Childhood Diarrhea

Globally, diarrhea continues to be one of the major causes of mortality; but among children aged less than five years. India as a country, has the highest number of childhood deaths due to diarrhea with 400,000 deaths annually. Three states of India, including Madhya Pradesh (MP), account for nearly half of India’s childhood diarrhea burden. The majority of childhood diarrhea deaths (80%) occur in rural areas, where informal healthcare providers (IHCPs) are the predominant providers.

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 including the objective to use community participation; and drug utilization research to improve diarrheal case management.

In India, diarrhea seasonality is well knowing. Rotavirus infections present two seasonal peaks in India; one in winter and the other in summer; the increase in temperature reduces the transmission of rotavirus infections. But in summer, the limited potable water supply poses potential public health risks for diarrhea. The scarcity of potable water during hot Indian summers and the peaking of diarrhea during summers probably shapes the community’s perception; that hot weather is an important risk factor for diarrhea.

Diarrheal index households

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.

Hence, the study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on the streets (89%). Therefore, the results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; but 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%).

Major public health concern

Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented. Childhood diarrhea is a major public health concern globally and in India. Effective interventions are known but are rarely implemented in resource-limited settings and settings with fragmented healthcare systems, similar to the settings in this study.

The results of this study provided insights into community awareness of causes of diarrhea, its treatment, and other WASH-related variables. The results of the present study will help the design of content-specific interventions at the community level for the mothers, children, and healthcare workers.