scholarly journals Oral Rehydration Therapy: WHO at 40, ORT at 30

1989 ◽  
Vol 3 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Jonathan LaPook ◽  
Richard N. Fedorak

Oral rehydration therapy may prove to be mankind's most significant therapeutic advance this century. Diarrheal disease remains the number one killer of children in the world and is a major cause of illness within Canada and other developed countries. Since its discovery 30 years ago, oral rehydration therapy, comprising glucose, salt and water, has been a simple and low cost treatment for people with life threatening diarrheal disease. Recent developments in solutions for oral rehydration therapy have led to the recognition chat the existing World Health Organization glucose based oral replacement salt could be improved. ln commercially available rehydration solutions, the sodium concentration has been lowered to reduce hypernatremia in noncholera induced diarrhea. Citrate has replaced bicarbonate as the base in oral replacement solutions to pro long shelf life. Organic substrates to replace glucose and enhance intestinal fluid and electrolyte absorption without osmotic penalty are being examined. However, their acceptance and proper utilization in developing countries remains to be determined.

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 980-980
Author(s):  
MARK L. TOCHEN ◽  
DON TSUKAMAKI

To the Editor.— The article by Dr Snyder, "Use and Misuse of Oral Rehydration Therapy for Diarrhea,"1 led us to review our treatment of gastroenteritis, revise our telephone protocols, and seek out rehydration solutions. Our difficulty in obtaining adequate supplies mirrored that of Dr O'Banion.2 Expense to the patient is also an important factor: commercial premixed solutions sell for $4 to $6 per quart in our area, which many families cannot pay. Our solution was to obtain from the World Health Organization the name of the US supplier of oral rehydration solution (ORS) packets and order direct from the supplier (Jianas Bros Packaging Co, 2533 SW Blvd, Kansas City, MO 64108).


PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 1073-1073
Author(s):  
LAURA O'BANION

The article, "Use and Misuse of Oral Rehydration Therapy for Diarrhea," reveals a very low rate of pediatrician adherence to guidelines of the American Academy of Pediatrics and the World Health Organization for oral rehydration. I recently conducted a small study that may shed some light on one underlying factor. A telephone survey of 14 major pharmacies, including the outpatient pharmacies of two teaching hospitals with departments of pediatrics, revealed that not a single pharmacy carried any of the recommended oral rehydration solutions.


PEDIATRICS ◽  
1996 ◽  
Vol 97 (3) ◽  
pp. 436-436
Author(s):  
GAIL R. BROWN ◽  
PETER MARGOLIS

This technical report describes the process followed in the development of the AAP practice parameter on acute gastroenteritis, as well as the evidence used to formulate the final recommendations. An evidence model that defined acute gastroenteritis and identified diagnostic tests and interventions used in its management and outcomes of importance was used to identify topics to include in the guideline. The three topics selected were: (1) methods of rehydration, (2) refeeding after rehydration, and (3) the use of antidiarrheal agents. Primary outcomes of interest were duration of disease, complications of therapy, parental satisfaction, and cost. Multiple bibliographic sources were searched to identify articles related to these areas; the sources included MEDLINE, reports on gastroenteritis from the Centers for Disease Control and Prevention and the World Health Organization, the Federal Register, a report to the Food and Drug Administration, and files of the expert panel. More than 4000 articles were initially reviewed, of which 230 were identified as being potentially related to the three topics. Qualitative aspects of the literature reviewed were summarized in evidence tables. Sufficient data for quantitative summary were available only for refeeding after rehydration. In this analysis, the weighted difference across studies between treatment and control groups in the mean duration of diarrhea was used as the measure of the relative benefit of one form of therapy over another. Methods of Rehydration Evidence comparing oral rehydration and intravenous therapy was limited to five reports of randomized trials conducted in developed countries. It was not possible to perform a quantitative synthesis of this information because of a lack of similar outcomes.


Author(s):  
Rini Mayasari Rini Mayasari

  ABSTRACT According to WHO (World Health Organization), diarrhea is a Chapter (bowel movement) in liquid form is more than three times in one day, and usually lasts for two days or more. In the UK 1 in 5 people suffer from diarrhea infections. Diarrheal disease in developed countries has occurred despite the health and economic improvement but still a high incidence of infectious diarrhea and is still a health problem. In Indonesia diarrheal diseases are still one of the major diseases in infants and children. Morbidity is estimated to range between 150-430 per thousand population annually. In Basuki Rahmat Health Center Palembang  , in 2011 the incidence of diarrhea in infants of 155 patients (59.2%). Factors influencing the incidence of diarrhea, including the factors of education, occupation, age, toddlers, environmental, nutritional, social, economic, food / beverage consumed, and the factors to lactose (milk cans). The purpose of this study is a known association between maternal education and employment with the incidence of diarrhea in infants in Basuki Rahmat  Health Center Palembang in 2011. This study uses the approach of Analytical Surveys Cross Sectional. The population in this study were all women who come to check babies for  Basuki Rahmat Health Center Palembang  in 2011 which amounted to 35 people. Sampling in this study with non-random methods with techniques Accidental Sampling. Data analysis carried out univariate and bivariate statistics with Chi-Square test with significance level α = 0.05. Results showed there were 35 respondents from 45.7% of respondents that babies suffering from diarrhea, higher education 57.1%, and working mothers 40%. The results of this study showed no significant association between maternal education and occupation on the incidence of diarrhea in infants in Basuki Rahmat Health Center Palembang in 2011. From the results of this study, researchers hope to improve health and implement counseling about prevention of diarrhea.   ABSTRAK Menurut WHO (World Health Organization), diare merupakan BAB (buang air besar) dalam bentuk cairan lebih dari tiga kali dalam satu hari, dan biasanya berlangsung selama dua hari atau lebih. Di Inggris 1 dari 5 orang menderita diare infeksi. Penyakit diare di negara maju walaupun sudah terjadi perbaikan kesehatan dan ekonomi masyarakat tetapi insiden diare infeksi tetap tinggi dan masih menjadi masalah kesehatan. Di Indonesia penyakit diare hingga kini masih merupakan salah satu penyakit utama pada bayi dan anak-anak. Diperkirakan angka kesakitan berkisar antara 150-430 perseribu penduduk setahunnya. Di Puskesmas Basuki Rahmat Palembang , pada tahun 2011 angka kejadian diare pada balita sebanyak 155 pasien (59,2%). Faktor-faktor mempengaruhi kejadian diare, diantaranya adalah faktor pendidikan, pekerjaan, umur balita, lingkungan, gizi, sosial ekonomi, makanan/minuman yang dikonsumsi, dan faktor terhadap laktosa (susu kaleng). Tujuan penelitian ini adalah diketahuinya hubungan antara pendidikan dan pekerjaan ibu dengan kejadian diare pada balita di Puskesmas Basuki Rahmat Palembang  tahun 2011. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang datang memeriksakan balitanya ke Puskesmas Basuki Rahmat Palembang  pada tahun 2011 yaitu berjumlah 35 orang. Pengambilan sampel pada penelitian ini dengan metode  non random  dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05.Hasil penelitian menunjukkan dari 35 responden terdapat 45,7% responden yang balitanya menderita diare, pendidikan tinggi 57,1%, dan ibu yang bekerja 40%. Hasil penelitian ini menunjukkan ada hubungan yang bermakna antara pendidikan dan pekerjaan ibu terhadap kejadian diare pada balita di Puskesmas Basuki Rahmat Palembang  tahun 2011. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan dan melaksanakan penyuluhan tentang pencegahan diare.


Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1485 ◽  
Author(s):  
Kurt J. Sollanek ◽  
Robert W. Kenefick ◽  
Samuel N. Cheuvront

Oral rehydration solutions (ORS) are specifically formulated with an osmolality to optimize fluid absorption. However, it is unclear how many ORS products comply with current World Health Organization (WHO) osmolality guidelines and the osmotic shelf-life stability is not known. Therefore, the purpose of this investigation was to examine the within and between ORS product osmolality variation in both pre-mixed and reconstituted powders. Additionally, the osmotic stability was examined over time. The osmolality of five different pre-mixed solutions and six powdered ORS products were measured. Pre-mixed solutions were stored at room temperatures and elevated temperatures (31 °C) for two months to examine osmotic shelf stability. Results demonstrated that only one pre-mixed ORS product was in compliance with the current guidelines both before and after the prolonged storage. Five of the six powdered ORS products were in compliance with minimal inter-packet variation observed within the given formulations. This investigation demonstrates that many commercially available pre-mixed ORS products do not currently adhere to the WHO recommended osmolality guidelines. Additionally, due to the presence of particular sugars and possibly other ingredients, the shelf-life stability of osmolality for certain ORS products may be questioned. These findings should be carefully considered in the design of future ORS products.


PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 503-503
Author(s):  
Mathuram Santosham ◽  
Robert Bertrando ◽  
Stephan Foster ◽  
Steven Garrett

In a letter in the September issue,1 Walker raises the same issues that were discussed in his recent letter to The New England Journal of Medicine2; namely: (a) Fluids prescribed for ingestion during typical episodes of diarrhea in the United States should contain less than 17 mmoles of sodium per liter. (b) Oral rehydration solutions containing 80 to 90 mmoles of sodium per liter, similar to the solution recommended by the World Health Organization (WHO) should be administered under direct supervision (implying a hospital setting).


1991 ◽  
Vol 8 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Yolanda Suarez de Balcazar ◽  
Fabricio E. Balcazar

About 4 million children die every year as a result of dehydration caused by acute diarrhoea. Oral rehydration therapy (ORT) is designed to prevent dehydration. In the past 10 years, several campaigns have been conducted throughout the world, mostly sponsored by the World Health Organization, to disseminate ORT, particularly in developing countries. This paper presents a review of 14 ORT campaigns categorising their components according to whether the researchers used antecedents, behaviours, and/or consequences. Only three campaigns manipulated all three components. Antecedent events were manipulated in all of the studies. A skills training component appears to influence the effectiveness of the campaign, since several new behaviours and complex discriminations need to be learned for people to use ORT correctly. The benefits of functionally analysing the components of current ORT campaigns are highlighted.


1994 ◽  
Vol 15 (12) ◽  
pp. 461-471
Author(s):  
Robert S. Northrup ◽  
Timothy P. Flanigan

Diarrheal disease is so common and so often short-lived and apparently benign that neither physicians nor parents may give it the attention it deserves. Unfortunately, this lack of concern plays an important role in the high mortality rate from diarrhea among children in developing countries. It also contributes to the high numbers and costs of hospitalizations for diarrhea in the United States. This review focuses on acute infectious diarrhea and on persistent diarrhea. These two conditions begin similarly, but persistent diarrhea by definition persists for longer than 14 days. It emphasizes appropriate management, particularly oral rehydration therapy (ORT) and current recommendations regarding feeding during diarrhea, and addresses new information about pathogens that cause both acute and persistent diarrhea. Although ulcerative colitis, Crohn disease, and other causes of chronic diarrhea must be considered in the differential diagnosis of acute or persistent diarrhea, a thorough discussion of chronic diarrhea is beyond the scope of this article. Information from developing countries as well as from the US and other developed countries is included. Epidemiology Gastroenteritis, both acute and persistent, may occur as often as 15 times per year in a child, although rates of 3 to 5 episodes annually are seen more commonly in most developing countries.


2021 ◽  
pp. 188-200
Author(s):  
I. N. Zakharova ◽  
I. V. Berezhnaya ◽  
A. T. Kamilova ◽  
D. K. Dmitrieva ◽  
D. I. Akhmedova

Today, as in ancient times, diarrhea (loss of water and electrolytes along with stool) accompanies many pathological conditions in humans. The pathophysiology of various types of diarrhea has been studied, which made it possible to optimize therapeutic approaches and save the lives of many people. The most dangerous conditions occur in young patients with osmotic and exudative types of diarrhea, as they result in exicosis within a short time. In arriving at a diagnosis, rehydration therapy should be started as soon as possible. The article presents the historical aspects associated with the global pandemics of cholera. The history of the creation of solutions for intravenous and oral rehydration is covered. The authors presented tables for calculating fluid losses and the required volume of solutions for oral or parenteral administration. The modern requirements for rehydration solutions and the principles of rehydration in children are presented. Oral rehydration is particularly problematic for young children due to the limited range of drugs and requirements for the composition of solutions used in pediatrics. According to the recommendations of the World Health Organization and ESPGHAN, clinical recommendations of the Russian Federation, low-osmolar solutions should be used. When complex solutions containing probiotic and zinc are used, the therapy compliance increases. A rehydration solution, which contains a weighted amount of salt for the preparation of a low-osmolar solution, as well as the probiotic L. reuteri DSM 17938 at least 1 billion of viable bacteria and zinc sulphate 0.004 g is one of the latest solutions. The results of studies of this solution are provided.


Author(s):  
Oksana Rybachok

Infectious diseases in the modern world continue to claim millions of human lives despite the achievements of medicine. While in developed countries the main cause of death is cancer and diseases of the cardiovascular system, it is the infectious processes that occupy leading positions in the structure of mortality in the third world countries. About 1.7 million children die from infections that could have been avoided by vaccination according to the World Health Organization. In contrast to the countries of Western Europe, where preventive vaccinations for the population are carried out for a fee, preventive vaccination in the Russian Federation is funded by the state. Immunoprophylaxis includes not only prevention of 12 major infections included in the calendar of preventive vaccinations (diphtheria, polio, tetanus, whooping cough, tuberculosis, measles, rubella, mumps, hepatitis B, pneumococcal infections and haemophilus influenzae, influenza), but also vaccination against 17 additional infections in case of epidemiological indications.


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