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Oral rehydration in infants in developing countries
1National Children's Hospital, Social Security System, San José, Costa Rica.
Insights
Oral rehydration therapy (ORT) effectively treats dehydration, a primary cause of infant mortality from diarrhoea. This accessible treatment is a significant advancement over older methods focusing on diarrhoea symptoms.
Area of Science:
- Pediatrics
- Public Health
- Tropical Medicine
Background:
- Diarrhoeal diseases are a leading cause of infant mortality globally.
- Severe dehydration is the primary fatal complication of diarrhoea, responsible for up to 80% of deaths.
- Historically, treatments focused on managing diarrhoea symptoms rather than dehydration.
Purpose of the Study:
- To highlight the critical role of dehydration in diarrhoeal disease mortality.
- To introduce and advocate for Oral Rehydration Therapy (ORT) as a superior treatment for dehydration.
- To contrast ORT with traditional intravenous therapy and symptomatic treatments.
Main Methods:
- Review of historical treatment approaches for diarrhoeal diseases.
- Comparison of intravenous therapy with Oral Rehydration Therapy (ORT).
- Emphasis on the accessibility and efficacy of ORT across various patient demographics.
Main Results:
- Intravenous therapy was historically limited to severely dehydrated patients near healthcare facilities.
- Oral Rehydration Therapy (ORT) offers a more accessible and versatile treatment option.
- ORT effectively resolves most serum disturbances associated with dehydration in neonates, infants, children, adults, and the elderly.
Conclusions:
- Focusing on diarrhoea symptoms is less effective than addressing dehydration.
- Oral Rehydration Therapy (ORT) is a life-saving intervention for dehydration caused by diarrhoea.
- ORT's ease of administration makes it a crucial tool for reducing infant mortality in developing countries.
Abstract:
Diarrhoeal diseases are the major cause of infant mortality in developing countries. Dehydration is the most common complication of diarrhoea, and severe dehydration causes up to 80% of diarrhoeal fatalities. For more than 100 years, physicians focused the treatment of diarrhoeal diseases on the symptom diarrhoea, and there were many 'antidiarrhoeal' drugs, such as water adsorbents (kaolin and pectin) and antiperistaltics (opium, paregoric elixir, diphenoxylate hydrochloride with atropine sulphate and loperamide). This approach focused on a non-dangerous symptom and diverted attention from the real killer, dehydration. A few decades ago, only severely dehydrated patients were treated by intravenous therapy. This treatment was prescribed by a group of professional health workers, administered intravenously by skilled nurses, and reserved for the few patients resident near health facilities. Oral rehydration therapy (ORT), developed 20 years ago, has several advantages over intravenous therapy; it can be administered at home, at health clinics or in modern hospitals, by parents or by nurses or physicians. Most serum disturbances in dehydrated neonates, infants, children, adults and the elderly are resolved by this treatment.