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A randomized community trial of prepackaged and homemade oral rehydration therapies
Insights
Homemade cereal-based oral rehydration therapy (HC-ORT) is as effective as prepackaged solutions for childhood diarrhea. HC-ORT showed better weight gain and compliance, especially in infants, making it a culturally acceptable alternative.
Area of Science:
- Pediatrics
- Public Health
- Gastroenterology
Background:
- Acute childhood diarrhea causes significant mortality in Ethiopia, contributing to 40% of deaths in children under five.
- Less than 15% of acute diarrhea cases are treated with oral rehydration solutions, highlighting a treatment gap.
Purpose of the Study:
- To compare the efficacy of homemade cereal-based oral rehydration therapy (HC-ORT) against prepackaged oral rehydration solutions (ORS) for acute childhood diarrhea.
- To evaluate HC-ORT as a culturally acceptable and effective treatment option for young children.
Main Methods:
- A randomized field trial involving 291 children under five with acute diarrhea.
- Comparison of HC-ORT (n=103) with glucose-based ORS (G-ORS, n=98) and cereal-based ORS (C-ORS, n=90).
Main Results:
- Homemade cereal-based oral rehydration therapy (HC-ORT) demonstrated equivalent or superior weight gain compared to G-ORS and C-ORS at 96 hours.
- HC-ORT showed the most significant weight gain benefits in infants under 12 months.
- Caregiver compliance was higher with HC-ORT, although preparation errors were more frequent with cereal-based regimens.
Conclusions:
- Homemade cereal-based oral rehydration therapy (HC-ORT) is an effective and culturally preferred alternative to prepackaged solutions for treating childhood diarrhea.
- Community-based HC-ORT programs are recommended for implementation in developing countries to improve diarrhea management.
Objective:
To compare the effectiveness of prepackaged oral rehydration solutions with homemade cereal-based oral rehydration therapy in the treatment of acute childhood diarrhea in children younger than 5 years.
Background:
In Ethiopia, approximately 40% of all mortality in children younger than 5 years, or over 200,000 annual deaths, is attributable to acute childhood diarrhea. Less than 15% of the episodes of acute childhood diarrhea are treated with oral rehydration solutions.
Subjects:
Two hundred ninety-one children younger than 5 years with acute childhood diarrhea.
Methods:
A randomized field trial comparing the effectiveness of an entirely homemade cereal-based oral rehydration therapy (HC-ORT, n = 103) with two alternative prepackaged salt solutions, a glucose-based oral rehydration solution (G-ORS, n = 98) and a cereal-based oral rehydration solution (C-ORS, n = 90), in the treatment of mild to moderate acute childhood diarrhea in children younger than 5 years.
Results:
Subjects in the HC-ORT group demonstrated equivalent or better weight gain than those in the C-ORS or G-ORS groups at 24, 48, 72, and 96 hours following the onset of treatment. The beneficial weight-gain effect of HC-ORT was most pronounced in infants younger than 12 months, following adjustment for demographic and baseline clinical characteristics. Compliance with ORT use through 96 hours was significantly better among caretakers of children receiving HC-ORT. Minor errors in the preparation of these oral rehydration regimens occurred more frequently among caretakers preparing either of the cereal-based ones.
Conclusions:
That HC-ORT is an effective, culturally more acceptable alternative to G-ORS or C-ORS. The implementation of well-monitored, community-based HC-ORT programs in less developed countries is recommended.