|Year : 2016 | Volume
| Issue : 4 | Page : 1012-1017
Knowledge and practice of mothers as determinants of gastroenteritis among preschool children in Sedi-Salim District, Kafer Al-Sheikh Governorate, Egypt
Mahmoud E Abo Salim1, Mohammad M Alkot1, Aml A Salama1, Shaimaa F Abo-Alkheur MBBCh 2
1 Community Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Sedi-Salim Family Health Center, Kafr AlShekh, Egypt
|Date of Submission||20-Jun-2015|
|Date of Acceptance||17-Jul-2015|
|Date of Web Publication||21-Mar-2017|
Shaimaa F Abo-Alkheur
Sedi-Salim District, Kafer Al-Sheikh Governorate, 33511
Source of Support: None, Conflict of Interest: None
The aim of this study was to assess the knowledge and practice of mothers as determinants of gastroenteritis among preschool children in Sedi-Salim District, Kafer Al-Sheikh Governorate.
Diarrhea has been considered as a major cause of mortality in children younger than 5 years. Most of these deaths are due to dehydration and mismanagement or delayed management of the disease. Most diarrhea episodes are treated at home by mothers. Therefore, the mothers' knowledge in management of diarrhea is likely related to its mortality and morbidity.
Patients and methods
A cross-sectional analytical study was conducted involving 170 mothers of patients and 352 mothers of controls, who had at least one child aged 2–5 years old. The study was conducted in Elmofty and Shalma family health units as well as the family healthcare center of Sedi-Salim city, which are randomly selected representing the family healthcare facilities in Sedi-Salim District, Kafer Al-Sheikh Governorate. The questions were about demographic characteristics and knowledge and practice regarding childhood diarrhea, and they had been designed to obtain information through an interview.
The study shows the number of mothers who had good and fair knowledge of diarrhea in the control group was higher than that in the case group. On the contrary, the number of mothers having poor knowledge of diarrhea in case group was higher compared with control group. The aforementioned differences between the two groups are statistically significant.
There is deficiency in mothers' knowledge and practice regarding dealing with gastroenteritis.
Keywords: diarrhea, gastroenteritis, maternal knowledge, practice
|How to cite this article:|
Abo Salim ME, Alkot MM, Salama AA, Abo-Alkheur SF. Knowledge and practice of mothers as determinants of gastroenteritis among preschool children in Sedi-Salim District, Kafer Al-Sheikh Governorate, Egypt. Menoufia Med J 2016;29:1012-7
|How to cite this URL:|
Abo Salim ME, Alkot MM, Salama AA, Abo-Alkheur SF. Knowledge and practice of mothers as determinants of gastroenteritis among preschool children in Sedi-Salim District, Kafer Al-Sheikh Governorate, Egypt. Menoufia Med J [serial online] 2016 [cited 2020 Feb 17];29:1012-7. Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1012/202504
| Introduction|| |
Diarrheal diseases pose a public health problem on a global scale, especially in developing countries . Moreover, two-third of the mortality because of it still occur in developing countries . Worldwide, children younger than 5 years have an estimated 1.7 billion episodes of diarrhea each year, leading to 124 million clinic visits, nine million hospitalizations, and 1.34 million deaths, with more than 98% of these deaths occurring in the developing world .
Studies from other countries in the Middle East estimate the overall annual proportion of rotavirus gastroenteritis (GE) among reported episodes of GE in young children to range between 33 and 53% , although lower rates (16–23%) have been reported from Saudi Arabia and Egypt .
Numerous studies about the maternal awareness of children with diarrhea suggested that the knowledge of the etiologic factors, symptoms, treatment, and caring methods is inadequate .
Mothers' basic knowledge about diarrhea depends on various factors such as educational status, prior experience of managing the disease, and even ethnicity .
Most episodes of diarrhea are treated at home, and mothers are the key caregivers in children younger than 5 years. They are the ones who decide about the nutrition and management of diarrhea in children; therefore, their knowledge about this common disorder is critically important. The main objective of our study was to assess the knowledge of mothers with children about diarrhea.
| Patients and Methods|| |
A cross-sectional analytical study involving 170 mothers of patients and 352 mothers of control individuals, who had at least one child aged 2–5 years old, was carried out. The study was conducted in Elmofty and Shalma family health units as well as the family healthcare center of Sedi-Salim city, which are randomly selected representing the family healthcare facilities in Sedi-Salim District, Kafer Al-Sheikh Governorate. Menoufia Faculty of Medicine committee for medical ethics of research and health authorities in Kafer Al-Sheikh Governorate formally approved the study before it began. The inclusion criteria were mothers of preschool children who were eligible for the study from the beginning of June 2014 till the end of January 2015. Regarding the selection of parents of children recruited in the study, mothers were suitable interviewees to provide adequate information about their children and other variables surrounding the children's environment because mothers spend more time with their children than fathers do. The exclusion criteria were mothers of children who had food intolerance and medication reaction. Data were collected using predesigned questionnaire, which consisted of three main parts. The first part had 20 questions involving age, number of children, and education of the mother and her spouse. Socioeconomic level was determined according to El-Gilany score  by using five parameters (occupation, education, family size, family income, and overcrowdedness).
The second part assessed the mother's knowledge about causes and symptoms of diarrhea. It consisted of 20 questions, including if they knew some causes of diarrhea – infective or malabsorption – and its association with some conditions.
The total scoring of all right answers of knowledge questions was subsequently classified as good, fair, or poor knowledge as follows:
- Good, ≥75% of answers were true
- Fair, 50–75% of answers were true
- Poor, <50% of answers were true.
The third part assessed the mothers' practice regarding GE. Mothers were asked if their children could feed on their own and if their children could, the child ate with a spoon or with his/her hands, and whether (or not) mothers washed their children's hands before eating. Questions were asked to find out if mothers washed their hands at four critical times. If the answer was yes, they were asked specifically if soap was used or not. Mothers were asked if cooked food items were stored, how long the food items were stored for later use, how they cleaned utensils for feeding their children, and how many times they cleaned latrines per week. They were also asked whether (or not) they often bought foods sold by street vendors for their children. In addition, questions on hygienic status of kitchen, the presence of flies in the kitchen, and type of latrines used (old or modern) were asked in the interview.
The data were tabulated and analyzed by SPSS program version 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY/USA : IBM Corp.) using a personal computer. Qualitative data were expressed as number and percentage and analyzed by using χ2-test. Quantitative data were expressed as mean ± SD and analyzed using t-test. P value of 0.001 was highly significant, P value of 0.05 or less was considered significant, and P value greater than 0.05 was considered insignificant.
| Results|| |
Among the 522 mothers recruited in the study, there were eight mothers (4.6%) in the case group and six mothers (1.6%) in the control group who had only primary education. There were 72 mothers (42%) in the case group and 143 mothers (40%) in the control group who had university education. Compared with primary education, higher levels of education of mothers, such as university, are associated with decreased risk of diarrhea ([Table 1]).
|Table 1 Demographic characters of family as risk factors of gastroenteritis among studied group|
Click here to view
The study shows that the number of mothers who had good and fair knowledge of diarrhea in the control group was higher than that in the case group. On the contrary, the number of mothers having poor knowledge of diarrhea in the case group was higher compared with the control group. The aforementioned differences between the two groups are statistically significant (P < 0.05) ([Table 2]).
|Table 2 Knowledge of mother as a determinant of gastroenteritis among studied group|
Click here to view
Regarding knowledge of diarrhea causes and symptoms, mothers having good and fair knowledge made up very high percentages. However, 105 mothers (61.8%) and 22 mothers (12.9%) in the case group had poor knowledge of diarrhea causes and symptoms, respectively. In the control group, 64 mothers (18.1%) had poor knowledge of diarrhea causes and only 10 mothers (2.8%) had poor knowledge of symptoms. A higher percentage of mothers in the control group (80.1%) versus (56.5%) the cases group reported that absence of flies protects against GE ([Table 2]).
There is a statistical significant difference between cases and controls regarding mothers practice, as 63.5% women in the case group versus 50% in the control group used old type of latrine, which constituted a statistical significant difference between cases and controls. Moreover, 4.2% women in the case group versus 27% in the control group cleaned latrines every time it is used, which constituted a statistical significant difference between cases and controls. There were 31.1% women in the case group versus 66.8% women the in control group who always washed vegetables, which constituted a statistical significant difference between cases and controls, and 13.5% women in the case group versus 30.1% the in control group always washed hands after going to bathroom, which constituted a statistical significant difference between cases and controls ([Table 3]).
|Table 3 Mothers practice as a determinant of gastroenteritis among studied group|
Click here to view
| Discussion|| |
A cross-sectional analytical study was undertaken involving 170 mothers of patients and 352 mothers of controls, who had at least one child aged 2–5 years old. The study was conducted in Elmofty and Shalma family health units as well as the family healthcare center of Sedi-Salim city. These were randomly selected, representing the family healthcare facilities in Sedi-Salim District, Kafer Al-Sheikh Governorate.
This study was conducted to assess the knowledge of mothers in Sedi-Salim District, Kafer Al-Sheikh Governorate regarding risk factors of GE among their preschool children.
The mothers of GE cases did not have adequate knowledge compared with mothers of control group about the causes of diarrhea. This low level of knowledge had been noted in other studies .
There was statistical significant difference between the case group (52.6%) and the control group (93.5%) regarding the knowledge of mothers that ORS (oral rehydration solution) is important for treatment of GE. Another study done  reported that three-fourth of women knew about ORS and only one-fourth used it when their child experienced diarrhea.
Regarding the degree of parent education and its effect on prevalence of GE in the present study, there was a statistical significant difference between the case group and the control group. Another study done  reported that educational interventions could improve the mothers' behaviors in the management of diarrhea, and education provides mothers the knowledge of the procedures of hygiene, feeding, and weaning practices; moreover, the interpretation of symptoms enhances timely action to childhood illness.
The study showed significant relation between family size and prevalence of GE. Another study  reported that in rural areas where income is low along with unhygienic environmental situation, there was a higher risk of diarrhea among children who have siblings than among those who are the only child because of lack of parental care.
| Conclusion|| |
There is deficiency in mother's knowledge and practice regarding dealing with GE. Therefore, there is a need for public health educational interventions.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Elnemer FM, El lahony DM, Gad NA. Comparative study of the efficiency of zinc integration in acute diarrhea. Menoufia Med J 2014; 27
Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta Z, et al.
Global burden of childhood pneumonia and diarrhea. Lancet 2013; 381
Fischer CL, Perin J, Aryee MJ, Boschi PC, Black RE. Diarrhea incidence in low and middle-income countries in 1990 and 2010: a systematic review. BMC Public Health 2012; 12
Khoury H, Ogilvie I, Khoury A, Duan Y, Goetghebeur M. Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population. BMC Infect Dis 2011; 11
Tayeb HT, Dela Cruz DM, Al-Qahtani A, Al-Ahdal MN. Enteric viruses in pediatric diarrhea in Saudi Arabia. J Med Virol 2008; 80
Ketsela T, Asfaw M, Belachew C. Knowledge and practice of mothers/care-takers towards diarrhea and its treatment in rural communities in Ethiopia. Ethiop Med J 1991; 29
Mwambete KD, Joseph R. Knowledge and perception of mothers and caregivers on childhood diarrhea and its management in Temeke municipality, Tanzania. Tanzan J Health Res 2010; 12
El-Gilany A, El-Wehady A, El-Wasify M. Updating and validation of the socioeconomic status scale for health research in Egypt. East Mediterr Health J 2012; 18
Othero DM, Orago AS, Groenewegen T, Kaseje DO, Otengah PA. Home management of diarrhea among under-fives in a rural community in Kenya: household perceptions and practices. East Afr J Public Health 2008; 5
Shah D, Choudhury P, Gupta P, Mathew JL, Gera T, Gogia S, et al.
Promoting appropriate management of diarrhea: a systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India. Indian Pediatr 2012; 49
Pahwa S, Kumar GT, Toteja GS. Performance of a community-based health and nutrition-education intervention in the management of diarrhea in a slum of Delhi, India. J Health Popul Nutr 2010; 28
Motlagh ME, Heidarzadeh A, Hashemian H, Dosstdar M. Patterns of care seeking during episodes of childhood diarrhea and its relation to preventive care patterns: National Integrated Monitoring and Evaluation Survey (IMES) of Family Health. Islamic Republic of Iran Int J Prev Med 2012; 3
[Table 1], [Table 2], [Table 3]