PROMOTION OF ORAL REHYDRATION THERAPY FOR DIARRHEA IN INDIA

Today, the great majority of cholera patients in the Infectious Diseases Hospital in Calcutta, India, are successfully being treated by oral rehydration. This switch over to oral fluid therapy, which in this hospital now saves about $50,000 every year in the cost of parenteral fluids alone, was the outcome of a study carried out by the Cholera Research Centre of the Indian Council of Medical Research, in collaboration with physicians in the Infectious Diseases Hospital, on the effectiveness of this treatment in cholera patients below the age of 5 years. The Cholera Research Centre, which is also in Calcutta, is a WHO Collaborating Centre for Reference and Research on Vibrios. The study showed that 92% of patients with moderate to severe dehydration responded well when given repeated small amounts (25-30 ml, every 10-15 minutes), rather than a single large volume (250 ml), of oral fluid. In this way, vomiting—which occurred invariably when the large volume was given—was found not to cause any problem. The Centre in the meantime developed a cheap and simple system for dispensing the ingredients (glucose-salts mixture) for oral rehydration in sealed polythene packets to facilitate distribution. Under the name of Chorosol, the packets—which cost about $0.10 each—have been very well received by medical and paramedical staff. The use of Chorosol in the field, in the management of cholera epidemics, has also been very successful.