Table 6.
Diarrhea assessment and management in children < 5 years of age, southern Malawi, January–March, 2015
| Characteristic | N | Weighted* % | 95% CI |
|---|---|---|---|
| Survey assessment | N = 723 | ||
| Diarrhea present | 272 | 37.7 | 34.1–41.3 |
| Meets definition of uncomplicated diarrhea† (1) | 222 | 30.7 | 27.4–34.1 |
| Meets definition of severe diarrhea‡(2) | 17 | 2.4 | 1.2–3.5 |
| HCW assessment of diarrhea | N = 723 | ||
| Diarrhea spontaneously reported by caregiver (3) | 231 | 32.0 | 28.6–35.4 |
| HCW documented presence of diarrhea (4) | 194 | 26.9 | 23.4–30.3 |
| HCW asked about diarrhea§ (5) | 86 | 17.9 | 13.8–21.9 |
| HCW ascertained diarrhea [(3), (4), or (5)] | 328 | 45.4 | 41.1–49.6 |
| HCW assessment and management of children with uncomplicated diarrhea [= (1)] | N = 222 | ||
| Diarrhea diagnosed by HCW | 128 | 57.7 | 50.3–65.0 |
| Recommended treatment given∥ | 94 | 42.3 | 34.7–49.9 |
| ORS given, with or without zinc | 143 | 63.3 | 55.9–70.6 |
| HCW management of children with severe diarrhea‡ [= (2)] | N = 17 | ||
| Referred for immediate hospitalization | 1 | 5.9 | 0–17.4 |
| HCW diagnoses given to children with surveyor-assessed uncomplicated diarrhea† but not receiving diarrhea diagnoses | N = 94 | ||
| Malaria | 53 | 56.4 | 46.3–66.5 |
| RDT tested | 41 | 43.6 | 32.6–54.6 |
| RDT confirmed | 38 | 40.4 | 29.3–51.5 |
| Acute respiratory illness | 17 | 18.1 | 9.8–26.4 |
| Sepsis | 13 | 13.8 | 6.6–21.1 |
| Pneumonia | 7 | 7.4 | 2.2–12.7 |
| Dysentery | 7 | 7.4 | 1.3–13.6 |
| Skin problem | 5 | 5.3 | 0.8–9.9 |
| Recommended treatment given∥ | 22 | 23.4 | 14.4–32.5 |
| HCW diagnoses given to children with surveyor-assessed uncomplicated diarrhea† but not receiving correct treatment | N = 128 | ||
| Malaria | 73 | 57.0 | 46.5–67.6 |
| RDT tested | 47 | 36.7 | 24.7–48.8 |
| RDT confirmed | 43 | 33.6 | 21.7–45.5 |
| Diarrhea | 56 | 43.8 | 33.3–54.2 |
| Upper respiratory illness | 28 | 21.9 | 15.1–28.7 |
| Sepsis | 12 | 9.4 | 4.7–14.1 |
| Skin problem | 3 | 2.3 | 0–5.0 |
| Eye infection | 3 | 2.3 | 0–5.0 |
| Ear infection | 3 | 2.3 | 0–5.0 |
CI = confidence interval; HCW = health-care worker; IMCI = integrated management of childhood illness; ORS = oral rehydration salts; RDT = rapid diagnostic test.
Accounts for outpatient department and patient sampling probabilities and nonresponse. The analysis also accounts for clustering at the health facility level.
Defined as children < 5 years of age with acute diarrhea with some or no dehydration without general danger signs per local IMCI.
Defined as acute diarrhea with danger signs or with surveyor-assessed severe dehydration. Local IMCI recommends that the child should be referred urgently to a hospital if danger signs are present or if intravenous hydration is needed.
If presence of diarrhea in the child was not spontaneously reported by the caregiver during the exit interview, or not documented by the HCW, then the survey team asked the caregiver if the HCW asked about presence of diarrhea in the child.
Defined as ORS and zinc for children 2–59 months of age with diarrhea, and ORS only for children with diarrhea < 2 months of age.