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Med J Malaysia. 1990 Dec;45(4):304-9.

Knowledge and use of oral rehydration therapy for childhood diarrhoea in Tumpat District.

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Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan.


A community based study was conducted on the understanding and knowledge of childhood diarrhoea and use of oral rehydration therapy (ORT), in four selected villages in Tumpat District, Kelantan. The calculated annual incidence of diarrhoeal disease in children aged 0 to four years in all study villages was 1.38 episodes for each child. The main care-givers of children aged 0 to four years were interviewed and asked to demonstrate how to mix a standard ORS (oral rehydration solution) sachet if they had previously used ORT. Forty percent of care-givers had heard of the locally available ORT and 30% had actually used ORT. Of those who had heard of or used ORT, 10% had good knowledge of what it was and what it was used for, 51% had some knowledge and 39% had either no knowledge or inaccurate knowledge. Of care-givers who had previously used ORT only 20.5% demonstrated the correct volume of water to add to one sachet of ORT, but 82% would discard an unused solution within 24 hours. Significantly more literate women had used ORT than those not literate (p = 0.002). Mothers, particularly those literate, are the primary target group for ORT intervention strategies. Components of health education should include advice on what ORS is, what it is used for, and how to correctly mix a standard sachet.


In May-June 1988, community medicine professors oversaw interviews of 265 primary caregivers of 0-4 year old children living in 4 villages in Tumpat District in Kelantan State, Thailand, and collected secondary data from the health centers and district hospital serving these villages to identify epidemiological features of childhood diarrhea and knowledge and use of oral rehydration therapy. The annual incidence of diarrhea stood at 1.38 episodes/child. 21 children (5.3%) had diarrhea in the 2 weeks before the interview. Literate mothers were considerably more likely to use oral rehydration solution (ORS) than were illiterate mothers (38.7% vs. 22.6%; p = .002). 40% of all mothers were familiar with ORS, but only 30% had used ORS. 10% of mothers who knew about our used ORS demonstrated strong knowledge of ORS and 39% had no knowledge. ORS usage was highest in village C (55.2% vs. 32.6% for the village with the next highest usage rate) which had the lowest proportion of houses with latrines (8.7% vs. 21.9% for the village with the next lowest proportion) and the second lowest proportion of houses with safe water (3.3% vs. 3.7% and 12.3%). 94.9% of mothers said they could correctly prepare ORS, yet only 20.5% could actually do so (31% in the village with the highest maternal educational level [49.5% vs. 19.2% for the village with the lowest educational level]). Nevertheless, 82.1% of the mothers stating they knew how to prepare ORS knew that they had to throw out the unused prepared solution in less than 24 hours. The study population used 5 different ORS sachets, the most commonly used sachet being that of the Ministry of Health (250 ml). Other ORS sachets included the 200-ml sachet (Eltolit) from the Universiti Sains Malaysia Hospital, an orange flavored Eltolit, and 2 sachets with instructions in English (240 ml and 250 ml). The abbreviation ml confused many of the literate women.

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