of under
Nutrition. 18(2): 103-108 five children attending OPD, CHTC, Rajapur.
JPBMS.19 (19):1-6
Ahmed IS, Eltom AR, Karrar ZA, Gibril AR.
1994. Knowledge, attitude and practices of Dutta P, Bhattacharya SK, Dutta D. 1990.
mothers regarding diarrhea among children in a Management of acute diarrhea. Ind J Public
Sudanese rural community. East Afr Med J. 71 Health. 34:38-40.
(11): 716-9
Edo Agricultural Development Programme (EADP).
Akpede GO, Omotara BA, Webb GD, Igene JO. 1995. Edo Agricultural Development Programme
1997. Caretakers knowledge and preparation Meteorological Main Station, Irrua, Edo State,
abilities of salt sugar solution in North eastern Nigeria. (unpublished meteorological report )
Nigeria. J Diarrhoeal Dis Res.15 (4): 232-40
Ekanem EE, Benebo NS. 1988. A community-based
Araoye MO . 2003. Research methodology with survey of the awareness and acceptability of ORT as
statistics for health and social sciences. Ilorin: a treatment for acute diarrhoea in children. Early
Nathadex Publishers. Child Development and Care . 34(1) : 95-102

Bachrach LR, Gardner JM. 2002. Caregivers Ellis AA, Winch P, Ddaou Z, Gilroy KE, Swedberg
knowledge, attitude and practice regarding E. 2007. Home management of childhood diarrhea in
childhood diarrhea and dehydration in Kingston Southern Mali- implications for the introduction of
Jamaica. Rev Panam Salud Publica. 12 (1): 37-44 zinc treatment. Social science and Med. 64: 701-712

Bentley ME. 1988. The household management of Federal Ministry of Health. Integrated maternal
childhood diarrhea in rural North India. Soc Sci newborn and child health strategy. 2007. [Cited 2011
Med. 27 (1): 75-85. February 12]. Available at : http://www.pathsnig.org/

Black RE, Morris SS, Bryce J. 2003. Where and why Gupta RK, Gupta R. 2000. First action
are 10 million children dying every year ?. Lancet . management of acute diarrhea in children by rural
(316): 2226-2234. mothers. JK Science. 2(2): 96-98.

Boschi-Pinto C., Lanata C.F., Mendoa W., Habte Isolauri E, Vesikari T, Saha P, Viander M. 1986.
D.2006. Diarrheal disease. In: Jamsion, D., Milk versus no milk in rapid feeding after acute
Feachem, R.G., Makgoba M.W et al., editors. gastroenteritis. J Paediatr Gastroenterol Nutr. 5 (2)
Disease and Mortality in Sub-Sahara Africa. 2 nd ed. : 254-61
Washington (DC): World Bank.
MacDonald SE, Moraalejo DG, Mattthews KM.
Chattopadhyay K.. 2008. Awareness of oral 2005. Correct preparation and administration of oral
rehydration salt ( ORS) among mothers of under rehydration solution: essentials for safe and effective
five children in Kamala village, West Bengal, home treatment of diarrhea in Indonesia.
India. A cross sectional study. [Cited 2012 March International quarterly of community health
23]. Available from: education. 24(3): 205-214
http://www.bookpump.com/dps/pdf-b/9423936b
Morisky D, Snehendu BK, Chaudhry AS, Chen KR,
Curtis V. 2003. Talking dirty: how to save a million Shaheen M, Chickering K. 2002. Updates on ORS
lives. International Journal of Environmental Health usage in Pakistan: results of a national study.
Research. 13(1): s73-9 Pakistan Journal of Nutrition. 1(3): 143-150.

Tobin, IJCR 2014; 3(4): 93 - 99. 98

International Journal of Community Research http://www.arpjournals.com
ISSN: 2315 6562 E-ISSN: 2384 - 6828

Ogunbiyi BO, Akinyele IO.2010. Knowledge and Seyal T, Hanif A. 2009. Knowledge, attitude and
beliefs of nursing mothers on nutritional management practices of the mothers and doctors regarding
of acute diarrhea in infants in Ibadan , Nigeria. feeding, oral rehydration solution (ORS) and use of
African Journal of Food, Agriculture, Nutrition and drugs in children during acute diarrhea. Annals (1):
Development. 10 (3): 2291-2304 38-41
Ogunrinde OG, Raji T, Owolabi OA, Anigo 2012.
KM. Knowledge, attitude and practice of home Subbotina MD, Timchenko VN, Vorobyov MM,
management of childhood diarrhea among Konunova YS, Aleksandrovih YS, Shushunov S.
caregivers of Under 5 children with diarrheal 2003. Effect of oral administration of tormentil root
disease in Northwestern Nigeria. J Trop Pediatr. extract ( Potentilla tormentilla) on rotavirus diarrhea
58 (2): 143-46 in children: a randomized, double blind, controlled
trial. Pediatr Infect Dis J. 22 (8): 706-11
Othero DM, Orago ASS, Groenewegen T, Kasefe
DO, Otenjah PA. 2008. Home management of Sultana A, Rizwana R, Ahmed R, Khurshid R.
diarrhoea among under-5s in a rural community in 2010. Knowledge and attitude of mothers
Kenya. Household perceptions and practices. East regarding oral rehydration salt. J of Rawalpindi
African J of Public Health 5(3): 142-146. Medical College. 14 (2) : 109-111

Onyema EC, Ibadin OM, Ofovwe EG. 2002. Current Taha AZ. 2002. Assessment of mothers knowledge
trends in the use of salt sugar solution in the and practice in use of ORS for diarrhea in rural
management of acute diarrhea episodes in Benin Bangladesh. Saudi Med J. 23 (8): 904-8.
City, Nigeria. Journal of Medicine and Biomedical
Research . 1(1): 43-50. United Nations Childrens Education Fund. Diarrhea:
why children are still dying and what can be done.
Onyema LA, Ofovwe GE, Ibadin MO, Abiodun PO. [Cited 2012 January 12]. Available from:
2004. Treatment of childhood diarrhea by operators http://www.7pointplan.org/global-burden-childhood-
of drug stores in Oredo LGA of Edo state. Nigerian diarrhea.html
Medical Practitioner. 64(3) : 42-45.
AUTHORS CONTRIBUTIONS
Rasania Sk, Singh D. Pathi S, Matta S, Singh S.
2005. Knowledge and attitude of mothers about All the authors involved in this study participate in
oral rehydration solution in few urban slum of the study design, data collection and analysis, as well
Delhi. Health and population - perspective and as the subsequent drafting and review of the
issues. 28 (2) : 100-107. manuscript. No conflict of interest is declared.

Rao KV, Vinod KM, Retherford RD. 1998.

Knowledge and use of ORT for childhood diarrhea in
India: effects of exposure to mass media. National
Family Health Survey Report.[Cited 2012 Feb 12].
Available from : http://rehydrate.org/ors/ort-
knowledge.htm

Rehan HS, Gautam K, Gurung K. 2003. Mothers

needs to know more regarding management of
childhood acute diarrhea. Indian J Prev Soc Med
.34(1 & 2):40-5.

Saunders N. 2005. Maternal knowledge, attitude

and practices concerning child health among
mothers of children younger than 60 months in
Kep district , Kingdom of Cambodia. [Cited 2011
Feb 20]. Available from:
http://wiki.straightjacketstudio.com/images/6/63/CIH
2005-6-NSaunders-ChildHealthKAP.pdf

Tobin, IJCR 2014; 3(4): 93 - 99. 99