Published in PLOS One on 2026-02-19, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Tsegazeab Ayele, Muluken Birhanu, Solomon Kassa, Sayih Mehari Degualem, Habtamu Wondmagegn, Kidus Temesgen, Habtamu Esubalew Bezie, Tamirayehu Abayneh, Maycas Gembe, Biniyam Demisse Andarge, Vinaya Tari
Source: PLOS One • DOI 10.1371/journal.pone.0343208
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Dehydration from diarrheal diseases remains a common cause of morbidity and mortality in developing countries. Nasogastric tube is an easy, efficient, and cost-effective method of management that could be a key to minimizing deaths from diarrheal disease. As such, this study assessed the current practices and barriers toward using nasogastric tube for managing moderate to severe dehydration in under-five children.
To assess the practices and barriers toward the management of moderate to severe dehydration using nasogastric tube in under-five children among health centers in Gamo Zone, South Ethiopia.
A qualitative study design was conducted among healthcare professionals at selected health centers in Gamo Zone. Data about the practice pattern of managing moderate to severe dehydration and barriers toward nasogastric tube utilization were obtained via in-depth interview. Data were reviewed using constant comparative analysis to identify emerging themes, and axial coding was performed to make connections between categories to organize themes into causal relationships. Hypotheses and concepts were developed inductively from the data.
In our study, of thirty participants, 21 (70.0%) correctly diagnosed severe dehydration, while 9 (30.0%) diagnosed moderate dehydration. Among those who diagnosed severe dehydration, 5 (23.8%) recommended intravenous resuscitation, and 16 (76.2%) chose oral rehydration. After being informed of failed attempts, four chose to refer, and one clinician remained fixed on intravenous resuscitation, while the remaining 16 clinicians opted for nasogastric tube. Major challenges mentioned by the participants in managing dehydration were late presentation of the patients and equipment shortage.
Participants in our study were aware of the significance of nasogastric tube for the treatment of moderate to severe dehydration. However, a gap in clinical skills, a lack of continuous training, high clinician turnover, and institutional policies limiting nasogastric tube utilization for the management of dehydration were major challenges. Therefore, improving clinicians’ skills through continuous training and improving management protocol is essential in ensuring safe and effective rehydration and better patient outcomes.
Introduction
Globally, 38 children out of 1000 live births died before reaching five years old by 2019. Half of the total deaths were from five countries, including Ethiopia, with 178 deaths per 1000 live births. The primary causes of these deaths were infectious diseases, including pneumonia, malaria, and diarrhea [1]. The burden of diarrheal disease persists; it was reported as the second most common cause of death in under-five children globally by 2017 [2]. Particularly, in developing countries, dehydration due to diarrheal disease contributed to high morbidity and mortality in under-five children. In Ethiopia, diarrheal disease accounted for 8.98% of deaths in under-five children making it the third most common cause of mortality in this age group [3]. Additionally, 9.96% of hospital admissions in under-five children were attributed to acute gastritis with dehydration [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Tsegazeab Ayele, Muluken Birhanu, Solomon Kassa, Sayih Mehari Degualem, Habtamu Wondmagegn, Kidus Temesgen, Habtamu Esubalew Bezie, Tamirayehu Abayneh, Maycas Gembe, Biniyam Demisse Andarge, Vinaya Tari. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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