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m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial

The standard of care for children with acute watery diarrhea (AWD) with no dehydration comprises oral rehydration solution, zinc, and feeding advice. Adherence to zinc therapy may be an issue in the management of acute watery diarrhoea. Mobile phones are used by over 90% of the population in Tanzani...

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Autores principales: Karim, Fatimah Zahra, Kisenge, Rodrick, Manji, Karim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547181/
https://www.ncbi.nlm.nih.gov/pubmed/37788258
http://dx.doi.org/10.1371/journal.pdig.0000348
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author Karim, Fatimah Zahra
Kisenge, Rodrick
Manji, Karim
author_facet Karim, Fatimah Zahra
Kisenge, Rodrick
Manji, Karim
author_sort Karim, Fatimah Zahra
collection PubMed
description The standard of care for children with acute watery diarrhea (AWD) with no dehydration comprises oral rehydration solution, zinc, and feeding advice. Adherence to zinc therapy may be an issue in the management of acute watery diarrhoea. Mobile phones are used by over 90% of the population in Tanzania, thus good means to improve adherence to prescribed medication and/or attendance to follow-up visits. The objective of this study was to see whether m-follow-up improves adherence rate to zinc therapy, possible reasons for non-adherence, in children with diarrhea.: A randomized controlled trial was carried out in a suburban municipality in Dar-es-Salaam. Block randomization of participants was carried out with a block size of 4 and a 1:1 ratio of intervention: control. The intervention group comprised participants who were to be followed up using text messages and voice calls; the control group was to be followed up in outpatient. The outcome of interest was adherence to the full course of 10 days’ oral zinc, reasons for nonadherence and acceptability. Chi-square was used to compare the categorical variables. δ, the targeted difference in adherence between arms, was pre-set at 20%. The total number of participants were 196, of which 98 participants were enrolled in each arm. Full adherence to the 10-day course of zinc sulphate in children with AWD and no dehydration was 84.1% in the control arm and 89.7% in the m-follow up group (P = 0.33). m-follow up significantly improved physical attendance at 14-day clinic visit compared to control group (39.8% vs. 60.2%; P = 0.006). Commonest reasons for non-adherence in both groups were related to vomiting (67%). Vomiting at enrolment due to gastroenteritis was significantly associated with vomiting zinc sulphate with RR 2.17 (95% CI 1.24–3.79, P = 0.007). The acceptability of m-follow-up was high (99%). In conclusion the idea of m-follow-up was well received by participants who considered it acceptable. In this study, the adherence to Zinc dosing was not significantly different between the intervention and control group, and we consider that for zinc in AWD, counselling alone was good enough to achieve high adherence. The trial was registered with the Pan-African Clinical Trial Registry. Trial number: PACTR201711002737120
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spelling pubmed-105471812023-10-04 m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial Karim, Fatimah Zahra Kisenge, Rodrick Manji, Karim PLOS Digit Health Research Article The standard of care for children with acute watery diarrhea (AWD) with no dehydration comprises oral rehydration solution, zinc, and feeding advice. Adherence to zinc therapy may be an issue in the management of acute watery diarrhoea. Mobile phones are used by over 90% of the population in Tanzania, thus good means to improve adherence to prescribed medication and/or attendance to follow-up visits. The objective of this study was to see whether m-follow-up improves adherence rate to zinc therapy, possible reasons for non-adherence, in children with diarrhea.: A randomized controlled trial was carried out in a suburban municipality in Dar-es-Salaam. Block randomization of participants was carried out with a block size of 4 and a 1:1 ratio of intervention: control. The intervention group comprised participants who were to be followed up using text messages and voice calls; the control group was to be followed up in outpatient. The outcome of interest was adherence to the full course of 10 days’ oral zinc, reasons for nonadherence and acceptability. Chi-square was used to compare the categorical variables. δ, the targeted difference in adherence between arms, was pre-set at 20%. The total number of participants were 196, of which 98 participants were enrolled in each arm. Full adherence to the 10-day course of zinc sulphate in children with AWD and no dehydration was 84.1% in the control arm and 89.7% in the m-follow up group (P = 0.33). m-follow up significantly improved physical attendance at 14-day clinic visit compared to control group (39.8% vs. 60.2%; P = 0.006). Commonest reasons for non-adherence in both groups were related to vomiting (67%). Vomiting at enrolment due to gastroenteritis was significantly associated with vomiting zinc sulphate with RR 2.17 (95% CI 1.24–3.79, P = 0.007). The acceptability of m-follow-up was high (99%). In conclusion the idea of m-follow-up was well received by participants who considered it acceptable. In this study, the adherence to Zinc dosing was not significantly different between the intervention and control group, and we consider that for zinc in AWD, counselling alone was good enough to achieve high adherence. The trial was registered with the Pan-African Clinical Trial Registry. Trial number: PACTR201711002737120 Public Library of Science 2023-10-03 /pmc/articles/PMC10547181/ /pubmed/37788258 http://dx.doi.org/10.1371/journal.pdig.0000348 Text en © 2023 Karim et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Karim, Fatimah Zahra
Kisenge, Rodrick
Manji, Karim
m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title_full m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title_fullStr m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title_full_unstemmed m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title_short m-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial
title_sort m-follow up for zinc adherence by caretakers of children with acute watery diarrhoea: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547181/
https://www.ncbi.nlm.nih.gov/pubmed/37788258
http://dx.doi.org/10.1371/journal.pdig.0000348
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