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Diapers in war zones: ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan.

Zaidi SH, Smith-Morris C - PLoS ONE (2015)

Bottom Line: Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition.In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease.These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases and Vaccinology, University of California, School of Public Health, Berkeley, California, United States of America.

ABSTRACT
This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services' admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts.

No MeSH data available.


Related in: MedlinePlus

The boxed words on both pictures display the brand of the ORT, Davisalts in English and Urdu.
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pone.0119069.g002: The boxed words on both pictures display the brand of the ORT, Davisalts in English and Urdu.

Mentions: Communication of instructions for ORT use is an additional cause for concern. Many ORT medications are packets of medication, which must be prepared in a specific way; namely, mixed into a precise quantity of boiling water. The written instructions pose an issue for this population, as 75% of the respondents interviewed were illiterate (Table 1). Literacy levels were determined based on whether or not the mother could read and write as indicated by yes, only read or write (partial) and could not read nor write (no).These sachets are purchased over-the-counter as per the doctor’s instruction and have explicit directions on how to prepare the ORT on the back (Fig. 2). The patient’s family is told to purchase the ORT and is typically given a quick overview of the purpose of it and a times how to prepare it by the prescribing physician. Many women simply pour the packet into what they feel is a sufficient pot of water. Women who cannot read the instructions are limited to instructions that they receive orally. They are at a disadvantage because their compliance is dependent on their ability to remember these oral instructions. This likely also limits their access to any supplementary written explanation of the medication.


Diapers in war zones: ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan.

Zaidi SH, Smith-Morris C - PLoS ONE (2015)

The boxed words on both pictures display the brand of the ORT, Davisalts in English and Urdu.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359116&req=5

pone.0119069.g002: The boxed words on both pictures display the brand of the ORT, Davisalts in English and Urdu.
Mentions: Communication of instructions for ORT use is an additional cause for concern. Many ORT medications are packets of medication, which must be prepared in a specific way; namely, mixed into a precise quantity of boiling water. The written instructions pose an issue for this population, as 75% of the respondents interviewed were illiterate (Table 1). Literacy levels were determined based on whether or not the mother could read and write as indicated by yes, only read or write (partial) and could not read nor write (no).These sachets are purchased over-the-counter as per the doctor’s instruction and have explicit directions on how to prepare the ORT on the back (Fig. 2). The patient’s family is told to purchase the ORT and is typically given a quick overview of the purpose of it and a times how to prepare it by the prescribing physician. Many women simply pour the packet into what they feel is a sufficient pot of water. Women who cannot read the instructions are limited to instructions that they receive orally. They are at a disadvantage because their compliance is dependent on their ability to remember these oral instructions. This likely also limits their access to any supplementary written explanation of the medication.

Bottom Line: Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition.In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease.These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases and Vaccinology, University of California, School of Public Health, Berkeley, California, United States of America.

ABSTRACT
This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services' admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts.

No MeSH data available.


Related in: MedlinePlus