Worldwide Misconceptions Limit Access to Life-Saving Diarrheal Disease Treatment for Children
Widespread Children’s Deaths Highlight Urgency
Despite the prevalence of a low-cost and highly effective remedy for potentially fatal diarrheal disease, a distressingly low number of children are receiving the necessary treatment, according to a recent analysis. This alarming trend strongly suggests that misconceptions held by healthcare providers are exacerbating the crisis.
Diarrheal Disease: A Leading Cause of Child Mortality
Diarrheal disease stands as the second-leading cause of death among children under the age of 5 according to the World Health Organization. In 2021 alone, the life-threatening condition claimed the lives of approximately 1,200 children under the age of 5 every day, totaling roughly 9 percent of child fatalities around the world. UNICEF, the United Nations International Children’s Emergency Fund, reports these alarming statistics.
Promising Treatment: Oral Rehydration Salts (ORS)
Oral rehydration salts (ORS) are a vital front-line treatment for pediatric diarrhea. This low-cost solution, composed of glucose and electrolytes, effectively prevents dehydration and remains listed among the World Health Organization’s Essential Medicines. Unfortunately, a recent study published in the prestigious journal Science reveals that due to the misconceptions held by healthcare providers, the inexpensive cure is being underprescribed.
Unequal Access in South Asia and Sub-Saharan Africa
The underprescription of ORS is particularly pronounced in regions such as South Asia and sub-Saharan Africa. Alarming disparities are observed between children in wealthy urban areas who are far more likely to receive the required treatment compared to their counterparts in impoverished rural areas.
Study Examines Providers in India
A study focused on ORS prescription rates analyzed the behavior of 2,282 providers in two Indian areas, namely Karnataka, characterized by above-average per capita income and notable ORS utilization, and Bihar, known for high poverty rates and below-average ORS usage. For the study, actors were recruited and trained to visit the providers, posing as caregivers seeking treatment for a 2-year-old child experiencing rotavirus-related diarrhea for two days.
Preference Impact on Prescription Rates
The expected standard of care for such cases is the administration of oral rehydration salts, as opposed to the prescription of unnecessary antibiotics or alternative medications. The actors expressed varying preferences during their visits, either leaning toward oral rehydration salts, antibiotics, or stating no preference at all. To negate the impact of monetary incentives on prescription behavior, the actors informed the providers that they would procure the medication from a pharmacy located elsewhere.
The study results revealed a promising increase of 27 percent in ORS prescription rates among patients who expressed a preference for the treatment. Surprisingly, many providers who didn’t prescribe ORS assumed that patients did not desire it, illustrating how this misconception accounted for 42 percent of the underprescription.
Challenges in Dispensation at Clinics
Among the attempted interventions, the inclusion of financial incentives triggered a rise in the likelihood of ORS prescriptions at pharmacies, though no such effect was observed at clinics. Encouragingly, attempts to increase the availability of ORS stocks at clinics revealed a small but not significant increase in dispensation.
A Win-Win Intervention to Save Lives
Researchers recommend interventions targeting both healthcare providers and patients, emphasizing the need to educate and empower patients and caretakers to advocate for and request oral rehydration salts for diarrhea treatment. By improving prescription rates of ORS, not only can lives be saved, but the risk of over-prescription of antibiotics, contributing to worldwide antibiotic resistance, can be mitigated.
