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A field trial of wheat-based oral rehydration solution among Afghan refugee children
H H Murphy1, A Bari, A M Molla
1Environmental Health Project, John Snow Inc./Camp Dresser & McKee, Arlington, Virginia, USA.
Insights
Wheat-salt solution (WSS) offers a faster recovery for children with diarrhea compared to glucose-oral rehydration salts (G-ORS). This home-based treatment also improved feeding and weight gain in young patients.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Diarrhea remains a significant health concern in children globally.
- Oral rehydration therapy is a cornerstone of diarrhea management.
- Exploring alternative, accessible rehydration solutions is crucial for home-based care.
Purpose of the Study:
- To compare the efficacy of wheat-salt solution (WSS) versus glucose-oral rehydration salts (G-ORS) for treating uncomplicated diarrhea in Afghan children.
- To evaluate recovery time, stool characteristics, feeding practices, and weight changes associated with each treatment.
Main Methods:
- A randomized controlled trial involving 326 children (6 months to 5 years) with diarrhea in Afghanistan.
- Children received either WSS or G-ORS at home, with daily assessments for 7 days.
- Mothers were interviewed to track progress, feeding, and treatment perception.
Main Results:
- Children treated with WSS recovered significantly faster (mean 4.0 days) than those on G-ORS (mean 6.4 days).
- WSS led to earlier formation of stools (56% vs 11% by day 2) and reduced stool frequency (3 vs 5 stools/day).
- WSS facilitated better feeding resumption (74% vs 33% by day 2) and resulted in significant weight gain, unlike G-ORS which caused weight loss.
Conclusions:
- Wheat-salt solution (WSS) demonstrates superior efficacy in treating childhood diarrhea compared to standard G-ORS.
- WSS promotes quicker recovery, improved nutritional status, and better feeding practices.
- WSS is a viable and effective first-line home fluid for managing uncomplicated diarrhea in children.
Abstract:
A total of 326 Afghan children aged between 6 months and 5 years with uncomplicated nondysenteric diarrhea for the previous 24 h to 5 days were treated at home by their mothers with either wheat-salt solution (WSS) or World Health Organization recommended glucose-oral rehydration salts (G-ORS). For 7 consecutive days the children were examined in the household and the mothers interviewed to assess the progress, feeding practices, and perception of treatment efficacy. Children treated with WSS recovered significantly earlier; the mean duration on treatment was 4.0 days (SD 1.7 days) on WSS compared to 6.4 days (SD 1.7 days) on G-ORS. By the second day of treatment, significantly more mothers using WSS (56%) reported that their children had formed stools versus 11% of their G-ORS counterparts; the mean stool frequency after 2 days was also significantly reduced; 3 stools day-1 (SD 2.1) on WSS versus 5 (SD 2.9) on G-ORS. The cereal-based solution was not confused with normal food and led to better feeding patterns. By day 2, 74% of the mothers using WSS had resumed their normal feeding frequencies as opposed to 33% of G-ORS mothers. On recovery the WSS group had gained significantly more weight; the WSS group gained 169 g (SD 142 g) while the G-ORS group lost 150 g (SD 174g). This study suggests by subjective and objective measures that WSS could be considered as an effective home fluid for the first-line treatment of diarrhea.
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