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Diarrhea management in some Jhuggi clusters of Delhi.


 In India, a survey was conducted of 6285 persons living in 1090 households in the Jhuggi clusters of Sanjay Amar Colony, Hathi Park, and Jai Prakash Colony in New Delhi to identify diarrhea management practices at home and at a health facility and to determine knowledge levels about preparation of oral rehydration solution (ORS) and sugar salt solution (SSS). 183 (2.9%) persons experienced diarrhea in the previous 2 weeks. 68.3% were younger than 5 years old. 13.1% of all diarrhea cases had blood in their stool. Oral rehydration therapy (ORT) was provided to 3.3% in ORS form, 10.4% in SSS form, 5.5% as dal water, and 5.5% as shikanji. Correct preparation of SSS via finger pinch, scoop, or spoon and glasses was performed in 36.6% of households. Only 11.5% could correctly measure the water needed to make 1 liter of ORS. The first action against the diarrhea was often taken on day 2 (13.1%) and day 3 (18%). 55.7% of diarrhea cases sought treatment at a private practice. 7.1% went to a government health facility. 79.1% of cases taken to a medical practitioner received a drug (e.g., antidiarrheals and antimicrobials). Yet, antimicrobials were indicated in only 13.1% of diarrhea cases taken to a health facility. These cases had dysentery. Only 31.3% received ORS or home-available fluids. Government health facilities were more likely to provide ORT than private practitioners (61.5% vs. 27.4%). All diarrhea cases experiencing dehydration received ORT or intravenous fluids. These findings stress the need for reorientation training of physicians on appropriate case management of diarrhea and rational use of drugs in cases of acute diarrhea. Families also need training in correct preparation and use of ORT and in restriction on the use of drugs.
