Oral Rehydration Therapy (ORT) for Childhood Diarrhea

 Since about 1 of every 10 children born in developing countries dies of diarrheal complications before age 5, this report establishes rationale, composition, and production of oral rehydration therapy (ORT) for treatment of childhood diarrhea.  In this context, ORT is defined as a solution of water, sugar, and mineral salts to be drunk to replace the water and salts lost via stool and urinary output during diarrheal diseases.  The effect of ORT is to counteract dehydration, the most direct cause of diarrheal deaths.  ORT has the advantage of low cost and easy access to ingredients, making it ideal for use in developing areas.  The oral rehydration formula recommended by WHO is as follows (and is available in preweighed packets from UNICEF): sodium chloride, 3.5 gm.; sodium bicarbonate, 2.5 gm.; potassium chloride, 1.5 gm.; glucose, 20 gm.; and water, 1 liter.  Another ORT formula can be concocted from sugar and salts available in most houeholds, thus solving problems of cost and distribution.  The scientific rationale for oral rehydration is firmly established and is based on the rapid loss of body fluids and the electrolytes of sodium, potassium, chloride, and potassium during diarrhea and the concommitent impairment of intestinal absorption of these salts during diarrheal disease.  In addition to outlining various ORT solutions, the following topics concerning the efficacy and use of ORT are discussed: measuring and mixing of ORT solutions, early use in the home, feeding during diarrhea, use of purgatives, antibiotics, and other drugs, program organization for control of diarrheal diseases, the possibility of an integrated program of family planning and ORT, and possible external assistance available to developing areas.

Johns Hopkins Bloomberg School of Public Health,Center for Communication Programs,Population Information Program