Treatment of Acute Diarrhea in Children Aged 1–5 Years Provided by Doctors in Surabaya
1. The focus of this study was on the treatment methods for acute diarrhea, which have not been extensively investigated in the region studied.
2. This study can provide an overview of doctors' adherence to the available guidelines for the treatment of acute diarrhea in children aged 1–5 years in Surabaya, Indonesia.
Diarrhea is the second leading cause of death among children under five, following pneumonia. Insufficient knowledge of diarrhea and dehydration management may contribute to this high mortality rate. Implementing prompt and effective management and prevention strategies has the potential to decrease morbidity and mortality associated with diarrhea. Therefore, this cross-sectional study aimed to investigate the treatment methods used by doctors for children aged 1–5 suffering from acute diarrhea in Surabaya, Indonesia. Data were collected from doctors in Surabaya using an online form containing case-based questions. Microsoft Excel for Mac version 16.17 (Microsoft Inc., Redmont, WA, USA) was used to process the binary data by calculating frequencies and percentages with a point estimate of 95% confidence interval (CI). A descriptive method was used in the data analysis, and the findings were presented in tables. From a total of 51 respondents who participated in this study, 18 (35.29%) only administered oral rehydration therapy. In addition, 49 respondents (96.08%) prescribed zinc supplementation for ten days, while 10 respondents (19.61%) opted for antibiotics. Interestingly, 49 respondents (96.08%) recommended both breast milk and food for the patients, and nearly all respondents provided guidance to the mother or caregiver of the patient. The findings of this study suggested that the respondents primarily used rehydration therapy to treat children suffering from acute diarrhea with moderate dehydration. However, some respondents still relied on antibiotics despite the available recommendations to use oral rehydration therapy. Nearly all respondents agreed on zinc supplementation, breast milk and food provision, and advice for the mother or caregiver of the patient. While certain aspects of the disease management for diarrhea align with the recommended guidelines, there is room for improvement in promoting the exclusive use of oral rehydration therapy and reducing unnecessary antibiotic prescriptions.
Abdul-Mumin A, Ervin S, Halvorson EE (2019). Clinical characteristics associated with increased resource utilization of hospitalized children under 5 years with acute gastroenteritis at a tertiary hospital in the northern region of Ghana: a retrospective study. Pan African Medical Journal. doi: 10.11604/pamj.2019.33.186.13133.
Adiba AF, Soedarmo SM, Sulistiawati S, et al (2022). Acute diarrhea patients among children under five hospitalized in a Tertiary Hospital in East Java, Indonesia. Folia Medica Indonesiana 58, 33. doi: 10.20473/fmi.v58i1.31423.
Akuffo R, Armah G, Clemens M, et al (2017). Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana. BMC Research Notes 10, 292. doi: 10.1186/s13104-017-2621-x.
Athiyyah AF, Shigemura K, Kitagawa K, et al (2019). Norovirus genogroup correlation with acute diarrhea severity in Indonesian pediatric patients aged 1-60 months: a cross-sectional study. F1000Research 8, 2130. doi: 10.12688/f1000research.21069.1.
Behera P, Bhatia V, Sahu DP, et al (2021). Adherence of doctors to standard diarrhoeal management guideline during treatment of under-five diarrhoeal episodes: A study from Eastern India. Cureus. doi: 10.7759/cureus. 13433.
Bishwakarma A (2022). Guideline for the management of diarrhoea in children. Ministry of Health Male’ Republic of Maldives. Available at: https://health.gov.mv/ storage/uploads/Bxope4wv/hgbg4afz.pdf.
Brandt KG, de Castro Antunes MM, da Silva GAP (2015). Acute diarrhea: evidence-based management. Journal de Pediatria (Rio J) 91, S36–S43. doi: 10.1016/j.jped.2015.06.002.
Cherukuri N, Wadhwa N, Sobhan PK (2022). Standard treatment guidelines 2022: Acute watery diarrhea. Indian Academy Pediatrucs. Available at: https://iapindia.org/pdf/Ch-020-STG-Acute-Watery-Diarrhea.pdf.
Church JA, Fitzgerald F, Walker AS, et al (2015). The expanding role of co-trimoxazole in developing countries. The Lancet Infectious Disease 15, 327–339. doi: 10.1016/S1473-3099(14)71011-4.
De T, Kondekar S, Rathi S (2016). Hospital based prospective observational study to audit the prescription practices and outcomes of paediatric patients (6 months to 5 years age group) presenting with acute diarrhea. Journal of Clinical Diagnostic Research 10, 1–5. doi: 10.7860/JCDR/2016/19924.7810.
Gawronska J, Koyanagi A, López Sánchez GF, et al (2022). The prevalence and indications of intravenous rehydration therapy in hospital settings: A systematic review. Epidemiologia 4, 18–32. doi: 10.3390/epidemiologia40100 02.
Guarino A, Ashkenazi S, Gendrel D, et al (2014). European society for pediatric gastroenterology, hepatology, and nutrition/European society for pediatric infectious diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. Journal of Pediatric Gastroenterology & Nutrition 59, 132–152. doi: 10.1097/MPG.0000000000000375.
Guarino A, Lo Vecchio A, Dias JA, et al (2018). Universal recommendations for the management of acute diarrhea in nonmalnourished children. Journal of Pediatric Gastroenterology & Nutrition 67, 586–593. doi: 10.1097/MPG.000000000000 2053.
Indriyani DPR, Putra IGNS (2020). Penanganan terkini diare pada anak: tinjauan pustaka. Intisari Sains Medis 11, 928–932. doi: 10.155 62/ism.v11i2.848.
Jordan N, Ranuh IGMRG, Sari GM (2020). Profile of diarrheal patients aged less than five years old hospitalized in Dr. Soetomo General Hospital Surabaya in 2016-2018. JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Univesritas Airlangga 11, 45. doi: 10.20473/juxta.V11I22020.45-50.
Kassa SF, Alemu TG, Techane MA, et al (2022). The co-utilization of oral rehydration solution and zinc for treating diarrhea and its associated factors among under-five children in Ethiopia: Further analysis of EDHS 2016. Patient Preference and Adherence 16, 1713–1721. doi: 10.2147/PPA.S356557.
Ke B, Ran L, Wu S, et al (2012). Survey of physician diagnostic and treatment practices for patients with acute diarrhea in Guangdong Province, China. Foodborne Pathogens and Dis 9, 47–53. doi: 10.1089/fpd.2011.0964.
Maskey S, Bajracharya M, Bhandari S (2019). Prevalence of cesarean section and its indications in a tertiary care hospital. Journal of Nepal Medical Association. doi: 10.31729/jnma.4282.
Minister of Health of the Republic of Indonesia (2012). Buku saku lintas diare untuk petugas kesehatan. Ministry of Health of the Republic of Indonesia, Jakarta. Available at: https://agus34drajat.files.wordpress.com/2010/10/buku-saku-lintas-diare-edisi-2011.pdf.
Minister of Health of the Republic of Indonesia (2019). Profil kesehatan Indonesia tahun 2019. Minist Heal Repub Indones. Available at: https://www.kemkes.go.id/downloads/ resources/download/pusdatin/profil-kesehat an-indonesia/Profil-Kesehatan-Indonesia-2019.pdf.
Ozuah PO, Avner JR, Stein REK (2002). Oral rehydration, emergency physicians, and practice parameters: A national survey. Pediatrics 109, 259–261. doi: 10.1542/peds. 109.2.259.
Shane AL, Mody RK, Crump JA, et al (2017). 2017 infectious diseases society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clinical Infectious Diseases 65, e45–e80. doi: 10.1093 /cid/cix669.
Shitemi CW (2018). Adherence to clinical guidelines in the management of diarrhoea diseases in children aged below five years admitted at Mama Lucy Hospital, Nairobi (thesis). University of Nairoby. Available at: http://erepository.uonbi.ac.ke/bitstream/handle/11295/105454/Shitemi_Adherence To Clinical Guidelines In The Management Of Diarrhoea Diseases In Children Aged Below Five Years Admitted At Mama Lucy Hospital, Nairobi.pdf?isAllowed=y&sequence=1.
Sudarmo SM, Shigemura K, Athiyyah AF, et al (2015). Genotyping and clinical factors in pediatric diarrhea caused by rotaviruses: one-year surveillance in Surabaya, Indonesia. Gut Pathogens 7, 3. doi: 10.1186/s13099-015-0048-2.
Toaimah FHS, Mohammad HMF (2016). Rapid intravenous rehydration therapy in children with acute gastroenteritis. Pediatric Emergency Care 32, 131–135. doi: 10.1097/PEC.0000000000000708.
World Health Organization (2013). Ending preventable child deaths from pneumonia and diarrhoea by 2025: the integrated global action plan for pneumonia and diarrhoea (GAPPD). WHO. Available at: https://apps.who. int/iris/bitstream/handle/10665/79207/WHO_FWC_MCA_13_01_eng.pdf.
World Health Organization (2017). Diarrhoeal disease. WHO. Available at: https://www.who.int/news-room/fact-sheets/ detail/diarrhoeal-disease.
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