CHAPTER ONE

INTRODUCTION

1.0 Background

Acute gastrointestinal infections are a major source of morbidity and mortality in preschool children and lead to about 446,000 deaths every year, mainly in low and middle-income countries (WHO-UNICEF, 2004). The highest burden is concentrated in tropical areas where populations lack access to clean water, sanitation and hygiene, making this condition a neglected disease (WHO, 2013). Gastroenteritis is a group of common childhood diseases, requiring a systematic approach to its diagnosis, management and prevention. This is because the child with gastroenteritis is at risk of becoming dehydrated, experiencing Hypernatremia, dehydration and developing shock.

Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain, with the main symptom being the passage of many episodes of watery stool (diarrhoea).

According to World Health Organization (WHO), Passage of 3 or more episodes of loose or watery stools a day or considers as abnormal by the mothers or stools more frequent than normal for a child is considered as diarrhoea (WHO, 2013). Diarrheal disease remains the second leading cause of death among children <5 years of age globally (WHO, 2005). Nearly one in every five deaths of a child or about 1.5 million infant death annually is due to gastroenteritis (Morris et al, 2003). It kills more young children than malaria HIV/AIDS, and measles together (WHO, 2013).

Diarrheal disease is one of the commonest illnesses that has the greatest negative impact on the growth and development of infants and young children. Worldwide, children whose age is less than 5 years’ experience, on average, 3 episodes of diarrhoea every year and consequently 1.87 million children will die from dehydration associated with diarrheal disease, particularly in the countries of Asia, Africa and Latin America (WHO, 2013). Diarrhoea is a major public health issue in developing countries. It accounts for one of the major causes of infant morbidity and mortality, as a result of the severe consequences which are essentially due to acute dehydration and malnutrition (OMS/UNICEF, 2001). Oral rehydration salts (ORS) and Oral rehydration therapy (ORT), adopted by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) in the late 1970s led to better management of cases of childhood diarrhoea (Bryce et al, 2005). Even though there is a double reduction in the prevalence of gastroenteritis in children under 5 years in the last 16 years in Cameroon, it is still one of the most important public issue and major health problems of the country.

Gastroenteritis can be caused by a number of factors with the Rotavirus among the commonest diarrheal pathogen in children worldwide that causes about one-third of diarrhoea-associated hospitalizations and 800,000 deaths per year (Walker et al, 2013).

Contaminated weaning food, inappropriate feeding practice, lack of clean water, poor hand washing, limited sanitary disposal of waste, poor housing conditions, and lack of access to adequate and affordable health care are aggravated factors of the under 5 diarrheal disease (Keusch et al, 2006). Optimal infant & young child feeding practices could prevent more than 10% of deaths from diarrhoea. On the other hand, better hygiene practices, particularly hand washing with soap & the safe disposal of excreta can reduce the incidence of diarrhoea by 35% (Hackett et al, 2015).

1.1 Problem Statement

According to UNICEF (2012), only 39% of children under five years receive appropriate Treatment for acute gastroenteritis in developing countries with little progress made since year 2000. In Cameroon, despite the existence of effective and available measures, the management of diarrhea remains a major problem in our context as demonstrated in the last 2011 demographic survey in which 21% of children had diarrhea, with only 23% seeking medical treatment from a health facility. Furthermore, only 17% and 22% of the sick children received ORT [4]. Thus the knowledge and practices of mothers with regards to diarrhea at home remains a crucial point in the management so as to intervene early on the first signs and avoid complications. That is why we proposed to evaluate the knowledge and practices of mothers in the management of diarrhea in children under 5 Buea town,

1.2 Rationale

Diarrhoea is not lethal itself, the improper knowledge, poor practice and negative attitudes of mothers and their misdirected approach towards its management and prevention leads to high degree of severe dehydration and lastly death (Mumtaz et al, 2014). The community of Buea Town like any other community, Mothers occupy very important role in the care of children especially those under the age of 5.  for  proper  intervention  and  quality  care  of  this children,  mothers need  to be up to date   with current trends in  the causes and management of  gastroenteritis Inappropriate home management of acute gastroenteritis in children under five years contribute largely to the number of children being admitted in various health facilities..  In this this regard this study seeks to assess Mothers Knowledge On the causes and Management of Gastroenteritis in Children less than 5 Years in the Buea town community.

1.3 Research Questions

• What is the level of knowledge mothers have on the causes of gastroenteritis in children less than 5 years old?
• What is the level of mother’s knowledge on the management of acute gastroenteritis in children <5 years old?
• What are the practices mother do to prevent gastroenteritis in children <5 years old?

1.4 Research Hypothesis

H0: Mothers in the Buea town community have a good knowledge on the causes and management of gastroenteritis in children less than 5 years old.

HA: Mothers in the Buea town community have a poor knowledge on the causes and management of gastroenteritis in children less than 5 years old.

1.5 Research Objectives

Main research objective

To assess mothers knowledge on the causes and management of gastroenteritis in children less than 5 years in Buea town.

Specific objectives

• To assess the level of mother’s knowledge on the causes of gastroenteritis in children less than 5 years old.
• To assess the level of mother’s knowledge on the management of acute gastroenteritis in children <5 years old.
• To determine mothers strategies in the management of gastroenteritis in children <5 years old.