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Effect of boiled-rice feeding in childhood cholera on clinical outcome
Insights
Adding boiled rice to oral rehydration solution (ORS) for children with cholera increased stool output but improved fluid absorption. This feeding strategy enhanced fluid retention and body weight gain during hospitalization.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Acute watery diarrhea in children, often caused by Vibrio cholerae, requires effective rehydration strategies.
- Early nutritional support alongside oral rehydration solution (ORS) is crucial for recovery but its impact on fluid balance needs further investigation.
Purpose of the Study:
- To evaluate the effect of incorporating boiled-rice feeding into oral rehydration solution (ORS) therapy on fluid balance and clinical outcomes in children with cholera.
Main Methods:
- A randomized controlled trial involving 48 children (aged 2-5 years) with cholera.
- Group 1 received ORS alone; Group 2 received ORS plus boiled-rice feeding (≥55 kcal/kg/d).
- Stool output, fluid absorption, and body weight changes were monitored over the first 24 hours of hospitalization.
Main Results:
- Children receiving boiled rice showed increased stool volume and duration of diarrhea.
- However, the boiled-rice group demonstrated significantly greater fluid absorption and retention (176 ml more).
- Body weight gain in the boiled-rice group was comparable to the unfed group, indicating improved nutritional support.
Conclusions:
- Incorporating boiled-rice feeding into ORS therapy for cholera in children enhances fluid absorption and retention.
- Despite increased stool output, this nutritional intervention supports better fluid balance and weight maintenance.
- Boiled-rice feeding can be a beneficial adjunct to ORS in managing pediatric cholera.
Abstract:
Forty-eight children, aged 2-5 years, presenting with watery diarrhoea of less than 48 h duration at home prior to hospitalization, were admitted into a randomized controlled clinical trial, 24 children being treated during the first 24 h of admission with oral rehydration solution (ORS) alone and 24 children being given 'ORS plus boiled-rice feeding'. The latter group received boiled-rice to supply at least 55 kcal/kg/d (about 150 g boiled-rice per feed, given four times daily). Vibrio cholerae were isolated by stool culture on admission from all children. No antibiotics were given. Clinical characteristics of children in the two treatment groups were comparable. Among children given 'ORS plus boiled rice', there was a significant increase in volume of diarrhoea stools (P less than 0.05), duration of diarrhoea in hospital (P less than 0.01), and more frequent diarrhoea motions (not significant statistically). However, the children fed boiled rice absorbed and retained 176 ml more fluid, and had gain in body weight comparable to that observed in children who were not fed during the first 24 h of hospitalization.