OBJECTIVES : Despite advancing global efforts and success in the reduction of diarrhea-associated mortality in the past three decades, diarrheal diseases prevail as the second leading cause of death in children under five years old albeit being treatable and even preventable. The current study aims to investigate maternal knowledge, attitudes and, practices of oral rehydration solution (ORS) use in the treatment of pediatric diarrhea of children below the age of five years old in Malaysia.

METHODS : A cross-sectional multi-center community-based survey conducted between November 20^th and December 20^th, 2018. A 35-item questionnaire were used to collect data on maternal awareness, knowledge, attitude, and practice toward the use of ORS. The study was approved by the research committee of Monash University Malaysia.

RESULTS : A total of 400 mothers were interviewed. majority of the mothers in our cohort (82.8%) were aware of the presence of ORS and 83% had correctly answered at least 4 of 5 questions on the preventive approaches of diarrhea. Apart from preventing dehydration in children (90.0%) and replacing water (38.8%), some mothers perceived that ORS also satisfies hunger (23.5%) and stops loose motion (40.5%). However, participants in our study demonstrated poor practice regarding the administration and storage of ORS.

CONCLUSIONS : Overall knowledge and awareness about diarrhea and ORS in its management amongst mothers in Kuala Lumpur was average, considering the high degree of urbanization of the setting. Although mothers are equipped with sufficient knowledge regarding diarrhea and ORS, certain issues are disconcerting namely the use of treated water for ORS solution preparation, ORS solution storage, the understanding regarding the urgency of ORS use and the preparation of ORS solution. Hence, extensive education interventions could prove useful in overcoming these false perceptions of ORS use for diarrhea and improve overall knowledge, practices and attitudes of mothers regarding diarrhea and its management with ORS