Knowledge and availability of oral rehydration solution in Khayelitsha.
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Oral rehydratation solution was conceived from physiological concepts to be used in primary health care centers. A new relationship between physiology and public health stems from the clinical use of this solution.
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The solutions preference and the body mass variations during rehydration was analyzed in dehydrated rats. The dehydration was provoked by hydroprivation during 72 hours. The results shows a sodium chloride specific appetite, mainly in the initial part of the rehydration, and hypo, and isotonic sodium chloride solutions preference. The sodium chloride, and glicose solutions treatment was better than other solution in the body mass recovery.
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Controversy remains concerning ORS composition in Europe. This centres chiefly upon the sodium level. Solutions with a low sodium content continue to be widely used in Europe. ORS with Na 90 mmol/l when given correctly is safe and effective. However when this solution is prepared incorrectly there is a risk of hypernatraemia. In most of Europe mortality and morbidity from gastroenteritis is now very low. Therefore any change from current formulation must not carry any risk in this regard. The need for bicarbonate or indeed any base in ORS is also controversial. There is a clear need in Europe for controlled trials of ORS solutions of various composition to determine the ideal solution for the children of Europe who have acute diarrhoea.
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The efficacy of three methods of training rural women in reconstituting ORS was studied by analysing the sodium, potassium, and glucose contents of the ORS reconstituted by the three groups of rural women. The women in Group I were verbally instructed in the regional language regarding how to reconstitute the entire contents of a sachet containing oral rehydration salts in half a litre of water. Women from Group II, were given the same verbal instructions and in addition, were demonstrated the correct method of doing the same. Subjects from Group III were provided with plastic bags containing oral rehydration salts, which when filled with water upto the printed line, was expected to accommodate half a litre of water, when the bag was hung from a hook or held by another person from its upper ends. The contents of ORS reconstituted by Group II, who were demonstrated the actual procedure following verbal instructions, were near ideal followed by the ORS reconstituted by Group III and by Group I.
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In a randomized double-blind trial, infants with mild or moderate diarrhoeal dehydration were rehydrated orally either with a simple solution containing table sugar and salt (without potassium or bicarbonate) or with a complete glucose/electrolyte formula. All 32 given glucose/electrolyte solution and 27 (93%) of 29 infants given sugar/salt were successfully rehydrated with similar improvement in metabolic acidosis and rapidity of rehydration. The drawbacks to oral therapy with simple sugar/salt solution were the frequent development of hypokalaemia and greater volume of vomiting during treatment. Carefully prepared sugar/salt solution, if accompanied by adequate potassium supplementation, may be used as an alternative to the preferred glucose/electrolyte formula when the latter is unavailable.