Factors associated with the co-utilization of oral rehydration solution and zinc for treating diarrhea among under-five children in 35 sub-saharan Africa countries: a generalized linear mixed effect modeling with robust error variance

• Published in: BMC public health 2024-05, Vol.24 (1), p.1329-1329, Article 1329
• Main Authors: Seifu, Beminate Lemma, Legesse, Bruck Tesfaye, Yehuala, Tirualem Zeleke, Kase, Bizunesh Fantahun, Asmare, Zufan Alamrie, Mulaw, Getahun Fentaw, Tebeje, Tsion Mulat, Mare, Kusse Urmale
• Format: Article
• Language: English
• Subjects: Africa South of the Sahara; Age; Care and treatment; Caregivers; Child, Preschool; Children; Children & youth; Confidence intervals; Data analysis; Diarrhea; Diarrhea - drug therapy; Diarrhea - epidemiology; Diarrhea - therapy; Diarrhea in children; Dosage and administration; Fatalities; Female; Fluid Therapy - statistics & numerical data; Health care facilities; Health insurance; Health surveys; Households; Humans; Infant; Infant, Newborn; Insurance; Linear Models; Male; Malnutrition; Mass media; Maternal & child health; Mortality; Multilevel analysis; Oral rehydration fluids; ORS and zinc co-utilization; Population; Regression analysis; Rehydration; Rehydration Solutions - therapeutic use; Robustness (mathematics); Statistical analysis; Sub-saharan Africa; Under-five children; Utilization; Variables; Variance; Zinc; Zinc - therapeutic use; Zinc in the body
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18827-w

Even though childhood diarrhea is treated with a simple treatment solution, it continues to be one of the leading causes of under-five child mortality and malnutrition globally. In resource-limited settings such as Sub-Saharan Africa (SSA), the combination of oral rehydration salts (ORS) and zinc is regarded as an effective treatment for diarrhea; however, its utilization is very low. The purpose of this study was to determine the proportion and associated factors of co-utilization of ORS and zinc among under-five children with diarrhea in SSA. The proportion and associated factors of co-utilization of ORS and zinc among under-five children with diarrhea in SSA were determined using secondary data analysis of recent Demographic and Health Surveys (DHS) of 35 SSA countries. The study included a total of 44,341 under-five children with diarrhea in weighted samples. A generalized linear mixed-effects model with robust error variance was used. For the variables included in the final model, adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were estimated. A model with the lowest deviance value were considered as the best-fitted model. The pooled proportion of co-utilization of ORS and zinc for the treatment of diarrhea among under five children in SSA countries was 43.58% with a 95% CI (43.15%, 44.01%). Sex of the child, maternal age, residence, maternal educational and employment status, wealth index, media exposure, perceived distance to health facility and insurance coverage were statistically significant determinants of ORS and Zinc co-utilization for treating diarrhea among under five children in SSA. Only less than half of under-five children with diarrhea in SSA were treated with a combination of ORS and zinc. Thus, strengthening information dissemination through mass media, and community-level health education programs are important to scale up the utilization of the recommended combination treatment. Furthermore, increasing health insurance coverage, and establishing strategies to address the community with difficulty in accessing health facilities is also crucial in improving the use of the treatment.