Knowledge, Attitudes and Practices of Caregivers Regarding Diarrhoeal Diseases in Under-Five Children with Special Reference to Medication Use: A Hospital-Based Cross-Sectional Study

Abstract

Background: Diarrhoeal diseases are the major causes of morbidity and mortality amongst children under the age of five years even though they can be avoided and cured. Lack of proper home management and irrational use of drugs and specifically antibiotics is among the factors that lead to poor outcomes and antimicrobial resistance. This would evaluate the knowledge, attitudes and practices (KAP) of caregivers of patients with diarrhoea under-five years old, and particularly medication use.

Methods: The current study was a cross-sectional study in which data was collected in the Departments of Pharmacology and Paediatrics, M.K.C.G. Medical College, between February 2020 and February 2021. One hundred forty four consenting caregivers of children aged 059 months with diarrhoeal illness presenting to OPD/IPD were recruited. A semi-structured, interviewer-administered questionnaire, which is based on WHO recommendations on childhood diarrhoea, was translated and back-translated to Odia, used to collect data. Socio-demographic variables and KAP domains were measured. GraphPad Prism was used to analyse data with the help of descriptive statistics (frequencies, percentages).

Results: Overall, [xx.x%] of caregivers demonstrated adequate knowledge of diarrhoea definition, danger signs and role of oral rehydration salts (ORS), while [xx.x%] had poor knowledge. Only [xx.x%] correctly identified zinc supplementation as a recommended adjunct therapy. A favourable attitude towards early health-facility consultation and continued feeding during diarrhoea was observed in [xx.x%] of participants. In practice, home initiation of ORS was reported by [xx.x%], whereas [xx.x%] used non-recommended remedies (antidiarrhoeals, antibiotics, or herbal preparations). Antibiotics were prescribed in [xx.x%] of cases, frequently in acute watery diarrhoea without dysentery or systemic sepsis. Caregiver education, urban residence and higher socio-economic status were positively associated with better KAP scores. Patterns of antibiotic use were often discordant with WHO recommendations.

Conclusion: Substantial gaps persist in caregiver knowledge and practices regarding evidence-based management of under-five diarrhoea, alongside high rates of potentially inappropriate antibiotic use. Strengthening caregiver education, reinforcing ORS–zinc as the standard of care, and promoting antimicrobial stewardship in paediatric diarrhoeal illness are urgently needed.