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In most cases, diarrhea can be treated at home by oral rehydration therapy (ORT) that has significantly decreased the mortality related to diarrhea disease.13 Although this method of treatment is cheap, adequate, reasonable, and safe, few mothers listed that the aim of using (ORS) during diarrhea is to treat dehydration of diarrhea.
In order to demonstrate the best home care of children with diarrhea in our community(Saudi) by investigating certain knowledge deficiencies, specific inappropriate attitude, and particular improper practice toward children diarrhea and its management
INTRODUCTION
Diarrhea is a common illness that is considered a major threat to children, and it may lead to death in developing countries particularly amongst children aged up to 5 years 1-3 Twelve million children are estimated to die in developing countries before the age of five years. Around 70% of those children die because of five medical issues; one of them is diarrhea. 1,4 Despite of that age, climate changes, and the use of rotavirus vaccine can contribute to variations in pathogen-causative diarrhea, rotavirus was the most common causative pathogen especially in unvaccinated children against rotavirus.5 In Saudi Arabia, rotavirus was noticed in 41.3% to 65.5 % of cases causing children diarrhea.6,7 In addition to microbial-induced diarrhea, Diarrhea can result from intolerance of certain kinds of food particularly lactose containing milk.8
Regardless of diarrhea-induced causes, dirty weaning food, improper nourishing practice, absence of clean water, poor hand washing, constrained sterile transfer of waste, poor lodging conditions, and absence of access to satisfactory and moderate social insurance are aggravating factors of diarrhea in children under 5 years old.9 A study in Saudi Arabia reported that environmental risk factors associated children diarrhea included sewage leakage near the home, eating out after school hours and utilizing reusable cloths or sponges to dry dishes.10
Enhancing mothers’ proper knowledge and demonstrating appropriate practice is a key to prevent or halt the progression of diarrhea. However, mothers’ harmful practices such as nourishment limitation, breast feeding avoidance, and utilization of inappropriate conventional therapy or wrong prescription have been reported.11 In addition, the knowledge of mothers toward the signs of dehydration secondary to diarrhea is poor.2,12 In most cases, diarrhea can be treated at home by oral rehydration therapy (ORT) that has significantly decreased the mortality related to diarrhea disease.13 Although this method of treatment is cheap, adequate, reasonable, and safe, few mothers listed that the aim of using (ORS) during diarrhea is to treat dehydration of diarrhea.2,13 In order to demonstrate the best home care of children with diarrhea in our community by investigating certain knowledge deficiencies, specific inappropriate attitude, and particular improper practice toward children diarrhea and its management, the aim of this study is to evaluate knowledge, attitude and practice of mothers towards diarrhea in children and its management at home.
METHODS AND MATERIALS
Online cross-sectional survey based study targeting mothers who are living in Saudi Arabia were carried out to measure knowledge, attitude and practice of mothers towards diarrhea and its management in their children at home. The data collection was carried out from the beginning of March to the end of April 2019. The questionnaires for this study was prepared after an extensive literature review from similar studies published in this regard 2,13. The questionnaires for this study grouped in four parts. The first part was to collect demographic data (such as age of mother, mother’s education level, mother’s job, child’s age, etc.). The second part is the knowledge domain questions with the multiple-choice options discussing subjects like signs and symptoms of diarrhea, diarrhea causes, preventive measures and critical signs of diarrhea as well as critical signs of dehydration. The third part focused on manner of management practice of diarrhea at home. The fourth part was the attitude domain questions that were composed of 11 questions assessed by 5 point Likert Scale (strongly agree, agree, neutral, disagree, and strongly disagree). A panel of 3 members (two professors and a researcher) from college of pharmacy, king Saud university who were experts in preparing the study tool were reviewed the questionnaire. The survey was translated into Arabic language by an independent translator, and reviewed again for the appropriateness of language before testing its validity. The questionnaire was then validated through randomly selected 10 respondents in a pilot study carried out at college of pharmacy king Saud university. The respondents recruited in the pilot study were mothers and did not include in the final results or had no contact with the subjects of the study. Reliability test was determined using Cronbach’s alpha of the questionnaire and it was found 0.73.
The sample size for this study was calculated using an online sample size calculator (http://www.raosoft.com/samplesize.html) by assuming a larger population size with a margin of error ± 5% and a confidence level of 95%, which resulted in a sample of 384 individuals.14 Statistical Package for Social Sciences version 25 (SPSS) software was applied to analyze the data. Descriptive statistics and Chi-squared test were also used.
RESULTS
A total of 1140 respondents filled the questionnaire. About 24% of respondents were aged from 36 to 40 years, and only 5.4 % of respondents received no formal education. More than half of mothers were housewife (52.1%). Slight more than one third of children were aged above 2 years. The demographic of mothers and their children are summarized in Table 1. Table 1. Demographic data of mothers and their children