A RANDOMIZED COMMUNITY TRIAL OF PREPACKAGED AND HOMEMADE ORAL REHYDRATION THERAPIES

Objective: To compare the effectiveness of prepackaged oral rehydration solutions with homemade cereal-based oral rehydration therapy in the treatment of acute childhood diarrhea in children younger than 5 years. Background: In Ethiopia, approximately 40% of all mortality in children younger than 5 years, or over 200 000 annual deaths, is attributable to acute childhood diarrhea. Less than 15% of the episodes of acute childhood diarrhea are treated with oral rehydration solutions. Subjects: Two hundred ninety-one children younger than 5 years with acute childhood diarrhea. Methods: A randomized field trial comparing the effectiveness of an entirely homemade cereal-based oral rehydration therapy (HC-ORT, n=103) with two alternative prepackaged salt solutions, a glucose-based oral rehydration solution (G-ORS, n=98) and a cereal-based oral rehydration solution (C-ORS, n=90), in the treatment of mild to moderate acute childhood diarrhea in children younger than 5 years. Results: Subjects in the HC-ORT group demonstrated equivalent or better weight gain than those in the C-ORS or G-ORS groups at 24, 48, 72, and 96 hours following the onset of treatment. The beneficial weight-gain effect of HC-ORT was most pronounced in infants younger than 12 months, following adjustment for demographic and baseline clinical characteristics. Compliance with ORT use through 96 hours was significantly better among caretakers of children receiving HC-ORT. Minor errors in the preparation of these oral rehydration regimens occurred more frequently among caretakers preparing either of the cereal-based ones. Conclusions: That HC-ORT is an effective, culturally more acceptable alternative to G-ORS or C-ORS. The implementation of well-monitored, community-based HC-ORT programs in less developed countries is recommended.