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  • Title: A quantitative assessment of the Nigerian mothers' ability to prepare salt-sugar solution for the home management of diarrhoea.
    Author: Ekanem EE, Akitoye CO, Adedeji OT, Salako QA.
    Journal: J R Soc Health; 1993 Oct; 113(5):243-6. PubMed ID: 8230075.
    Abstract:
    This study aimed at assessing qualitatively and quantitatively the ability of Nigerian mothers to prepare salt-sugar solutions (SSS) (according to the Nigerian standard formula) under the usual home environment. Mothers were provided with the ingredients but not with measurement spoons nor containers. 274 mothers randomly selected from a peri-urban community participated in the study. Of the 192 (70.1%) who claimed knowledge on SSS preparation, only 47 (24.5%) gave a correct description of its constitution and 103 (54.2%) were willing to prepare the solution. Of the 103 who prepared the solution, 34 (33.0%) used the correct number of teaspoons of salt and of sugar. The composition of the solutions prepared by the mothers varied greatly with sodium levels ranging from 0-760 mmols/l (mean 225.8 +/- 155.3, median 177.3) and glucose, 0-262.6 mmols/l (mean 68.7 +/- 54.4, median 52.0). Only 7 mothers (6.8%) prepared solutions with acceptable sodium and glucose levels. It is concluded that salt-sugar solutions prepared by Nigerian mothers are not safe. There is a great need to review the oral rehydration therapy (ORT) promotion strategies and messages in order to avoid the dangers associated with improperly constituted solutions. In June-August 1989, in Nigeria, the College of Medicine at the University of Lagos conducted qualitative and quantitative assessments to determine mothers' ability to make salt-sugar solutions (SSS) under typical home conditions to manage diarrhea in their children. 234 (85.4%) of the 274 mothers knew about oral rehydration therapy (ORT) and 192 (70.1%) said that they knew how to prepare SSS. Just 47 (24.5%) of the mothers who knew the recipe for and how to prepare SSS could actually describe the correct recipe. Only 103 (37.1%) of the mothers claiming to know the recipe were willing to prepare SSS. Just 34 (33%) of these mothers used the right number of teaspoons of salt and sugar to prepare SSS. Most mothers (92.2%) used the correct amount of water (600 ml equal to the volume of 1 standard beer bottle or 2 bottles of soft drink). Considerable variability occurred in both the sodium and glucose levels of the SSS prepared by mothers (range = 0-760 mmols/l, mean = 225.8 mmols/l, median = 177.3 mmols/l, and range = 0-262.6 mmols.l, mean = 68.7 mmols/l, median = 52 mmols/l, respectively). High sodium content ( 100 mmols/l) and low glucose content ( 50 mmols/l) were the norm for SSS that mothers prepared (92% and 49.5%, respectively). Just 7 (6.8%) of the mothers made SSS within the acceptable range for sodium and glucose. These findings showed that SSS prepared at home in Nigeria is dangerous, indicating a need to reexamine ORT promotion strategies and messages to prevent the risks linked to incorrectly prepared solutions. The Nigerian Federal Ministry of Health could also target ORT messages to primary school pupils and teachers to expand SSS knowledge and correct preparation. Standard plastic measurement cups clearly marked and indicating salt and sugar levels could help achieve compliance.
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