Volume 3 Issue 3 2023

Caregivers’ Knowledge and Attitude about Using ORS in the Management of Diarrhea among Under-Five Years Aged Children in Gomma Sub County Mukono District Central Uganda

Chebet Sowedi

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.


The use of ORS in treating childhood diarrhoea reduces its severity, duration and recurrence. Therefore, WHO and UNICEF recommend the use of 10-14 days, treatment regimens for under five-year-old diarrhoea cases The Ugandan Ministry of Health adopted the same regimen that is now part of the Uganda Clinical guidelines. This study determined caregiver’s knowledge and attitude towards use of Oral Rehydration Therapy in the management of childhood diarrhoea in Gomma sub county Mukono district, Central Uganda. This was a descriptive cross-sectional study among caregivers of underfive year children. Structured questionnaires were administered to consenting respondents with ORS use as the main dependent variable. Analysis of the data was done using Microsoft excel program and presented in percentage frequency distribution tables. Out of the 200 participants, majority 192(96% were females, 122(61%) were aged 25 – 49 years, 88(44%) had attained secondary education, about one half, 102(51%) were peasant farmers while 128(64%) were married. According to the study, only 48.0% of caregivers had good knowledge and majority (71.0%) had a favorable attitude towards use of ORS. An overwhelming majority 180(90.0%) had reportedly ever heard about ORS. When asked about the contents of ORS, only two thirds, and 130(65.0%) mentioned all the components of ORS while about a quarter, 34(17.0%) did not know them. About the use of ORS, 130(65.0 %) mentioned treatment or prevention of diarrhea with only 30(15.0%) mentioning treatment/ prevention of dehydration. The majority, 124(62.0 %) knew the correct amount of water used to mix one sachet of ORS while slightly less than one half, 80(40.0 %) knew the correct length of time that prepared Oral Rehydration Solution should be kept. The majority 167(83.5%) agreed that ORS is very important in the treatment of diarrhea, with 123(61.5%) agreeing that all under five-year-old children with diarrhea must receive ORS as part of treatment for diarrhea while 106(53%) were of the view that even if ORS is not given in health facilities, they ought to have to try and buy it to treat childhood diarrhea. The knowledge about ORS among participants was below average. Almost three-quarters of the participants had a favourable attitude towards the use of ORS. There is a need to strengthen caregivers’ awareness of the use of ORS among children under five years.

Keywords: Childhood diarrhoea, Oral Rehydration Therapy, Caregivers, Under five-year-old children, Health facilities.


World Health Organization (WHO) reports that about 2.4 billion diarrhoea cases occur among children under five-year-old children annually. The end result of most of these diarrhoea cases, most of which occur in Africa is death or other severe outcomes. Most of these deaths are due to dehydration [1]. Dehydration causes a decrease in total body water (TBW) in both the intracellular and extracellular fluid volumes. Volume depletion closely correlates with the signs and symptoms of dehydration and the younger the child the more the effects of dehydration in case of body water loss by any means [2]. In dehydration, the body cells are deprived of an adequate amount of water for normal functioning [3]. Dehydration usually as a result of diarrheal diseases is a major cause of malnutrition, delayed physical development, and early childhood mortality in developing countries and poor communities, and one of the major causes of death in under five-year-old children [4]. To prevent dehydration from occurring or worsening it is important that children get good management at home using either homemade sugar salt water or ORT. The caregivers who are well informed on home remedies and or ORT should commence it immediately even before they seek any medical advice once their children start losing fluids from any cause. The “early home remedies” and ORT given in time prevent dehydration and nutritional problems from occurring. This can be done by continuous feeding as well also giving extra fluids. By performing these practices, dehydration can be prevented and this results in a reduction in the adverse effects of diarrhoea on the nutritional status of the young one [5]. Since the early 1980’s the introduction of Oral Rehydration Therapy (ORS) has led to a significant decrease in mortality due to diarrhoea [6]. In view of this scientific discovery, in May 2004, WHO and United Nations Children’s Fund (UNICEF) released a joint statement recommending a switch to a new lower osmolarity formulation for ORS. In 2007 the Government of Uganda adopted World Health Organization/UNICEF recommendations for the clinical management of acute diarrhoea to include both oral rehydration salt (ORS) as part of its national treatment policy and is now part of the Uganda clinical guidelines [7]. Despite improved treatment protocols, diarrhoea continues to be a major cause of childhood morbidity and mortality in Uganda and Mukono district in particular. The 2016 Uganda Demographic and Health Surveys reported underutilization of ORS in treating under-five-year-old children with diarrhoea as up to 20% of under-five year children presenting g with diarrhoea did not receive ORT therapy. The situation is worse in Mukono district where up to 25 % of children under-five years with diarrhea do not receive ORS (Mukono District Annual work plan 2018/19). No study has been done in the Mukono district to explain why there is low use of ORS in managing under five diarrhoea cases. This study was therefore meant to find out factors that hinder the use of ORS in treating under five diarrhoea cases. Knowing these factors will help to improve diarrhoea case management in Mukono district, thereby reducing infant and under-five morbidity and mortality. This study therefore aimed at assessing the knowledge and attitude of caregivers on the use of ORS in the management of under-five childhood diarrhoea.


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CITE AS: Chebet Sowedi (2023). Caregivers’ Knowledge and Attitude about Using ORS in the Management of Diarrhea among Under-Five Years Aged Children in Gomma Sub County Mukono District Central Uganda. NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES (NIJSES) 3(3): 41-49.