Oral Rehydration Therapy, Zinc, Continued Feeding and Other Treatments for Diarrhea

Among children under age 5 who had diarrhea in the 2 weeks preceding the survey, percentage given fluid from an ORS packet or pre-packaged ORS fluid, zinc, ORS and zinc, ORS and continued feeding, ORS, zinc, and continued feeding, ORS or increased fluids, recommended homemade fluids (RHF), oral rehydration therapy (ORT), ORT and continued feeding, and other treatments; and percentage given no treatment

Definition

Percentage of living children under age 5 with diarrhea who were given:

1)      Fluid from oral rehydration salts (ORS) packet or pre-packaged ORS fluid

2)      Zinc

3)      ORS and zinc

4)      ORS and continued feeding

5)      ORS, zinc, and continued feeding

6)      ORS or increased fluids

7)      Recommended homemade fluids (RHF)

8)      Oral rehydration treatment (ORT – ORS, RHF, or increased fluids)

9)      ORT and continued feeding

10)   Antibiotic drugs

11)   Antimotility drugs

12)   Intravenous solution

13)   Home remedy/other treatment

14)   No treatment

Coverage:

Population base: Living children under age 5 years (KR file)

Time period: 2 weeks preceding the interview

Numerators:

Number of living children under age 5 with diarrhea at any time during the 2 weeks preceding the interview (b5 = 1 & b19 < 60 & h11 in 1,2) who were given:

1)      Fluid from oral rehydration salts (ORS) packet or pre-packaged ORS fluid (h13 in 1:2 or h13b = 1)

2)      Zinc (h15e = 1)

3)      ORS and Zinc ((h13 in 1:2 or h13b = 1) & h15e = 1)

4)      ORS and continued feeding ((h13 in 1:2 or h13b = 1) & h39 in 3:5)

5)      ORS, zinc, and continued feeding ((h13 in 1:2 or h13b = 1) & h15e = 1 & h39 in 3:5)

6)      ORS or increased fluids ((h13 in 1:2 or h13b = 1) or h38 = 5)

7)      Recommended homemade fluids (RHF) (h14 in 1:2)

8)      Oral rehydration treatment (ORT – ORS, RHF, or increased fluids) (h13 in 1:2 or h13b = 1 or h14 in 1:2 or h38 = 5)

9)      ORT and continued feeding ((h13 in 1:2 or h13b = 1 or h14 in 1:2 or h38 = 5) & h39 in 3:5)

10)   Antibiotic drugs (h15 = 1 or h15b = 1)

11)   Antimotility drugs (h15a = 1)

12)   Intravenous solution (h15c = 1)

13)   Home remedy/other treatment (h15d = 1 or any of h15d, f – m = 1 or h20 = 1)

14)   No treatment (h21a = 1)

Denominator: Number of children under age 5 with diarrhea in the 2 weeks preceding the interview (b5 = 1 & b19 < 60 & h11 in 1,2)

Variables: KR file.

Calculation

Numerator divided by the denominator, multiplied by 100.

Handling of Missing Values

“Don’t know” responses and missing values on whether had diarrhea are excluded from numerators and denominator, assuming no illness. “Don’t know” responses and missing values for each type of treatment are excluded from the numerator but included in the denominator assuming the treatment was not given.

Notes and Considerations

Continued feeding includes children who were given more than usual, same as usual, or somewhat less food during the diarrhea episode.

Changes over Time

The terminology has changed since DHS-VI. Oral rehydration therapy (ORT) used to be defined as ORS or RHF. ORT is now defined as ORS, RHF, or increased fluids to be comparable with MICS.

Zinc as a diarrhea treatment was added as an indicator in DHS-7.

References

Rutstein, S.O., S. Staveteig, R. Winter, and J. Yourkavitch. 2016. Urban child poverty, health, and survival in low- and middle-income countries. DHS Comparative Reports No. 40. Rockville, Maryland, USA: ICF International. https://www.dhsprogram.com/publications/publication-CR40-Comparative-Reports.cfm

WHO and UNICEF. 2013. Ending preventable child deaths from Pneumonia and Diarrhoea by 2025: The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD). Geneva: WHO https://apps.who.int/iris/bitstream/handle/10665/79207/WHO_FWC_MCA_13_01_eng.pdf

World Health Organization. 2018. Global reference list of 100 core health indicators. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/259951

UNICEF. 2012. Pneumonia and diarrhea: Tackling the deadliest diseases for the world’s poorest children. New York, New York, USA:UNICEF https://data.unicef.org/resources/pneumonia-and-diarrhoea-tackling-the-deadliest-diseases-for-the-worlds-poorest-children/

Resources

DHS-8 Tabulation plan: Table 10.11

API Indicator IDs:

CH_DIAT_C_ORS, CH_DIAT_C_RHF, CH_DIAT_C_ORT, CH_DIAT_C_INC, CH_DIAT_C_ORI, CH_DIAT_C_ABI, CH_DIAT_C_AMO, CH_DIAT_C_ZNC, CH_DIAT_C_IVS, CH_DIAT_C_HOM, CH_DIAT_C_NOT

(API link, STATcompiler link)

WHO 100 Core Health Indicators: Coverage of diarrhea treatment

MICS6 Indicator TC.13a: Diarrhoea treatment with oral rehydration salt solution (ORS)

MICS6 Indicator TC.13b: Diarrhoea treatment with oral rehydration salt solution (ORS) and zinc

MICS6 Indicator TC.14: Diarrhoea treatment with oral rehydration therapy (ORT) and continued feeding