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Prescribing pattern by doctors for acute diarrhoea in children in Delhi, India
1National Institute of Communicable Diseases, Delhi, India.
Insights
In Delhi, India, healthcare providers rarely prescribed oral rehydration solutions (ORS) for young children with acute watery diarrhea, instead opting for drugs or IV fluids. This highlights a critical need for better education on ORS use in pediatric care.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Acute watery diarrhea is a significant cause of childhood morbidity and mortality globally.
- Oral rehydration therapy (ORT) using oral rehydration solutions (ORS) is the recommended first-line treatment for dehydration due to diarrhea.
- Suboptimal ORS utilization persists in many regions, necessitating investigations into treatment practices.
Purpose of the Study:
- To investigate the pre-hospitalization treatment patterns for acute watery diarrhea in children under five years old in Delhi, India.
- To assess the utilization rates of oral rehydration solutions (ORS) versus other treatments like drugs and intravenous fluids.
- To identify factors contributing to the observed treatment profiles.
Main Methods:
- A cross-sectional study involving interviews with parents (primarily mothers) of 264 children under five years old admitted with acute watery diarrhea.
- Data collection focused on treatments administered before hospitalization, including ORS, medications, and intravenous fluids.
- Statistical analysis was performed to compare treatment groups.
Main Results:
- Only 22% of children received prescriptions for oral rehydration solutions (ORS).
- A substantial majority (64%) were treated with drugs (antibiotics, antidiarrhoeals), and 40% received intravenous fluids.
- Both government and private healthcare providers demonstrated low ORS prescription rates, indicating a widespread lack of confidence in ORS.
Conclusions:
- The study reveals a significant underutilization of oral rehydration solutions (ORS) for childhood diarrhea in Delhi.
- Healthcare professionals exhibit low confidence in ORS, leading to the prevalent use of less appropriate treatments.
- A targeted, high-profile continuing education program is essential to promote ORS prescription and improve diarrhea management in the region.
Abstract:
Parents (mostly mothers) of 264 children aged less than 5 years with acute watery diarrhoea were interviewed about their treatment profile before hospitalization in Delhi, India in 1993. Only 22% of the cases were given prescriptions for oral rehydration solutions (ORS), whereas a very high proportion (64%) of them were given drugs, including antibiotics and antidiarrhoeals and 40% were given intravenous fluids. The differences among the treatment groups were highly significant. The government and private doctors were equally responsible for the low rate of prescription of ORS. The confidence of health professionals in ORS appears to be very low. The findings suggest the need of a high-profile continuing education programme to encourage ORS prescription in Delhi.