Oral rehydration in infants in developing countries.

Abstract

Diarrhoeal diseases are the major cause of infant mortality in developing countries. Dehydration is the most common complication of diarrhoea, and severe dehydration causes up to 80% of diarrhoeal fatalities. For more than 100 years, physicians focused the treatment of diarrhoeal diseases on the symptom diarrhoea, and there were many 'antidiarrhoeal' drugs, such as water adsorbents (kaolin and pectin) and antiperistaltics (opium, paregoric elixir, diphenoxylate hydrochloride with atropine sulphate and loperamide). This approach focused on a non-dangerous symptom and diverted attention from the real killer, dehydration. A few decades ago, only severely dehydrated patients were treated by intravenous therapy. This treatment was prescribed by a group of professional health workers, administered intravenously by skilled nurses, and reserved for the few patients resident near health facilities. Oral rehydration therapy (ORT), developed 20 years ago, has several advantages over intravenous therapy; it can be administered at home, at health clinics or in modern hospitals, by parents or by nurses or physicians. Most serum disturbances in dehydrated neonates, infants, children, adults and the elderly are resolved by this treatment.