Oral Rehydration Therapy for Diarrhea: An Example of Reverse Transfer of Technology

Abstract

ABSTRACT. On November 13 and 14, 1996, a scientific symposium on oral rehydration therapy (ORT) was held at the Johns Hopkins University School of Hygiene and Public Health in Baltimore, MD. The purpose of the meeting was to review the current treatment practices for the treatment of this disease in the United States. The group noted that diarrhea resulted in 300 to 400 deaths per year among children, ‫002ف‬ 000 hospitalizations, 1.5 million outpatient visits, and costs >$1 billion in direct medical costs.ORT is well established therapy for the treatment and prevention of dehydration due to diarrhea. The principles of ORT treatment include early adequate rehydration therapy using an appropriate oral rehydration solution (ORS), replacement of ongoing fluid losses from vomiting and diarrhea with ORS, and frequent feeding of appropriate foods as soon as dehydration is corrected.The effective use of ORT has saved millions of lives around the world. However, in the United States, ORT is grossly underused. Contrary to the recommendations of the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), health care providers overuse intravenous hydration, prolong rehydration, delay reintroduction of feeding, and inappropriately withhold ORT, especially with children who are vomiting.The expert panel noted that the majority of deaths, hospitalization, and visits to emergency departments could be prevented by the appropriate use of ORT. They generated guidelines for the treatment and prevention of dehydration secondary to diarrhea. These measures, together with training providers, could substantially reduce diarrhea mortality and decrease hospitalizations of children by 100 000 per year in the next 5 years. Pediatrics 1997;100(5). URL: http://www.pediatrics.org/cgi/content/ full/100/5/e10; oral rehydration therapy, oral rehydration solution, diarrhea.

Evaluation of the use of oral rehydration therapy in the management of diarrhoea among children under 5: knowledge attitudes and practices of mothers/caregivers

“…2 In South Africa, according to a burden of disease report, diarrhoea is estimated to be the cause of death of over 10 000 children under 5 annually, 3 and this is worrisome especially as the Millennium Development Goals (MDGs) 2015 target date for the reduction of overall under-5 mortality is a decrease of at least two-thirds. 4 Most of these deaths would have been avoided by the simple administration of ORT, which was introduced in 1979 to reverse the dehydration that predisposed these children to death, 5,6 but emerging evidence still points to unsatisfactory implementation of ORT globally with childhood diarrhoea especially common in developing countries. 2,7 Some studies have shown clearly that caregivers' responses and the use of ORT is aligned to their knowledge and attitudes towards this therapy, 7,8 and that is why some resort to traditional remedies or prescriptions instead of giving rehydrating ORT to their children during episodes of diarrhoea.…”

Enteral fluid therapy in neonatal calves and features of commercially available electrolyte solutions in Brazil

“…According to the World Health Organization (WHO) the development of therapy with OES was the most significant advance of twentieth century medicine, avoiding the death of thousands of children affected by diarrhea in poor countries (SANTOSHAM et al, 1997). Drawing on the successful experience with children, the EH became the main treatment protocol of diarrhea in calves due to its practicality and ease administration and its low cost (SMITH, 2009;SMITH & BERCHTOLD, 2014).…”

Background information on the current status of South African HIV/AIDS hospices in the context of hygiene and quality of life: A review

“…Diarrhoea, however, remains a prolific killer of children. The burden of diarrhoeal illness sits firmly in the developing world, both for morbidity (6-7 episodes per child per year when compared with 1 or 2 in the developed world) and mortality (Santosham et al, 1997).…”