Caregiver sociodemographic factors associated with adherence to zinc treatment of childhood diarrhoea, Kirinyaga county, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260287Keywords:
Diarrhoea, Zinc treatment, Medication adherence, Sociodemographic factors, Caregivers, KenyaAbstract
Background: Zinc supplement is critical for managing childhood diarrhoea. However, adherence to zinc treatment remains low in low-resource settings. This study determined the association between zinc utilization for treatment of diarrhoea among children below five years old and caregivers’ sociodemographic factors in Kirinyaga County, central Kenya.
Methods: A cross-sectional study was conducted from February to March 2025, involving 223 caregivers and 25 healthcare workers across four hospitals.
Results: Only 20% (45/223) of children in this study received zinc treatment for the recommended period of 10–14 days. Low adherence to zinc treatment was associated with caregiver level of education and employment status (p<0.05). Lack of IMNCI training (96%; 24/25) among health workers was observed, despite most of them having access to the IMNCI guidelines.
Conclusions: Findings of this study underscore the need to sensitize caregivers on the benefits of zinc supplements in management of childhood diarrhea. These efforts should be complemented with periodic health worker training on guidelines that support effective management of childhood diarrhea in Kirinyaga County, particularly the IMNCI protocol.
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References
World Health Organization. Diarrhoeal disease. Geneva: World Health Organization; 2017. Available at: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease. Accessed on 3 December 2025.
He Z, Ghose B, Cheng Z. Diarrhea as a disease of poverty among under-five children in Sub-Saharan Africa: A cross-sectional study. International Journal of Environmental Research and Public Health; 2023:20(9),1-15.
Kenya Demographic Health Survey. Social Welfare Africa. 2022: 1-358.
Centers for Disease Control and Prevention. Vaccines by Age. 2023. Available at: https://www.cdc.gov/vaccines/parents/by-age/index.html. Accessed on 3 December 2025.
Khan W, Siddiqui R, Begum A. Global burden of parasitic diarrhoeal diseases: An empirical review of Giardia, Cryptosporidium, and Entamoeba infections. Parasite Epidemiol Control. 2021;13:e00211.
Azer SA, Sun Y. Colitis. In: StatPearls. Treasure Island (FL); StatPearls Publishing; 2024.
Kinabo GD, Temba HT, Mushi DL, Mafuwe TK, Makubi AU. Prevalence, epidemiological characteristics and clinical features of monoinfection and coinfection in childhood diarrhoeal diseases in Tanzania. BMC Infect Dis. 2018;18:20.
Talaat KR, Alaimo C, Martin P. Human challenge study with a Shigella bioconjugate vaccine: analyses of clinical efficacy and correlate of protection. EBioMedicine. 2021;66:103310.
Troeger C, Blacker BF. Khalil, IA, Rao PC, Cao S, Reiner RC. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrheal diseases. Lancet Infect Dis. 2018;18(11):1211-28.
UNICEF. Data: Monitoring the situation of children and women. New York; Diarrhoea. 2019.
Gachau S, Ayieko P, Gathara D. Effectiveness of zinc treatment in children admitted with diarrhoea in Kenya’s public hospitals. BMJ Global Health. 2019;4(5):e001570.
Lam F. Prosnitz D, Lapping K. Coverage of oral rehydration solution and zinc supplementation for the treatment of childhood dirrhea in Kenya. Evidence from a nationally representative survey. J Global Health. 2019:9(1):010505.
Kenya National Bureau of Statistics. The Kenya Population and Housing Census-Population Distribution by Age. Nairobi, Kenya. Kenya National Bureau Statistics. 2022.
Kirinyaga County Hospitals. Diarrhea cases among children under five. DHIS2 report: 2024.
Gitonga J, Home P, Murage H, Mwangi J. Effects of irrigation water regimes, soil types and their interaction on water use and water productivity from rice (Oryza sativa L.) cultivation in Mwea, central Kenya. J Agriculture Sci Tech. 2019;19(1):100-17.
Shetty B, Unnikrishnan S, Kaushik SN, Rai A. Prevalence, patterns, and predictors of diarrhea: a spatial-temporal comprehensive evaluation in India. BMC Public Health. 2018;18(1):1288.
Gebremedhin S. Mamo, G. Gezahign H, Kung’u J. Adish A. The effectiveness bundling of zinc with oral rehydration salts (ORS) for improving adherence to acute watery diarrhea treatment in Ethiopia: Cluster randomised controlled trial. BMC Public Health. 2016;16:457.
Muhande IK. Mapesa J, Ouna B. Evaluation of the determinants of uptake of oral rehydration solution and zinc supplementation for childhood diarrhea in Kakamega County, Kenya. Int J Community Med Public Health. 2024;11(10):3758-64.
Wagner Z, Shah M, Sood N. Barriers to use of oral rehydration salts for child diarrhea in the private sector. Evidence from India. J Trop Pediatr. 2015;61:37-43.
Roberton T, Carter E, Chou V, Stegmuller A, Jackson B, Tam Y. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: modelling study. Lancet Global Health. 2020;8(7):e901-e908.
Braimoh T, Danat I, Abubakar M, Ajeroh O, Stanley M. Private health care market shaping and changes in inequities in childhood diarrhoea treatment coverage: evidence from surveys of an ORS and zinc program in Nigeria. Int J Equity Health. 2021;20(1):88.
Wagner Z, Shah M, Sood N. Barriers to use of oral rehydration salts for child diarrhea in the private sector. Evidence from India. J Trop Pediatr. 2015;61:37-43.
Pharr JR, Moonie S, Bungum TJ. The impact of unemployment on mental health and physical health, access to health care and health risk behaviours. ISRN Public Health. 2012:1-7.
Strand TA, Sharma PR, Gjessing HK, Ulak M, Chandyo RK, Adhikari RK. Risk factors for extended duration of acute diarrhea in young children. PLoS One. 2012;7(5):e36436.
Gebremedhin SH, Admassu B, Teferra AA. Effectiviness of IMNCI training on dirrhea management among under-five children in public health facilities of Ethiopia. A cross-sectional study. Pediatric Health Med Therap. 2021;12:59-67.
Fagbamigbe AF, Joseph J. Evaluation of the awareness and utilization of oral rehydration salt and zinc in managing diarrhoea among under-five children in Oyo State, Nigeria. Int J Community Med Public Health. 2022;9(7):2785-91.
Koshal SS, Ray A, Mehra R, Kaur A, Quadri SF. Partnering for rotavirus vaccine introduction in India: A retrospective analysis. Vaccine. 2021;39(44):6470-6.
Sienar JP, Patel RK, Al-Khalidi H. Global trends in zinc supplementation for childhood diarrhoea: Progress and challenges. Pediatrics. 2024;153(4):e2023063521.
Ministry of Health, Kenya. Kenya Strategy for Maternal Infant and Young Child Nutrition. 2023-2028. 2023. Available at: https://pathecd.org/wp-content/uploads/2024/06/1-Kenya-Strategy-for-Maternal-Infant-and-Young-Child-Nutrition-2023-28.pdf. Accessed on 3 December 2025.
Owolabi OA, Anido KM, Ogunrinde OG, Raji T. Knowledge, attitude and practice of home management of childhood diarrhoea among caregivers of under-5 children with diarrhoeal disease in Northwestern Nigeria. J Trop Pediatr. 2019;58(2):143-14.
Okafor IP, Akinyemi OT, Wika-Kobani BN, Olubodun T. (2022) Childhood diarrhoea: a cross-sectional survey on maternal knowledge, hygienic practices and use of oral zinc for home management in a Nigerian community. Pan African Med J. 2022;42:123.
Karlsson O, Kim R, Bogin V, Subramanian SV. International Trends in Zinc Treatment for Childhood Dirhhhea. Pediatrics. 2024;154(5):e2024066701.
Larson CP, Saha UR, Nazrul H. Impact monitoring of the national scale up of zinc treatment for childhood diarr in Bangladesh: PLoS Med. 2009;6(11):e1000175.
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