BMJ Paediatrics Open最新文献

{"title":"Daily life situations and participation of siblings of children with childhood-onset disabilities: a scoping review.","authors":"Johanna Linimayr, Judith Graser, Selina Gredig, Hubertus J A van Hedel, Anne Tscherter, Sebastian Grunt, Christina Schulze","doi":"10.1136/bmjpo-2024-003189","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003189","url":null,"abstract":"<p><strong>Background: </strong>Siblings of children with disabilities or childhood-onset chronic conditions (eg, autism, cerebral palsy or congenital heart disease) often face challenges in mental health, quality of life and psychosocial adjustment. However, comprehensive knowledge of their participation in daily activities remains limited. Understanding their participation patterns and potential restrictions can help clarify their needs.</p><p><strong>Aims and methods: </strong>This scoping review aims to summarise current research on the participation of siblings of children with childhood-onset chronic conditions. Following the Joanna Briggs Institute methodology, we systematically searched MEDLINE, CINAHL, AMED, PsycINFO and ERIC for peer-reviewed studies published in English between 2001 and 2024. Eligible studies focused on siblings of children with disabilities or early-onset chronic conditions (population) and their participation, including attendance and involvement in daily activities (concept) across children's homes, communities and schools (context). The review adheres to the Preferred Reporting Items for Scoping Reviews guidelines.</p><p><strong>Results: </strong>A total of 62 articles met the inclusion criteria: 45 qualitative (73%) and 7 quantitative (11%) studies, 7 reviews (11%) and 3 meta-studies (5%). The studies covered various chronic conditions (eg, cancer, chronic kidney disease and Down syndrome), with autism being the most common (22 studies). Key participation themes identified include family life, home participation, school involvement, leisure activities, social interactions with peers, information-seeking and continuous meaning-making. Factors such as normalcy, advocacy, identity, gender, age, culture and socioeconomic status were found to intersect with participation.</p><p><strong>Conclusions: </strong>This review provides a comprehensive overview of current research and contributes to our understanding of how participation in daily activities has been studied so far in the population of siblings of children with disabilities. It reveals a gap in research specifically measuring participation among siblings. The identified themes enhance our understanding of potential participation restrictions in this population.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School participation, supports and barriers of children with and without attention deficit hyperactivity disorder.","authors":"Koray Kara, Ozgun Kaya Kara, Barkin Kose, Mert Doğan, Sebahat Yaprak Cetin, Sedef Sahin, Dana Anaby","doi":"10.1136/bmjpo-2024-002917","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002917","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the differences in participation patterns, environmental barriers and supports across specific activities typically done at school between children with attention deficit hyperactivity disorder (ADHD) and without ADHD.</p><p><strong>Design: </strong>Prospective cross-sectional study.</p><p><strong>Setting: </strong>The children and adolescents with ADHD were selected from those routinely referred to the Health Sciences University Research and Training Hospital's child and adolescent psychiatry department, which is a reference centre for the region.</p><p><strong>Participants: </strong>A total of 365 children (n _{children with ADHD} =175, n _{children without ADHD} =190, mean age 11.66 years, SD 2.96 years) and their primary caregivers were included in the study.</p><p><strong>Primary outcome measures: </strong>Participation and Environment Measure for Children and Youth was used to evaluate children.</p><p><strong>Results: </strong>The mean frequency of participation in five different school activities was significantly lower in children with ADHD than in children without ADHD, with moderate to large effect sizes. Children with ADHD were less likely to be involved in any activity type than children without ADHD, with moderate to large effect sizes. The characteristics of the school environment typically made it more challenging for children with ADHD to participate than for children without ADHD, with moderate effect sizes.</p><p><strong>Conclusions: </strong>Children with ADHD have challenges in classroom activities and with socialising with peers outside class, cognitive demands, sensorial qualities and safety. Relationships with friends, cultural acceptance and support could improve the school participation of children with ADHD.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac-related neonatal collapse presenting to the emergency department: a retrospective cohort study.","authors":"Manson Chon In Kuok, Jennie Lambert, Anitha Janjanam, Jon Lillie","doi":"10.1136/bmjpo-2024-003149","DOIUrl":"10.1136/bmjpo-2024-003149","url":null,"abstract":"<p><strong>Background: </strong>To describe the characteristics of cardiac-related neonatal collapses referred to a critical care transport service and evaluate the diagnostic accuracy and management at referral and retrieval.</p><p><strong>Methods: </strong>Retrospective cohort analysis of cardiac-related neonatal collapses who were referred to and transferred by a paediatric intensive care retrieval team based in London, UK between 2013 and 2021. Patients with antenatal diagnoses were excluded.</p><p><strong>Results: </strong>There were 71 neonates identified of whom 49 (69%) had structural heart defect, 12 (17%) arrhythmia and 10 (14%) with cardiomyopathy/myocarditis. Among structural defects, left ventricular outflow tract (LVOT) obstruction (71%) and mixing of circulation (22%) were the predominant pathologies. Cardiac murmur was absent in 66% of the patients. The referring teams' diagnostic performance was suboptimal for LVOT obstruction and cardiomyopathy/myocarditis, with 63% and 30% recognised as cardiac cause of collapse at referral. Less than half of neonates with duct-dependent lesions received prostaglandin at referral, which later improved to 97% during retrieval. The number of patients requiring intubation and inotropic support also increased at various time points throughout the patient journey. 98% of patients with structural defects required cardiac interventions at a median of 1 day after admission.</p><p><strong>Conclusions: </strong>Structural heart defect, particularly LVOT obstruction, was the leading cause of cardiac-related neonatal collapses. However, a significant portion were initially misdiagnosed leading to delay in prostaglandin administration. Our findings highlight the importance of a high index of suspicion for cardiac pathologies as a cause of neonatal collapse, which is essential for appropriate treatment and timely referral.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of neuromuscular scoliosis in paediatric patients: experiences from a tertiary centre multidisciplinary team.","authors":"Faris Khan, Anas Khan, Lucy Chinnery, Jake Loveridge, James Zhang, Theofilos Polychronakis","doi":"10.1136/bmjpo-2023-002456","DOIUrl":"10.1136/bmjpo-2023-002456","url":null,"abstract":"<p><strong>Background: </strong>Management of neuromuscular scoliosis (NMS) is challenging, with both surgical and conservative options involving risks. This study aimed to evaluate multimorbidity in patients with NMS and how this influences multidisciplinary team (MDT) decisions as well as postoperative outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study of patients referred for assessment by the scoliosis MDT in the 8-year period between 2013 and 2021 from a single tertiary centre.</p><p><strong>Results: </strong>84 patients with NMS were referred for assessment to the MDT. The most common underlying cause of NMS was cerebral palsy (51%). The MDT recommended surgery for 60 patients and 24 were conservatively managed. There were no significant differences in age, sex, body mass index or baseline Cobb angle between the two groups. Patients recommended surgery had fewer comorbidities (2.3 vs 3.5, p<0.05) and greater Cobb angle progression in the 18 months prior to MDT decision (22° vs 8°, p<0.05). No single comorbidity significantly influenced the MDT decision. Of the 48 patients that proceeded with surgery, immediate postoperative complications were documented in 54.1%, with no mortality. The most common complications were postoperative anaemia and respiratory infections. Multivariate logistic regression identified the use of non-invasive ventilation, forced vital capacity <70% of predicted and full-time wheelchair use as significant predictors of immediate postoperative complications. Improved posture was the most common long-term outcome (41.7%) and 81.3% of patients reported no complications at 12 months following their surgery.</p><p><strong>Conclusions: </strong>Multimorbidity in children with NMS influences scoliosis MDT decisions, alongside factors such as scoliosis curve progression. Immediate postoperative complications were common but longer term outcomes were favourable for most patients. Further research aiming to better inform shared decision-making, improve surgical selection and ultimately enhance the quality of life for patients with NMS is required.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a core outcome set for paediatric achalasia: a joint ERNICA, ESPGHAN and EUPSA study protocol.","authors":"Jonathan J Neville, Iris den Uijl, Willemijn Irvine, Simon Eaton, Frederic Gottrand, Nigel J Hall","doi":"10.1136/bmjpo-2024-003130","DOIUrl":"10.1136/bmjpo-2024-003130","url":null,"abstract":"<p><strong>Introduction: </strong>Achalasia is a rare disease in children. Studies investigating the efficacy of interventions and disease outcomes in paediatric achalasia are predominantly retrospective, consist of small cohorts and report heterogeneous outcomes. The variation in the use and definition of reported outcomes impedes meta-analysis, which is problematic in a rare paediatric condition. Similarly, there is a risk of under-reporting patient-relevant outcomes, such as quality of life. To overcome these issues, a minimum set of important and patient-relevant outcomes should be reported in all studies of paediatric achalasia. Core outcome sets (COS) are a standardised set of outcomes that can guide further research and facilitate data pooling and meta-analysis. The development of a COS in rare paediatric disease is essential, prior to conducting efficacy studies or creating a disease registry, to ensure that the most important outcomes are reported. Currently, no COS exists for children with achalasia. In this study, we aim to define a COS for paediatric achalasia for use in clinical research.</p><p><strong>Methods and analysis: </strong>This study will consist of three parts. The first will be a systematic review of the literature, evaluating the outcomes and outcome definitions reported in published clinical research studies investigating paediatric achalasia. Second, a three-stage Delphi consensus process will be undertaken to identify and prioritise outcomes. This process will involve healthcare professionals, patients and parent representatives. Third, a consensus meeting will be held, during which the final COS will be defined.</p><p><strong>Dissemination: </strong>The results of this study will be disseminated to stakeholders via the European Reference Network for Rare Inherited Congenital Anomalies, European Society for Pediatric Gastroenterology Hepatology and Nutrition, European Paediatric Surgeons' Association, and patient groups. The COS will be published in a peer-reviewed journal and uploaded to the Core Outcome Measures in Effectiveness Trials (COMET) initiative website.</p><p><strong>Trial registration number: </strong>The study was pre-registered with the COMET initiative in July 2024 (https://www.comet-initiative.org/Studies/Details/2568). The systematic review component of the study was pre-registered on PROSPERO (CRD42024509855).</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Hackathon: empowering students as tomorrow's leaders in health.","authors":"Smita Shah, Kym Rizzo Liu, Kathryn Short, Catriona Lockett","doi":"10.1136/bmjpo-2024-003271","DOIUrl":"10.1136/bmjpo-2024-003271","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sepsis beyond bundles: contextualising paediatric care in resource-limited settings through situational analysis.","authors":"Leah Ratner, Allysa Warling, Sheila Agyeiwaa Owusu, Charles Martyn-Dickens, Gustav Nettey, Emma Otchere, Ahmet Uluer, R Elaine Cagnina, John Adabie Appiah, Maame Fremah Kotoh-Mortty, Eugene Martey","doi":"10.1136/bmjpo-2024-003134","DOIUrl":"10.1136/bmjpo-2024-003134","url":null,"abstract":"<p><strong>Background: </strong>Paediatric sepsis remains a significant contributor to morbidity and mortality, particularly in low- and middle-income countries (LMICs), where healthcare resources are often limited. Paediatric sepsis bundles, which include prompt administration of antibiotics, fluid resuscitation and continuous organ function monitoring, are crucial for improving outcomes, especially when initiated within the first 'golden hour' of sepsis recognition. These bundles, adapted from adult sepsis care protocols through the Surviving Sepsis Campaign, are increasingly emphasised in global sepsis management guidelines. However, the implementation of these protocols in LMICs is challenged by resource limitations and systemic barriers.</p><p><strong>Methods: </strong>This situational analysis, conducted at two hospitals in Ghana-a tertiary facility and a district (secondary) facility-maps the availability of critical resources for paediatric sepsis care through a structured environmental scan using survey methodology. We assess staffing levels, access to medications, airway support and diagnostic capabilities. Methods were conceptualised through inner and outer settings of the Consolidated Framework for Implementation Research (CFIR) and reported through the Donabedian model for healthcare quality.</p><p><strong>Results: </strong>This study compared paediatric care at a tertiary hospital (Komfo Anokye Teaching Hosptial (KATH)) and a district hospital (Presbyterian Hospital, Agogo (PreHA)) in Ghana, highlighting KATH's emergency and intensive care unit (ICU) services, specialised staff and broader respiratory support. PreHA, although without a paediatric-specific ICU, leveraged research funding to enhance clinical care capacity. Both hospitals experienced regular power outages but had reliable generators, and while they offered basic medications and treatments, resource limitations, including out-of-pocket costs for families, impacted access to essential medications and laboratory tests.</p><p><strong>Conclusion: </strong>Concerns around resource availability, compounded by structural determinants such as financial barriers and historical underfunding hypothesised to be rooted in colonialism, highlight the need for context-sensitive adaptations of paediatric sepsis bundles. Our findings underscore the importance of a participatory approach to guideline adaptation and resource distribution, incorporating local expertise and addressing structural inequities to improve paediatric sepsis outcomes in Ghana. Future qualitative research will explore pre- and peri-hospital barriers to care and inform more effective, contextually appropriate interventions.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted oxygenation in the respiratory care of premature infants at delivery-effects on outcome: a randomised controlled trial (Torpido 3060) study protocol.","authors":"Ju Lee Oei, Javeed Travadi, Adrienne Kirby, Ian Marschner, Carbo Yeung, Melinda Cruz, Ian Wright, Wendy Hague, Peter Davis, Alpana Ghadge, John Simes, Anthony Keech, Kei Lui, David Osborn, William Tarnow Mordi","doi":"10.1136/bmjpo-2024-003262","DOIUrl":"10.1136/bmjpo-2024-003262","url":null,"abstract":"<p><strong>Introduction: </strong>The safest oxygen levels needed for preterm infant respiratory support at birth are uncertain. We aimed to compare the outcomes of infants up to 28⁶ weeks gestation who had respiratory care initiated at birth with fractional inspired oxygen (FiO₂) 0.3 or 0.6, which was adjusted to meet specific oxygen saturations (SpO₂).</p><p><strong>Methods: </strong>This randomised controlled phase III trial was stratified by (1) site, (2) gestation and (3) multiplicity. Infants between 23+0 to 28+6 weeks gestation were randomised to initial respiratory support with FiO₂ 0.3 or 0.6, adjusted to meet common SpO₂ targets for the first 10 min.</p><p><strong>Primary outcome: </strong>Survival to 36 weeks gestation without documented brain injury.</p><p><strong>Assessments: </strong>FiO₂, SpO₂ and heart rate were recorded each minute from delivery for 10 min. Assessments were obtained at baseline, 36 weeks, discharge and at 2 years corrected gestation, along with a parent questionnaire.</p><p><strong>Statistical analysis plan: </strong>Assuming 32% of infants would die or survive with brain injury by 36 weeks, 735 infants per arm (1470 total) were needed to detect a risk difference of 8% (25% relative risk reduction), with 10% non-adherence to protocol, 85% β and 5% α.</p><p><strong>Ethics: </strong>Approved by the John Hunter Human Research Ethics Committee (2019/ETH/3837) for waiver of consent for all Australian sites for randomised allocation and primary outcome.</p><p><strong>Conclusion: </strong>Recruitment started in 2018 and was achieved on 30 September 2024. The Data and Safety Committee review found no major safety concerns at 50% recruitment.</p><p><strong>Trial registration number: </strong>ACTRN 12618000879268.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young people and parent or carers views on type 2 diabetes mellitus care in England and Wales: analysis of parent and patient-reported measures survey.","authors":"Katherine Hawton, Hannah Hickingbotham, Pooja Sachdev","doi":"10.1136/bmjpo-2024-002901","DOIUrl":"10.1136/bmjpo-2024-002901","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of type 2 diabetes mellitus (T2DM) in children and young people (CYP) is increasing in the UK and worldwide. Little is known about the experience young people and their families have when attending for their diabetes care. The aim of this study is to analyse the responses to the Parent and Patient Reported Experience Measures (PREM) survey 2021-2022 for patients with T2DM and their families to inform care.</p><p><strong>Methods: </strong>As part of the National Paediatric Diabetes Audit (NPDA) (2022), the NPDA PREM survey was open online between August 2021 and January 2022. The data have previously been analysed collectively for all diabetes; however, we specifically analysed the data for patients living with T2DM.</p><p><strong>Results: </strong>9.2% (105/1144) of young people living with T2DM in England and Wales responded to the NPDA PREM survey, mostly aged 12-16 years (61.9%) and the majority were female (67.6%). 87% of patients and 95% of carers said that they would recommend their diabetes team, and 73% of patients felt happy after appointments. Only just over half of the patients and parents felt well prepared for transferring to adult care. Only 38% of patients felt that their school or college often had the necessary information to support them with their diabetes.</p><p><strong>Conclusions: </strong>This analysis describes the experience of CYP and their parents/carers of T2DM care and highlights areas for improvement. These findings may help to inform recommendations about the development of better patient-centred care for young people with T2DM.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal knowledge, attitude and practice regarding commercial oral rehydration salt solution: experience from a diarrhoeal disease hospital in Bangladesh.","authors":"Sharika Nuzhat, Md Ridwan Islam, Md Fuad Al Fidah, Shoeb Bin Islam, Md Mushfiqur Rahman, Sneha Paul, Mahfuz-Un Nesa, Devjani Chowdhury, Shayontan Fardin Nabi, Awni Mokhtar Sallam Ali Awn, Liaquat Ali Khan, Chowdhury Ali Kawser, Mohammod Jobayer Chisti, Tahmeed Ahmed","doi":"10.1136/bmjpo-2024-003299","DOIUrl":"10.1136/bmjpo-2024-003299","url":null,"abstract":"<p><strong>Background: </strong>Despite oral rehydration salt (ORS) solution being a life-saving medication, mothers of affected children often lack proper knowledge and exhibit improper practice of using ORS in sachets. We aimed to assess maternal knowledge, attitude and practice towards commercially available ORS and its use in treating under-5 children with diarrhoea.</p><p><strong>Methods: </strong>The study was conducted at the Dhaka Hospital, Bangladesh. We included 350 mothers of under-5 children suffering from diarrhoea. Data were collected using a pretested questionnaire and modified Bloom's cut-off was used to determine adequate knowledge (≥80%), positive attitude (≥90%) and proper practice (≥75%). Logistic regression models were developed after adjusting for confounding variables. Adjusted ORs (AORs) and their 95% CIs were reported.</p><p><strong>Results: </strong>The prevalence of inadequate knowledge, negative attitude and improper practice was 88.0%, 59.1% and 72.5%, respectively. Participants with up to the higher secondary level of education had significantly higher odds of possessing adequate knowledge (AOR 7.47; 95% CI 2.76 to 20.12) and following proper practice (AOR 3.04; 95% CI 1.66 to 5.77). The majority (97.4%) reported being aware of the process of ORS preparation. Only 2.9% correctly knew all recommended steps. Approximately half (51.1%) knew the purpose of ORS use, and 24.6% believed that antibiotics are more helpful than ORS.</p><p><strong>Conclusions: </strong>The findings of the study emphasise the need for substantial improvements to the existing health education program with a focus on parental education. Emphasis should be given to reading instruction on the sachet and promoting access to information via mass media outlets.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}