Discussion
This study assessed the knowledge of mothers about the critical signs of
diarrhea. About 49% of the mothers stated that the passage of three or
more loose stools with blood during the day is an obvious critical sign
of diarrhea that require hospital or physician visit, and almost 23%
reported no knowledge of any critical sign of diarrhea. These results
showed low knowledge among Saudi mothers about the critical sings of
diarrhea, but their knowledge of the critical signs of diarrhea were
higher compared to other mothers in different communities. A study
carried out in Ethiopia found that 39.5% of mothers stated that passage
of three or more loose stools with blood during the day is mark of
severe diarrhea.15 A similar study was done in rural
setting of Kenya determined that majority of mothers (76.4%) did not
identify the critical signs of childhood diarrhea.16 A
study from Nepal reported that 20.8 % of mothers identified the
red-colored diarrhea as “the most dangerous
diarrhea”.2 The critical signs of dehydration have
the similar importance of bloody diarrhea, and the participating mothers
in our study were unable to identify the most common signs of
dehydration. Only 32.1%, 11.6%, and 24.3% were able to recognize
thirst/dry mouth, tearless eyes, and loss of strictness of skin
respectively as the critical signs of dehydration secondary to diarrhea.
The poor knowledge and unrecognized sings of dehydration among mothers
are noticed globally. 2,17-19 Adequate knowledge of
mothers about the critical sings of childhood diarrhea is essential as
the early referral of child with severe diarrhea is fundamental for
appropriate treatment. 15
Poor sanitation of food and water may lead to diarrhea with
approximately 3000 deaths and 135,000 hospitalizations annually
secondary to food-borne transmission of diarrhea causative pathogens in
the United States.20 With the regards for the causes
and transmission of diarrhea, nearly 50 % of participating mothers
believed that eating polluted food is the most common cause of childhood
diarrhea, and only 31 % of mothers identified drinking unclean water as
the reason for childhood diarrhea. In consistent with our findings, many
studies reported low level of mothers towards causes and transmission of
diarrhea.2,16,22 A study from Nigeria reported that
the most common causes for childhood diarrhea were contaminated food
(24.1%) and unclean water (11.3%).8 Another study
from Iran showed that only 24.66% of mothers knew that the unclean
water can cause diarrhea.22 A study was carried out in
Malawi reported that 55 % of mothers stated that unhealthy water is the
main causes of diarrhea.23 The change in knowledge of
childhood diarrhea could be due to variance in mothers’ education
levels.
The misconception between teething and diarrhea seems disseminated
widely. The results of present study showed that 66 % of mothers stated
teething is a reason of their children diarrhea. These results come
agreed with other studies from different
countries.8,22 In addition to the wrong belief of
association between diarrhea and teething, mothers tend to consider
diarrhea secondary to teething as “non-serious diarrhea”, and they may
deal with it loosely even if it’s accompanied by critical signs like
dehydration.24 The efforts should be applied to
educate the mothers about the critical signs of children diarrhea and to
disassociate the belief link between diarrhea and teething.
The mothers’ sufficient knowledge on reasons, prevention and management
of diarrhea utilizing proper therapies is the key for home management of
childhood diarrhea.14,25 According to the Integrated
Management of Childhood Illness (IMCI) guidelines, the use of ORS is the
principle therapy of diarrhea 26. However, the use of
ORS seemed not highly encouraging among mothers. Although of 62 % of
our participating mothers knew about the ORS, only 23.5 % of them used
it for their children. Similar findings were reported. A study from
Nigeria reported that most of mothers (63%) were aware of ORS, but 27%
of them used it for their children.8 In another study did in Pakistan
mentioned that 58% mothers used ORS to treat their childhood diarrhea
disease. 12 Also in our study, it was found the main
resources of mothers regarding ORS usage were medical prescriptions
(50.3%), family/relatives/friends (15.7%), and pharmacists (15.1%).
In a similar study the two main resources of ORS information were
families/friends (76%) and pediatricians (58%). 27Despite of 53.3 % of our participants reports that “ORS prevents a
child from getting dehydrated”, few mothers are using ORS (23.5%). The
reason for a few mothers used ORS could be due to their level of
education and awareness of the mothers on diarrhea management due to
inadequate public information on this issue.
Due to the high rate of literacy and social media usage among Saudis,28,29 and the aim of study to assess the knowledge,
attitude, and practice of mothers towards childhood diarrhea from
community perspective, the study was conducted online to diminish
geographical dependence. The study was performed with significance that
mothers’ knowledge of childhood diarrhea prevention and management would
decrease the unnecessary hospital or clinic visits; however, most of the
participating mothers (68.9%) seek treatment from medical doctor for
their children with diarrhea. This practice of mother was observed in
previous study. 15 In contrast, our subjects showed
good preventive measure. The majority of mothers (70.9 %) believed that
handwashing, which is one essential measure to decrease the prevalence
of diarrhea, 30 prevents childhood diarrhea.
CONCLUSION
About of 40.3 % of participating mothers believed that childhood
diarrhea is major problem in Saudi community. These beliefs are
supported by reports mentioned the prevalence of diarrhea is high in
some area of Saudi Arabia.1 However, insufficient
knowledge of childhood diarrhea and its management were observed.
Adequate knowledge of mothers about the critical sings, causes,
transmission, prevention, and management of childhood diarrhea should be
applied in simple language to communicate the health-related information
in clear manner. Also, There is a lack between the understanding the
role of ORS and its use. Understanding of ORS is not adequate and it
needs reliable efforts to highlight on importance of ORS in resolving
dehydration of childhood diarrhea.