Zinc Treatment for Childhood Diarrhea in Bangladesh - Recent Advances and Issues in Environmental Science - page 216

In summary, the national scale up of zinc treatment for childhood diarrhea in
Bangladesh, the fi rst national campaign to be undertaken, has met with modest success
over the initial 2 years of promotion and has not had a detrimental effect on the use
of ORT. While the relative benefi ts of provider versus caretaker mass media-focused
promotion cannot be separated in this study, it is concluded that both strategies are
important to undertake. To improve upon the overall coverage attained of about 20% of
childhood diarrhea episodes will require greater, more consistent support from health
providers and strengthened demand for zinc treatment from caregivers. Both of these
objectives would benefi t from an improved understanding of health system constraints
as well as societal, household, and provider characteristics facilitating sustained behav-
ioral change leading to the successful scale up of zinc and other life-saving interventions.
RESULTS
Seven survey rounds were completed with the range in the 2-weeks prevalence (p) of
diarrhea and the number of cases (n) surveyed by location as follows; urban slums p
= 0.20-0.25 and n = 642-646; urban nonslums p = 0.17-0.23 and n = 641-658; mu-
nicipalities p = 0.15-0.19 and n = 965-979; rural p = 0.19-0.23 and n = 962-976. The
mean age of the children at each survey ranged from 26.3 ± 0.3 months to 27.4 ± 0.3
months and the percentage of cases being female ranged from 44.2% to 46.6%. Of all
cases identified, 98.5% were enrolled in the surveys.
Figure 2 summarizes caretaker awareness of zinc as a treatment for childhood
diarrhea over time stratifi ed by the location of the household. At baseline, prior to the
launch of the mass media campaign, but following multiple workshops with licensed
pediatricians, awareness was under 5% for all but urban, nonslum caregivers (99%
mothers). In all locations awareness rapidly increased following the onset of mass
media zinc promotion, reaching peak levels by 10 months into the campaign. Among
the urban slum and rural populations surveyed, zinc treatment awareness reached 65%
and 55%, respectively, by 23 months.
Figure 2. Caretaker awareness of zinc treatment for childhood diarrhea before and up to 23 months
following the onset of the mass media campaign.