Home management of childhood diarrhoea in southern Mali - Implications for the introduction of zinc treatment
Home management of childhood diarrhoea in southern Mali - Implications for the introduction of zinc treatment
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DOI：
10.1016/j.socscimed.2006.10.011
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发表时间：
2007-02-01
影响因子：
5.4
通讯作者：
Swedberg, Eric
中科院分区：
文献类型：
--
作者：
Ellis, Amy A.;Winch, Peter;Swedberg, Eric
腹泻仍然是幼儿的主要杀手之一。最近的一项荟萃分析表明，每天一次锌片的两周疗程显著降低了幼儿腹泻的严重程度和持续时间以及死亡率（Bhutta等人，2000.口服锌对发展中国家儿童急性和持续性腹泻的治疗作用：随机对照试验的汇总分析American Journal of Clinical Nutrition，72（6），1516-1522）。一些国家正在进行形成性研究，为大规模推广这种新疗法做准备。对父母、社区卫生工作者和传统治疗师进行了深入和半结构化的访谈，以审查马里南部锡卡索地区腹泻的家庭管理，为在社区一级引入儿童腹泻每日短期锌做准备。还提供了随后进行的家庭调查的支持数据。虽然几乎所有的父母都知道口服补液溶液可以补充流失的液体，但它无法阻止腹泻，导致父母从当地市场寻求抗生素、传统药物或抗疟疾药物来治疗疾病。将多种治疗方法结合起来以确保最大的治疗效益的概念很普遍，现代药物往往与传统疗法同时使用。由于家长往往认为口服补液盐不足，并认为应将补充治疗与口服补液盐结合起来治疗腹泻，因此锌和口服补液盐联合治疗的概念应在社区中得到广泛接受。在制定新的促进锌的计划时，在决定为患病儿童寻求治疗方面发挥重要作用的婆婆和父亲以及传统治疗师也应该考虑。形成性研究进行了上一代腹泻控制方案的相似之处进行了讨论。(c)2006爱思唯尔有限公司保留所有权利。
Diarrhoea remains one of the leading killers of young children. A recent meta-analysis demonstrated that a two-week course of zinc tablets once daily significantly reduces the severity and duration of diarrhoea and mortality in young children (Bhutta et al., 2000. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: Pooled analysis of randomized controlled trials. American Journal of Clinical Nutrition, 72(6), 1516-1522). Formative research is being conducted in a number of countries to prepare for the large-scale promotion of this new treatment. In-depth and semi-structured interviews with parents, community health workers, and traditional healers were conducted to examine the household management of diarrhoea in the Sikasso region of southern Mali in preparation for the introduction of a short-course of daily zinc for childhood diarrhoea at the community level. Supporting data from a subsequent household survey are also presented. Although nearly all parents knew oral rehydration solution (ORS) could replace lost fluids, its inability to stop diarrhoea caused parents to seek antibiotics from local markets, traditional medicines or anti-malarials to cure the illness. The notion of combining multiple treatments to ensure the greatest therapeutic benefit was prevalent, and modern medicines were often administered simultaneously with traditional therapies. As parents often deem ORS insufficient and judge that an additional treatment should be combined with ORS to cure diarrhoea, the concept of joint therapy of zinc and ORS should be well accepted in the community. Mothers-in-law and fathers, who play a significant role in decisions to seek treatment for sick children, as well as traditional healers, should also be considered when designing new programs to promote zinc. Similarities with formative research conducted for a previous generation of diarrhoea control programmes are discussed. (c) 2006 Elsevier Ltd. All rights reserved.