SEVERITY SIGNS OF CHILDHOOD DIARRHEA IN NORTH EASTERN NIGERIA

Oral Rehydration Therapy (ORT) use in Nigeria is currently far short o f the national Control of Diarrhoeal Diseases (CDD) programme goals. T owards designing health education strategies to improve this, maternal lay health concerns during diarrhoea in under-fives were examined amo ng two large ethnic groups, the Kanuris and Buras, in northeastern Nig eria. Over half of the respondents judged the severity of diarrhoea by more than one sign and expected ORT to stop diarrhoea. Severity signs frequently described (averaging from a quarter to a half of responden ts) included weakness and refusal of food; frequent stooling and fever were more frequently used by the Kanuris (p < 0.001) compared to Bura s and weight loss and dehydration by the Buras (p < 0.01) compared to Kanuris. Generally, rural residents were less concerned with dehydrati on and weight loss (p < 0.0001 and 0.003 respectively, compared to urb an residents) and more concerned with restlessness, including excessiv e crying (p < 0.07 to 0.0001). Stool characteristics and vomiting were rarely used as severity signs although the Kanuris in focus group dis cussions related severity to diarrhoea typology. Concerns with persist ent diarrhoea, and diarrhoea associated with measles, were rarely expr essed by participants, irrespective of ethnic group and domicile, sugg esting that health education aimed at increasing awareness in relation to these two serious illnesses is urgently needed in Nigeria. Several of the lay health concerns expressed by participants in the study cou ld form a useful basis for promoting ORT use in Nigeria and elsewhere.