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Table 1 Prevalence of harmful practices by region and country

From: Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review

Author, Year [reference] Country Study design, study population, number of participants Proportion restricting fluid Proportion restricting breastfeeding Proportion restricting food Proportion using drugs
Americas           
 Emond et al., 2002 [84] Brazil Cross-sectional baseline survey preceding intervention, Northeast Brazil 1997, Caregivers of children with diarrhea in the previous 2 days, n = 922        Generally give medicines other than ORS 7
 Strina et al., 2005 [63] Brazil Longitudinal survey, Salvador 1997–1999, Caregivers of children ≤36 months with diarrhea in previous 2 weeks, n = 2403 episodes        Gave industrial medicines 40.9
       Gave industrial medicines & home preparation 2.7
 Webb et al., 2010 [85] Guatemala Longitudinal survey, Population of Spanish-Mayan Descent 1996–1999, Caregivers of children <36 months with diarrhea in previous 19 days, n = 466 Stopped or less fluida 55 Stopped or less breastfeedingb 26.6 Stopped or less food 15   
 Bachrach et al., 2002 [21] Jamaica Case-control hospital based survey, Kingston 2007, Caregivers of children <5 years presenting at hospital, n = 215 total, 117 gastroenteritis cases        Child presenting with gastroenteritis: Gave antidiarrheal/ antimotility drug before coming to hospital 36
 Martinez et al., 1991 [52] Mexico Cross-sectional survey, Rural Highlands of Central Mexico (year not specified), Caregivers of children <5 years, diarrhea episode reference unclear, n = 38        Give pill as first treatment for diarrhea 47
       Give over-the-counter drug to child 53
 Perez-Cuevas et al., 1996 [40] Mexico Cross-sectional survey, Tiaxcala (year not specified), Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 747 “Withheld” non-breast milk 27.2 Stopped breastfeedingb 12.2 Stopped or reduced food other than milk 9.1 Treated with any drug 35.2
No liquids given 3    Any dietary restriction 36.6   
 Martinez et al., 1998 [86] Mexico Cross-section of ethnographic study participants, 3 States (year not specified), Caregivers of children <5 years in reference to most recent diarrhea episode, n = 186        Gave antimicrobial 37.1
       Gave antidiarrheal 28
       Gave antipyretic 18
 Smith et al., 1993 [51] Nicaragua Cross-sectional survey, Rural Pacific Coastal Plain (year not specified), Caregivers of infants, diarrhea episode reference unclear, n = 70    Stopped breastfeeding (among those who reported changing feeding)b 4 Did not give solid foods (among those who reported changing feeding)c 13   
 Gorter et al., 1995 [79] Nicaragua Cross-section of ethnographic study participants, Rural Pacific Coastal Plain 1990, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 216        Gave antibiotic 22
       Gave parasite medicine 19
       Gave laxative 6
 Vazquez et al., 2002 [33] Nicaragua Cross-sectional survey, North of Central Region 1990, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 187      Child ate less than usual 43.5 Gave any pharmaceutical 60
 Kristiansson et al., 2009 [87] Peru Cross-sectional survey, Yurimaguas and Moyobamba Departments 2002, Caregivers of children 6–72 months with illness in previous 2 weeks, n = 780        Antibiotic use reported by wealth quintile only  
Europe           
 Berisha et al., 2009 [16] Kosovo Cross-sectional survey, Kosovo 2005, Mothers of children <5 years in reference to most recent diarrhea episode, n = 107 Less fluid or nonea 62.6 Stopped or reduced amount of food or breastfeeding 43.9     
Same fluidsa 19.6 Same amount of food or breastfeeding 48.6     
Eastern Mediterranean           
 Azim et al., 1993 [37] Afghanistan Cross-sectional study, Paktika Province 1991, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 87 Same or less fluidd 43.7 Stopped breastfeedingb 5.9 Stopped or less food 33.5 Gave any drug 66
 Langsten et al., 1994 [88] Egypt Longitudinal survey, Lower Egypt 1990, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 4900 Stopped fluids other than BF and milkd 2.8 Stopped breastfeedingb 2.5 Stopped food 5.8   
Reduced other fluidsd 10.9 Decreased breastfeedingb 11.9 Reduced food 22.7   
Reduced non-breast milkd 15.3       
Stopped non-breast milkd 9.9       
 Langsten et al., 1995 [57] Egypt Longitudinal survey, Lower Egypt 1990–1991, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 4900        Among acute non-dysenteric cases: Used antibiotics 46.5
       Among acute non-dysenteric cases: Used antibiotics only 3.2
       Among acute non-dysenteric cases: Used other medicine 63.3
       Among acute non-dysenteric cases: Used other medicine only 18.6
       Among all cases: Used antibiotics 45.6
       Among all cases: Used antibiotics only 3.4
       Among all cases: Used other medicine 63.0
       Among all cases: Used other medicine only 19.3
 Jousilahti et al., 1992 [75] Egypt Cross-sectional cluster study, Lower Egypt 1992, Caregivers of children <5 years with diarrhea in previous 24 h, n = 766 Same or less fluidd 75.6 Stopped breastfeedingb 3.7 Stopped or less solid or semi-solid food 30.2 Gave any drug 54.2
       Gave drug and ORS 17.6
       Gave drug but no ORS 36.5
 El-GIlany et al., 2005 [62] Egypt Cross-sectional study, Dakahalia 2002–2003, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 1052 Same or less fluide 29    Stopped feedinge 12.7 Gave any drug 74.7
       Among those receiving a drug: 36.9
       Antibioticf 73.9
       Antidiarrhealf 73.9
       Antiemeticf 16.7
       Antiprotozoalf 5.7
       Antipyreticf 9.6
       Antispasmodicf 1.7
 Amini-Ranjbar et al., 2007 [53] Iran Cross-sectional study, Kerman 2005, Caregivers of children 6–24 months with diarrhea in previous 2 months, n = 330    Same or less breastfeedingg 53.8 Decreased solid foods 20   
 WHO, 1991 [89] Morocco Cross-sectional study, National 1990, Caregivers of children <5 years with diarrhea in previous 24 h, n = 1066 Same or less fluide 70      Gave any drug 22.6
 Morisky et al., 2002 [90] Pakistan Cross-sectional survey, National 1991–1992, Caregivers of children <2 years in reference to most recent episode, n = 5433 Stop fluidse 9.2    Stopped food 5.9 Gave antibiotic 11
     Reduced food 6.2 Gave other medicine 9.2
 Quadri et al., 2013 [13] Pakistan Cross-sectional study (HUAS), Low-Income peri-urban area near Karachi 2007, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 959 Did not offer “to drink” (at home before seeking care)e 22.5    Did not offer “to eat” (at home before seeking care)c 44.1 Gave antibiotic (at home) 7.7
 Nasrin et al., 2013 [91] Pakistan Cross-sectional study (HUAS), Low-Income periurban area near Karachi 2007, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 349 Offered same or less than usual to drink 33.9    Offered less than usual to eate 33.6   
 Bella et al., 1994 [92] Saudi Arabia Case–control study, Eastern Province (year not specified), Caregiver of infant with diarrhea at time of survey versus caregiver of infant without diarrhea, n = 344 total, 68 cases Stopped bottle feeding (among cases who were bottle feeding) 35       
 al-Mazrou et al., 1995 [93] Saudi Arabia Cross-sectional survey, National 1991, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 6300 screened        Gave drugs 40.7
       Gave IV fluids 4.7
 Bani et al., 2002 [12] Saudi Arabia Cross-sectional hospital based survey, Riyadh City (year not specified), Mothers of children ≤24 months with diarrhea attending primary health clinic, n = 237 Less fluid givene 11.3 Less frequency of breastfeedingb 24.6 Less solid/semi-solid food given 22.7   
Same fluid givene 13.2 Same frequency of breastfeedingb 37.7 Same solid/semi-solid food given 22.6   
 Moawed et al., 2000 [20] Saudi Arabia Cross-sectional hospital based survey, Riyadh City 1998, Mothers of infants with diarrhea attending 2 pediatric hospital diarrhea centers, n = 300    Stop breastfeeding or milk feeding 62    Gave unprescribed medicine 38
Africa           
 Wilson et al., 2012 [11] Burkina Faso Cross-sectional survey, Orodara Health District 2012, Primary caregivers of children <27 months with diarrhea in previous 2 weeks, n = 1067 Same or less fluide 64.1 Stopped breastfeedingb 1.2 Stopped or decreased feeding normal diete 53.2 Gave any drug other than ORS 41.2
       Gave antibiotic or unidentified drug 27.6
 Olango et al., 1990 [17] Ethiopia Cross-sectional survey, Rural population in Wolayta district (year not specified), Mothers of children <5 years with diarrhea in previous 2 weeks, n = 619 Stopped fluids (breastfed children separate category within fluid intake measure) 8.6    Stopped food (not weaned are additional category) 15.2 Gave injection 40.8
Decreased fluids 42.3    Decreased food 54.4 Gave tablets 19.6
Same amount of fluids 10.3    Same amount of food 10.2   
 Ketsela et al., 1991 [94] Ethiopia Cross-sectional survey, Shewa Administrative Regions 1990, Mothers of children <5 years, diarrhea episode reference unclear, n = 750 No fluidsa 26.8 No breastfeedingg 3.5 Gave less fluid thanc 35.9   
Less than usual fluida 31.4    Gave same fluid as usualc 38.2   
Same as usual fluida 23.8    Gave no foodc 10.5   
 Mash et al., 2003 [95] Ethiopia Cross-sectional survey, Oromia Region 1997, Caregivers of children <24 months with diarrhea in the previous fortnight, n = 111 Stopped or decreased fluidsa 47.7 Stopped or decreased breastfeedingb 67.6 Stopped or less solid or semi-solid food 67.6   
 Mediratta et al., 2010 [9] Ethiopia Case–control hospital based study, Gondar 2007, Caregivers of children <5 years with diarrhea attending referral hospital, case n = 220 Less of other fluidsa 29 Gave less breast milkb 24 “Withheld” food 46   
Same amounta 44 Same amount of breast milkb 34     
 Saha et al., 2013 [96] Gambia Cross-sectional survey, Upper River Region 2009, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 258 Same or less fluide 36.1    Less than usual amount of food 72.5 Gave antimicrobial (at home) 9.7
       Gave antimicrobial (among those seeking care at health facility) 18.6
       Gave injectable medicine (among those seeking care at health facility) 43.7
 Oyoo et al., 1991 [39] Kenya Cross-sectional survey, 6 sites across Kenya 1990, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 23884 screened Same or less fluide 74 - 96 Stopped breastfeedingb 0-3.1 Stopped feedinga 19.5 - 53.3 Gave any drug (range across clusters) 25.9 - 47.1
 Mirza et al., 1997 [97] Kenya Longitudinal study with 24 h dietary recall, Kibera Slum 1989–1990, Caregivers of children 3–37 months with diarrhea in the previous 3 days, n = 1496 episodes Gave less cow’s milk than before diarrhea 28.7       
 Othero et al., 2008 [7] Kenya Longitudinal study, Nyanza Province 2004–2006, Caregivers of children <5 years in reference to most recent episode, n = 927 Offered nothing to drinke 20.5    Did not eat anything (among all children) 39 Gave anti-diarrheal drugs 45.3
Offered much lesse 59.9       
Offered somewhat lesse 3.3       
Offered samee 5.3       
 Burton et al., 2011 [98] Kenya Cross-sectional survey, Rural Western Kenya 2005, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 188        Gave antibiotic 62.4
       Gave antimalarial 52.4
       Gave IV fluid 2.6
 Olson et al., 2011 [42] Kenya Cross-sectional survey, Asembo (n = 371) and Kibera (n = 389) 2007, Caregivers of children <5 years with diarrhea in the previous 2 weeks Asembo: Stopped fluids other than breast milk and porridge (among those giving fluids in week before illness) 9 Asembo: Stopped breastfeedingb 5 Asembo: Stopped porridge 9 Asembo: Gave oral medication (not ORS or herbs) 77
Kibera: Stopped fluids other than breast milk and porridge 18 Kibera: Stopped breastfeedingb 16 Kibera: Stopped porridge 36 Kibera: Gave oral medication (not ORS or herbs) 81
Asembo: Decreased fluidsh 42 Asembo: Decreased breastfeedingh 32 Asembo: Decreased porridgeh 54 Asembo: Gave injected medication 24
Kibera: Decreased fluidsh 47 Kibera: Decreased breastfeedingh 47 Kibera: Decreased porridgeh 69 Kibera: Gave injected medication 28
Asembo: Same fluidsh 47 Asembo: Same breastfeedingh 59 Asembo: Same porridgeh 41 Asembo: Gave IV fluids 8
Kibera: Same fluidsh 22 Kibera: Same breastfeedingh 28 Kibera: Same porridgeh 18 Kibera: Gave IV fluids 7
     Asembo: Stopped soft or solid food 10   
     Kibera: Stopped soft or solid food 37   
     Asembo: Decreased solid foodh 54   
     Kibera: Decreased solid food< 70   
     Asembo: Same solid foodh 41   
     Kibera: Same solid foodh 23   
     Asembo: Stopped or Decreased feeding (including BF, porridge, solids) 36   
     Kibera: Stopped or Decreased feeding (including BF, porridge, solids) 54   
 Omore et al., 2013 [41] Kenya Cross-sectional survey (HUAS), Western Kenya 2007, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 275 Offered same amount to drink 19    Offered usual amount to eat 16   
Offered less to drink 67    Offered less to eat 83   
Among those offering less:
Somewhat less
52    Among offering less:
Somewhat less
33   
Much less 38    Much less 30   
Nothing 10    Nothing 37   
 Nasrin et al., 2013 [91] Kenya Cross-sectional survey (HUAS), Western Kenya 2007, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 275        Gave leftover antibiotics at home 16
 Zwisler et al., 2013 [68] Kenya Cross-sectional survey, 4 Provinces 2012, Caregivers of children <5 years with diarrhea in the previous 2 months, n = 857        Gave antibiotic 51.3
       Gave antimotility agent 10.4
 Simpson et al., 2013 [99] Kenya Cross-sectional survey, Western Kenya (year not specified), Caregivers of children 6–60 month with diarrhea in the previous 6 months, n = 100        Gave antibiotic (at any point) 64
       Gave antimotility (at any point) 13
       Gave antibiotic (1st treatment) 26
       Gave antibiotic (1st or 2nd treatment) 46
 Winch et al., 2008 [71] Mali Cross-sectional baseline survey preceding intervention, Southern Mali 2004, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 228 Same or less fluid or breast milk 82.7      Gave antibiotics 57
Stopped feeding or breastfeeding 46      Gave metronidazole 7.5
       Gave antidiarrheal 2.6
       Among children with only diarrhea symptoms gave: Antibiotic 16
       Antimalarial 16
       Paracetamol 10
 Perez et al., 2009 [100] Mali Cross-sectional survey in intervention comparison area, Mopti Region 2006, Caregivers of children <5 years, reference episode unclear, n = 401        Gave any drug 56.1
 Nasrin et al., 2013 [91] Mozambique Cross-sectional survey, Rural Southern Mali 2007, Caregivers of children <5 years with diarrhea in the previous 2 weeks, n = 67      Offered less than usual to eat 38.3 Gave leftover antibiotics at home 3.6
 Nhampossa et al., 2013 [15] Mozambique Cross-sectional study (HUAS), Rural Southern Mozambique 2007 (Study 1 n = 67) and 2009–2012 (Study 2 n = 246), Caregivers of children <5 years with diarrhea in previous 2 weeks Study 1: Reduced or stopped breastfeeding/usual fluid intake 12      Study 1: Gave antibiotic (Among those seeking treatment) 14
Study 1: Maintained same fluid or breast milk intake 73       
Study 2: Reduced or stopped breastfeeding/usual fluid intake 79       
Study 2: Maintained same fluid or breast milk intake 1       
 Ekanem et al., 1990 [47] Nigeria Diarrhea surveillance survey, Periurban Lagos (year not specified), Mothers of children 6–36 months, reference episode is general case, n = 200    Normal breastfeeding pattern continuedb 76.9     
   Decreased breastfeedingb 10.4     
 Babaniyi et al., 1994 [10] Nigeria Cross-sectional study, Suleja 1991, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 340 Normal amount of “other” fluidsai 55.6 Stopped breastfeedingb 7.7 Stopped or less solid food 42.4 Gave any drug (at home) 53.5
Less “other” fluidsai 22.6       
 Okoro et al., 1995 [74] Nigeria Cross-sectional study, Cross River State 1994, Caregivers of children <5 years with diarrhea in previous 24 h, n = 488        Gave any drug 75.6
       Gave drug and ORS/SSS 51.9
 Okunribido et al., 1997 [26] Nigeria Longitudinal study, Rural Yoruba communities of rural Oyo State (year not specified), Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 98 Stopped fluids (among those who noticed fluid intake)e 2 Child could not suck 23.4 Stopped food 3 Gave Western medicine: 1sttreatment, among those treating 37.7
Child refused fluid 29.5 Lost appetite 34.6 Reduced appetite 68.8 Gave Western medicine: 2ndtreatment, among those treating 30.3
       Gave Western medicine at any point for watery diarrhea 50
       Gave Western medicine at any point for presumed dysentery 52.7
 Edet et al., 1996 [101] Nigeria Cross-sectional study, Oduknani 1994, Caregivers of children <5 years with diarrhea in previous 24 h, n = 5296 screened Less fluida 48.2 Stopped breastfeedingb 59.9 Stopped feeding 13.8   
Same fluida 37.3    Less food 32.8   
     Same food 49   
 Omokhodion et al., 1998 [102] Nigeria Cross-sectional study, Market women in Ibadan 1996–1997, Market women with children <5 years in reference to any diarrhea episode, Bodia n = 266, Gbagi n = 260        Bodija Market: Went to chemist to buy drugs 12
       Gbagi Market: Went to chemist to buy drugs 19
       Bodija Market: Used drugs prescribed for previous illness 7
       Gbagi Market: Used drugs prescribed for previous illness 5
 Ene-Obong et al., 2000 [81] Nigeria Surveillance study, Market women in Enugu State 1993–1994, Market women with children <5 years with diarrhea in previous 2 weeks, n = 80        Gave pharmaceutical 28.8
       Gave pharmaceutical & sugar-salt solution 33.8
 Omotade et al., 2000 [38] Nigeria Surveillance study, Oyo State 1993–1994, Caregivers of children <5 years with diarrhea in previous week, n = 158        Gave antimicrobial 46.8
 Uchendu et al., 2009 [60] Nigeria Cross-sectional hospital based study, Enugu 2006, Caregivers of children <5 years attending health clinic with diarrheal disease and vomiting, n = 156        Gave antibiotic (at home) 51.3
       Gave antimotility/antidiarrheal (at home) 44.9
 Uchendu et al., 2011 [45] Nigeria Cross-sectional hospital based study, Enugu 2006, Caregivers of children <5 years attending health clinic with diarrheal disease and vomiting, n = 156      Stopped feedse 5.2   
 Ogunrinde et al., 2012 [103] Nigeria Cross-sectional hospital based survey, Northwestern Nigeria (year not specified), Caregivers of child 1–59 months attending health clinic with diarrheal disease, n = 186        As first line treatment gave:  
       Antibiotic 23.7
       Antidiarrheal 12.7
       ORS, antibiotic, antidiarrheal 3
 Ekwochi et al., 2013 [64] Nigeria Cross-sectional hospital based study, Enugu 2012, Caregivers of children ≤5 years attending university teaching hospital, reference any diarrhea episode, n = 210        Gave unprescribed antibiotic 46.7
 Cooke et al., 2013 [104] South Africa Cross-sectional hospital based study, Capetown 2007–2008, Caregivers of children <65 months with severe diarrhea attending hospital, n = 142 Same or less fluid among all (but gave some ORS or milk) 36.6 Stopped breastfeeding/milk (but gave other fluids)b 35.2     
 Haroun et al., 2012 [105] Sudan Cross-sectional hospital based study, Gezira (year not specified), Mothers of children <5 years, diarrhea episode reference unclear, n = 110 Stopped or reduced fluid during episodee 49    Stopped feedinge 30   
Same amount of fluid during episodee 33       
Stopped or reduced fluid during episode but didn’t change amount of foode 23       
 Kaatano et al., 1997 [8] Tanzania Cross-sectional survey, North-western lake districts (year not specified), Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 89 Stopped or decreased fluide 12.6 Stopped breastfeedingb 46.7 Stopped or decreased food 13.8 Gave anti-diarrheal 29.2
       Gave antibiotic 13.5
South East Asia           
 Alam et al., 1998 [82] Bangladesh Cross-sectional survey, Metropolitan Chittagong 1996–1997, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 360        “Inappropriate or non-recommended drug use” among those receiving treatment 73.5
       Gave metronidazole (denominator all consultations) 38.6
       Gave antibiotic (denominator all consultations) 17.5
       Gave antiemetic (denominator all consultations) 12.2
       Gave antidiarrheal (denominator all consultations) 8
 Ali et al., 2000 [27] Bangladesh Cross-sectional survey, Brahmanharia district 1993, Caregivers of children <5 years with diarrhea in previous 24 h, n = 186 Drank less than usual amount of water (not amount offered) 17       
 Taha et al., 2002 [106] Bangladesh Cross-sectional survey, Cox’s Bazar district 1994, Mothers of children <5 years, diarrhea episode reference unclear, n = 297 No fluids for treating diarrheae 11.7 Stopped breastfeedingb 11.7 Did not give solid or semi-solid foodc 40.4   
 Baqui et al., 2004 [73] Bangladesh Community based controlled trial, Matlab 1998–2000, Caregivers of children 3–59 months with diarrhea in previous week, n = 297        Gave antibiotic 34.3
       Gave other medicine 44.8
       Gave IV 0.3
 Larson et al., 2009 [107] Bangladesh Cross-sectional baseline survey preceding intervention, Dhaka 2006, Caregivers of children 6–59 months with diarrhea in previous 2 weeks, n = 640        Gave antibiotic 34.7
 Das et al., 2013 [14] Bangladesh Cross-sectional survey (HUAS), Rural Mirzapur 2007, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 1128 Offered less than usual amount of fluids 10.8    Offered less to eat (at home before seeking care) 28.7 Gave antibiotics (at home before seeking care) 2.4
Same amount 61.3       
Same or less 72.1       
 Sood et al., 1990 [108] India Cross-sectional survey, Rural Haryana State (year not specified), Caregivers of children <5 years, reference any diarrhea episode, n = 108    Generally stopped breastfeeding 0 Some food restricted 83.33   
 Rasania et al., 1993 [23] India Cross-sectional survey, New Delhi (year not specified), Caregivers of children <5 years, diarrhea episode reference unclear, n = 254    Restricted breastfeedingb 12.59 Gave less food during convalescence 26.38   
   Stopped breastfeedingb 19.29 Shifted from solid to liquid diet 45.27   
     Stopped all foode 9.84   
     Restricted “few” foods 16.53   
 Gupta et al., 2007 [109] India Cross-sectional survey, Urban Delhi slum 2004, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = unclear 1307 Stopped fluide 20    Stopped feeding (not clear if food or breastfeeding) 50   
 Ahmed et al., 2009 [46] India Cross-sectional survey, Kashmir Valley 2006, Caregivers of children <5 years with diarrhea in previous 24 h (n = 1055) and 2 weeks (n = 2836)      Among diarrhea in 15 days: Feeding restrictede 4 Diarrhea in last 24 h: Gave antibiotic 77.9
     Diarrhea in last 24 h: Feeding restrictede 6.9   
 Shah et al., 2012 [31] India Cross-sectional survey, Urban slum of Aligarh 2009, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 101    Stopped or decreased breastfeeding (among EBF 0-6 m)b 30.77 Interrupted, stopped or decreased feeding (among not breastfeeding: 7 m-5 years) 37.8   
   Stopped or decreased breastfeeding (among non-EBF 0-6 m)b 80     
 Zwisler et al., 2013 [68] India Cross-sectional survey, 7 States 2012, Caregivers of children <5 years with diarrhea in the previous 2 months, n = 988        Gave antibiotic 56.4
       Gave antimotility agent 3
 WHO 1991 [110] Nepal Cross-sectional survey, Terai (n = 335) and Midhills (n = 526) 1990, Caregivers of children <5 years with diarrhea in previous 24 h Terai: Same or less fluida 72 Terai: Stopped breastfeedingb 1 Terai: Stopped or Less Feeding 25 Terai: Gave drug, no ORS 21.5
Midhills: Same or less fluida 91 Midhills: Stopped breastfeedingb 1 Midhills: Stopped or Less Feeding 39 Midhills: Gave drug, no ORS 14.3
       Terai: Gave drug and ORS 4.5
       Midhills: Gave drug and ORS 4.9
 Jha et al., 2006 [111] Nepal Cross-sectional hospital based study, Sunsari District (year not specified), Caregivers of children <5 years with diarrhea attending PHC, n = 330      Not Given Foodec 2.1 Gave any drug at any point 70
     Less frequency of food givenec 12.5 Gave antibiotic 19.9
     More liquid mixed food given 13.1 Gave antimotility drug 16.8
     Fed as usual, child refused 14.6 Gave anti-vomiting drug 15.5
     Usual feeding 57.7 Gave IV 17.7
 WHO 1993 [77] Sri Lanka Cross-sectional survey, North-western Province 1992, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 10077 screened Same or less fluide 63    Stopped feedinge 23 Gave any medicine 71
 Wongsaroj et al., 1991 [65] Thailand Cross-sectional survey, 12 Regions 1991, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 733 Same or less fluide 91.8 Stopped breastfeedingb 16.6 Stopped solid foods 28.7 Gave any antibiotic or antidiarrheal 58.6
       Gave IV 6.2
       Gave antibiotic 18
       Gave antidiarrheal 19.3
       Gave both antibiotic and antidiarrheal 21.3
 Prohmmo et al., 2006 [28] Thailand Surveillance survey, Northeast Region 2002, Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 47 episodes Same or decreased fluid 42.5 Stopped breastfeedingb 0    Gave antimicrobial 45
       Gave antiemetic 19
       Gave antidiarrheal 13
       Gave cold medicine 15
       Gave antipyretic 25
Western Pacific           
 Dearden et al., 2002 [22] Vietnam Cross-sectional survey, Rural northern province, Caregivers of children 6–18 months, reference any diarrhea episode, n = 100      Generally give less or no foods and liquids 71   
 Hoan et al., 2009 [112] Vietnam Cross-sectional survey, Rural district (year not specified), Caregivers of children <5 years with diarrhea in previous 2 weeks, n = 133        Among children with only diarrhea symptoms gave: 54.1
       Antibiotics 36.1
       Anti-diarrheal 36.1
       Antihistamine 3
       Analgesic/antipyretic 13.5
       Cough and cold prep 0.8
       Corticosteroid 2.3
  1. aExcluding breast milk
  2. bAmong those breastfeeding
  3. cUnclear if only among those receiving solid or semi-solid food before illness
  4. dAmong drinking fluids other than breast milk
  5. eInclusion/exclusion of breastfeeding not specified
  6. fAmong those receiving drug as treatment
  7. gUnclear if only among those breastfeeding at time of illness
  8. hAmong those who continued to receive fluids; breast milk; food
  9. iExplicitly excluding ORS/SSS