MODELLING OF MITIGATING DIARRHOEA IN THE WETLAND AREA OF BANYUASIN DISTRICT, INDONESIA: A CROSS-SECTIONAL STUDY

Diarrhoea is one of the causes of high morbidity and mortality rates in developing countries that have poor environmental sanitation, inadequate water supply, high poverty rates and low levels of education. The purpose of this study was to examine diarrhoea control models in toddlers of Banyuasin District wetlands. This study used a cross-sectional study design. The study was conducted in the wetland area of Banyuasin District with a sample of 296 respondents. Data analysis was performed in univariate, bivariate and multivariate. The results showed that there was a correlation between chemical indicators (p-value = 0.035), latrine sanitation (p-value = 0.004), latrine quality (p-value = 0.005), income (p-value = 0.023), and hand washing with soap (p-value = 0.035) with the occurrence of diarrhoea in toddlers of Banyuasin District wetlands area. 51.9% of diarrhoea prevention can be explained by the water factor (19.7%), sanitation factor (15.6%), personal hygiene factor (8.2%), toddler factor (4.8%) and mother factor (3.5%) in this study. Improvements of environmental sanitation related to healthy latrines, rubbish bins, sewerage and clean / drinking water sources, as well as intensive education about personal hygiene and breastfeeding toddlers can contribute in reducing the occurrence of diarrhoea in toddlers.

Communication in Health - A Challenge

The recent discussion nationally on vaccine hesitancy and reluctance to follow Covid appropriate behaviour has once again brought focus on how communication in health has remained a challenge after all these years.Why haven't we convinced mothers to wash hands and use fluids available at home for diarrhoea prevention? Why do doctors fail to give proper advice to patients even for their own prescription? Why aren't proper instructions given while dispensing IFA? Why are the four key messages not given by health workers during vaccination? One common thread runs through all these: lack of communication.

Non-antibiotic possibilities in prevention and treatment of calf diarrhoea

Due to increasing bacterial antibiotic resistance and the consumers’ tendency to choose organic products, cattle farmers are interested in alternative methods of calf diarrhoea treatment. This is a major challenge for veterinarians. Few methods of non-antibiotic treatment that bring satisfactory results have been reported in the related literature so far. In this article, the authors compare different non-antibiotic methods of diarrhoea prevention and treatment in calves. Among the alternatives discussed are herbs, probiotics, prebiotics and synbiotics, lactoferrin, and bacteriophages. It was found that the best results could be achieved through the use of pro-, pre- and synbiotics. However, the authors would like to point out that with the expansion of knowledge about the practical use of broad-scale bacteriophages, they could be the best alternative to antibiotics.

Process of developing education material on water, sanitation and hygiene (WaSH) and diarrhoea prevention and testing its acceptability among tribal mothers

The study aimed to develop education material on WaSH practices and assess its content and acceptability. Online survey of 19 posters identified two Marathi posters that were not context- or setting-specific. A three-phased evaluation study was conducted to assess (i) WaSH practices of mothers attending an ANC centre (n = 40) and (ii) performed a quantitative content analysis of education material developed on WaSH (n = 38). Focus group discussions (FGDs) were employed for qualitative content analysis (n = 10). (iii) Acceptability was derived from the scores of quantitative content analysis. Relevance of content and use of fear appeal emerged as significant characteristics using qualitative content analysis. In quantitative content analysis, the maximum score for the domains pertaining to relevance and comprehension was 5 each and for the layout was 3. The mean scores for posters 1 and 2 were 4.34 ± 0.9 and 4.00 ± 1.1 for relevance; and 4.89 ± 0.3 and 4.95 ± 0.2 for comprehension, respectively. Acceptability ranging between 68 and 100% in all three domains for both the posters indicated high acceptability. Maximum acceptability score was obtained for comprehension followed by relevance and layout for both the posters. Tribal populations can benefit from these communication aids that are context- and setting-specific. These can be adopted with relevant cultural modifications to suit similar settings.

Using ICT for diarrehoea intervention in resource constrained environments : a case study of Narok County in Kenya

Diseases are the major causes of mortality worldwide with developing countries having the highest disease prevalence. Diarrhoea is one of the major diseases worldwide and especially in poor countries with its victims being mostly children below the age of five years. Diarrhoea is most prevalent in rural areas of poor countries which is due to poor awareness about the disease. Effective use of ICTs can greatly enhance health information dessimination and consequently improve disease awareness. The aim of this study was to reduce diarrhoea prevalence by raising awareness using suitable technologies in the context environment. The study was based in Narok County, one of the counties in Kenya with most of the people living in the rural areas. The county has high diarrhoea prevalence due to low levels of awareness which is attributed to use of ineffective strategies and technologies in dissemination of health information. A control and an experimental group from two similar sub-locations were identified for the study. Purpose sampling technique was used in data collection. The study was quantitative conducted in three parts concurrently. Part one was a retrospective chart review of dispensary records of children under the age of five years who suffered from diarrhoea. Part two consisted of a pre-test post-test experimental study of 175 mothers with children below the age of five years from each group.The experimental study was a diarrhoea intervention through awareness on children below the age of five years through their mothers who are the caregivers. A structured questionnaire was used to collect data during this phase. Part three conducted concurrently with parts one and two was a cross sectional survey on community health volunteers. The study established that the previously used strategies and technologies had failed because they were not suitable for the area. Mobile phones were identified as the most pervasive and preferred technology in the area for diarrhoea information dissemination. A mobile phone-based system was developed and used in diarrhoea intervention through awareness. Diarrhoea education voice messages were sent through the system to the mothers in the experimental group for three months but not to the control group. The system was unique in that it used mobile phones, which is the most pervasive technology in the area, the messages were in voice and in the Maasai language which is the local language. This allowed the illiterate to benefit from the intervention. The system allowed interaction between the participants and the system and the system allowed participants in emergency situations to contact a health worker. The intervention caused an improvement in diarrhoea awareness in the experimental group from 42.69% to 87.10% which was significant (effect size= 0.81) but there was no significant change in the control group (p>0.999). On diarrhoea prevention practices, there was a significant improvement from 36.9% to 73.0% in the experimental group (effect size=0.643) however there was no significant change in the control group (p=0.526). Diarrhoea prevalence significantly reduced from 28% to 19.6% in the experimental group (p=0.002) but there was no significant change in the control group (p=0.557). Using the data collected during the study, a diarrhoea intervention framework for resource constrained environments that integrates use of suitable technology in the context environment in diarrhoea intervention was developed. The framework addresses diarrhoea intervention from the awareness point of view because high diarrhoea prevalence is associated to low diarrhoea awareness. The framework can also be adopted in interventions of other diseases that can be prevented by creating awareness. The study concluded that when the right technology for the context environment is used to raise diarrhoea awareness, the awareness increases which leads to improved diarrhoea prevention practices and consequently to reduced diarrhoea prevalence.

Dukungan Sosial sebagai Faktor Utama Pemberian Intervensi Gizi Spesifik pada Anak Usia 6-24 Bulan dengan Kejadian Stunting berbasis Transcultural Nursing

Introduction: Stunting is a chronic nutritional issue that happens in the world including Indonesia caused by local cultural factors. Madurese people are one of the races that closely live to their culture. Madurese people practice a culture that is related to nutrition intervention provision for toddlers. This study was aimed to analyse the factors related to specific intervention provision as an effort to prevent stunting from occurring to toddlers aged 6-24 months old.Methods: This study used analytical design in Galis community health care December 2019. The population in this study were 160 mothers with toddlers aged 6-24 months old in which 115 of them were selected as sample based on purposive sampling. The inclusion criteria were the mothers who lived with their child in one house and caring for the child themselves. Exclusion criteria were mothers with a history of Special Economic Zone (SEZ) and mothers who were not present at the time of the study. The independent variables in this study were technological factor, religious and philosophical factor, social support factor, cultural value and lifestyle, political and legal factor, economic factor, and educational factor. Meanwhile, the dependant variable was the provision of specific nutritional interventions, namely colostrum, exclusive breastfeeding – breastfeeding up to 23 months accompanied by complementary foods, worm medicine, zinc supplements, iron, complete immunization, and diarrhoea prevention and treatment. The data were collected by questionnaires with Logistic Regression Analysis.Results: The result of this study showed that social support is related to specific nutrition intervention provision with significance of p= 0.003. Cultural values and life style are related to specific nutrition intervention provision with significance of p= 0.048.Conclusion: According to this study, factors that give significant influence is social support consisting of instruction information and advice. Madurese people still believe that the most influential and experienced persons in child caring are grandmother, mother in law, and parents.

Qualitative exploration of local knowledge, attitudes and use of Moringa oleifera seeds for home-based water purification and diarrhoea prevention in Niger State, Nigeria

This qualitative study explored stakeholders' knowledge of diarrhoea; their attitude to and perceptions of the use of Moringa oleifera seeds for home-based water treatment (HWT) and diarrhoea prevention in a low resource setting. Data were collected using semi-structured interviews with 13 respondents comprising rural community dwellers, health implementers and policy makers, and analysed using thematic analysis. Most rural community members interviewed had no knowledge of specific causes of diarrhoea or of the link between unsafe water and diarrhoeal diseases. They also practised inadequate or no methods of HWT. Although respondents were unaware of the use of M. oleifera seeds for HWT, community members and policymakers were keen on adopting it after observing demonstrations of its use for this purpose. Reasons for this behaviour change included easy accessibility to and a familiarity with M. oleifera for other uses. These results highlight the importance of providing health education on diarrhoea and water safety to motivate and empower community members to adopt healthy HWT behaviours. The use of M. oleifera seeds for HWT should be taught and advocated because it is a cheap, efficient and acceptable method of water purification for stakeholders.

Knowledge of Prevention and Management of Childhood Diarrhoea among Nigerian Mothers: A Public Health Survey

Background: Diarrhoea accounts for 1,300 deaths every day globally. Mothers’ knowledge of preventive measures and practices in the management of childhood diarrhoea influences the disease’s morbidity and mortality. Objectives: This study assessed the knowledge of, and practices mothers adopt in childhood diarrhoea prevention and management. Methods: A cross sectional study was carried out among mothers in five rural communities in South-Eastern Nigeria using pretested questionnaires. Completed questionnaires were subjected to descriptive and associative analysis. Results: Two thirds of the mothers surveyed (N=374; 67.9%) had poor knowledge of diarrhoea. Less than half mentioned a good hygienic environment (33.5%) as being essential to keeping diarrhoea at bay, 16.5% boiled their drinking water while 70.9% could not prepare a simple oral rehydration solution (ORS) correctly. Two out of ten mothers (20.6%) used an antibiotic in the treatment of diarrhoea and 27% visited the hospital only when the child became very weak. Mother’s occupation (P = 0.002) and her monthly income (P = 0.004) significantly affected their knowledge while age, monthly income and level of education significantly influenced their practices (P<0.05). A higher knowledge of diarrhoea was significantly associated with better feeding practice (P = 0.0001) and correct actions taken to treat diarrhoea (P = 0.003). Conclusion: Most of the mothers surveyed had poor knowledge about diarrhoea prevention and management and also exhibited poor practices. Educational strategies aimed at improving parental knowledge and practices towards diarrhoea in their children could produce better gains in reducing the menace of poorly treated diarrhoea.