Community use of oral rehydration solution and antibiotics for diarrhea in the Far North and Littoral regions of Cameroon: distribution and determinants

Diarrhea is a significant health issue in low- and middle-income countries. There is an urgent need to identify and implement actions aimed at reducing the associated mortality and morbidity. The aim of this study was to determine the frequency and determinants of home use of oral rehydration solution (ORS) and antibiotics for the treatment of diarrheal diseases in the Far North and Littoral regions of Cameroon. This was a cross-sectional study using sentinel surveillance data collected from four health facilities in the cities of Kousseri and Douala in Cameroon. The study targeted patients seeking consultations for diarrhea at these health facilities. Patients were selected through consecutive sampling. Data were collected using a questionnaire administered face-to-face by a trained nurse, which included questions about the reason for consultation, socio-demographic characteristics, and prior exposure to ORS and antibiotics before arriving at the health facility. A total of 1,065 patients with diarrhea agreed to participate in the study, including 160 (15.0%) from Kousseri and 905 (85.0%) from Douala. Of the 1,065 participants, 215 (20.2%) and 637 (59.8%) reported using ORS and antibiotics at home as part of their diarrhea treatment prior to arriving at the health facility. The most used antibiotics were metronidazole (31.9%), amoxicillin (3.6%), doxycycline (3.6%), and ciprofloxacin (2.6%).The use of ORS was associated with place of residence (aOR = 0.20; 95% CI [0.10 - 0.40]), and duration of diarrhea (aOR = 0.51; 95% CI [0.33 - 0.78]) were associated with home use of ORS among patients with diarrhea. The city of residence (aOR = 3.06, 95% CI = 1.85 - 5.05) and the absence of ORS use at home (aOR = 2.17; 95% CI = 1.30-3.62); having diarrhea for less than 24 h (aOR = 0.36, 95% CI = [0.24 - 0.54]) and traveling less than one hour to reach the health facility (aOR = 0.44, 95% CI = [0.21 - 0.91]) were associated with home use of antibiotics among patients with diarrhea. The frequency of antibiotic use in the community is significantly high, while the utilization of ORS remains low. More efforts are required to enhance community management of diarrhea effectively.