KNOWLEDGE OF DIARRHEAL MANAGEMENT IN VARIOUS LEVELS OF PUBLIC HEALTH SYSTEM IN ALIGARH
L Agarwal*, S Alam**, A Malik***, Z Waris****
Department of Pediatrics and Community Medicine, JNMC, AMU, Aligarh, UP. *, Department of Pediatrics and Community Medicine, JNMC, AMU, Aligarh, UP. **, Department of Pediatrics and Community Medicine, JNMC, AMU, Aligarh, UP. ***, Department of Pediatrics and Community Medicine, JNMC, AMU, Aligarh, UP. ****
Aim: To study the knowledge about management of acute diarrhea in the various levels of public health care system in Aligarh.

Methods: Study was done in 4 randomly selected blocks of rural Aligarh district and at JN Medical College. Two different questionnaires were tested in the Medical group (Medical officers and Interns) and the paramedic group (ANM, Anganwadi, Health Assistants and nursing students) followed by a sensitization programme.

Results: 72 medical personnel (MG) and 290 paramedics (PMG) were tested. More than 90% and 44% of the MG an PMG respectively were aware of the correct definition of diarrhea. More then 60% of both the groups felt that presence of mucous was dysentery. More then 90% of both the groups could identify dehydration status adequately. Only one third to half of the various groups were aware of the standard management of diarrhea. All the MG and 60% of the PMG knew the correct formulation of ORS. Almost all of both the groups felt that mothers should be told about breastfeeding, feeding and ORS formulation when treating diarrhea. 33% of MG and 65% of PMG preferred rice water and dal water over energy dense feeds. 41% and 61% of the MG and PMG respectively felt that antibiotics are needed in the management of majority of diarrheal cases. Among the MG 14 of the 19 medical officers and 44 of the 53 interns knew the composition and advantages of the low osmolarity ORS. The same proportions were also aware that the low osmolarity ORS is a universal ORS.

Conclusions: Knowledge about identification of diarrhea and dehydration is present adequately in the majority. But the misconcept about dysentery are probably responsible for the inappropriate usage of antibiotics. This is also responsible for the wrong concepts of the standard management of majority diarrheal cases. Moreover the awareness regarding energy dense feeds during diarrhea is poor.
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