Nutritional management of childhood diarrhoea in korogocho informal settlement Nairobi City County, Kenya
Maina, Matthew Mwaniki
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Diarrhea is the second leading cause of death in children under five years old worldwide. Nearly one in five children deaths – about 1.5 million each year is due to diarrhea. Diarrhea is the third most common cause of mortality and morbidity in Kenya, with a case fatality of up to 21 percent causing approximately 9 percent of deaths in children less than five years of age. The primary focus of diarrheal disease control programs has been on improved case management through the promotion of oral rehydration therapy, while nutritional management has been relatively neglected. The purpose of this study was to determine the nutritional management of childhood diarrhea in Korogocho informal settlement. This was a descriptive cross sectional survey that was carried out in Korogocho informal settlement, Nairobi City County. Semi structured interviewer administered questionnaires and focus group discussions were used to collect data. Cluster sampling was used where several steps were taken in selecting the sample. Simple random sampling was used in selecting five out of eight villages and then systematic random sampling was used in respondents’ selection in the selected villages. Participants of focus group discussion were selected through purposive sampling. A sample size of 354 caregivers was selected. Quantitative data was analyzed using the SPSS software version 20 and ENA for Smart software and was presented in graphs and tables. The qualitative data collected from the focus-group discussions was categorized and analyzed using thematic content analyses. Chi square was used to test for statistical significance. Participation in the study was voluntary and written informed consent was obtained from the participants before conducting the interviews. Referrals were made through community health volunteers in case the participants fell ill or a child was diagnosed with danger signs of diarrhea or malnutrition during the study. The prevalence of diarrhea was 17.8%. Majority of the caregivers (89.3%) were mothers and there were more male children (51.1%) than females. Only 5.1% of caregivers had excellent knowledge on nutritional management of childhood diarrhea. Most of the caregivers (58.5%) gave less amount of food to their children when they had diarrhea. Correct use of oral rehydration solution and zinc supplementation was at 65.1% and 7.9% respectively. Prevalence of underweight, stunting and wasting levels among study children were 16.7%, 29.1% and 6.8% respectively. Male children were more stunted and wasted than female children. Children who had diarrhea were 2.3 times as likely to be malnourished as compared to those who did not have diarrhea. There was no significant difference in the nutritional management of childhood diarrhea according to caregiver’s number of children (p=0.815), and age (p=0.491) but there was significant difference according to level of education (p=0.003). The study demonstrated that caregivers’ were not aligned with optimal feeding, zinc supplementation, and fluid intake including oral rehydration solution during childhood diarrhea. Further studies on dietary patterns should be carried out to come up with guidelines for counseling the caregivers on nutritional management of diarrhea.