The use of oral rehydration salt in managing children under 5y old with diarrhea in the Gambia: Knowledge, attitude, and practice

Objective: Diarrhea is a leading cause of mortality in children under the age of 5y in developing countries. To our knowledge, no other studies have investigated the management of diarrhea in the Gambia. The aim of this study was to assess maternal knowledge, attitude, and practice in the causes, prevention, and management of diarrhea in children under the age of 5 y in the Gambia. Methods: Four hundred mothers with children who have diarrhea and are under the age of 5 y were randomly recruited. Data were collected using structured questionnaires, including demographic information, knowledge about diarrhea, attitude toward the management of diarrhea, and practice for the prevention and management of diarrhea. χ² and Student's t tests were used for the descriptive and quantitative analysis, respectively. Simple and multiple linear regressions were used to determine the association between the variables. A P-value < 0.05 was considered statistically significant. Results: The mean of maternal knowledge (K), attitude (A), practice (P), and knowledge-attitude-practice sum (KAP) scores were 14.4, 6.3, 13.2, and 33.9, respectively. The mean of knowledge scores were significantly higher in mothers who responded positively for germs (13.4 versus 12.6) and dirty hands (13.7 versus 13.0) as causes of diarrhea. Mothers with education had significantly higher knowledge (14.7 versus 14.2) and attitude scores (6.6 versus 6.1) in management of diarrhea. However, the study found a low use rate (4%) of oral rehydration solution in practice. Multiple linear regression analysis revealed that maternal age was positively associated with practice (β=0.061) and KAP scores (β=0.102). The number of children in the family was positively correlated with attitude scores (β=0.408). Socioeconomic status was positively associated with attitude (β=0.549), practice (β=0.841), and KAP scores (β=1.887). Conclusions: The mothers have high knowledge scores in the management of diarrhea; however, use of oral rehydration solution is low among children with diarrhea under the age of 5 y in the Gambia. Higher maternal age and socioeconomic status are correlated with higher practice and KAP scores.