Diarrhea causes 16% of all child deaths in Pakistan. We assessed patterns of healthcare use among
caretakers of a randomly selected sample of 959 children ages 0–59 months in low-income periurban
settlements of Karachi through a cross-sectional survey. A diarrheal episode was reported to have occurred
in the previous 2 weeks among 298 (31.1%) children. Overall, 280 (80.3%) children sought care. Oral
rehydration solution and zinc were used by 40.8% and 2%, respectively; 11% were admitted or received
intravenous rehydration, and 29% sought care at health centers identified as sentinel centers for recruiting
cases of diarrhea for a planned multicenter diarrheal etiology case-control study. Odds ratios for
independent predictors of care-seeking behavior were lethargy, 4.14 (95% confidence interval = 1.45–
11.77); fever, 2.67 (1.27–5.59); and stool frequency more than six per day, 2.29 (1.03–5.09). Perception of
high cost of care and use of home antibiotics were associated with reduced care seeking: odds ratio = 0.28
(0.1–0.78) and 0.29 (0.11–0.82), respectively. There is a need for standardized, affordable, and accessible
treatment of diarrhea as well as community education regarding appropriate care in areas with high
diarrheal burden.