Cost effective strategy for promotion of appropriate case management of diarrheal diseases — Establishment of DTUs

Abstract

Oral rehydration therapy (ORT) is one of the essential components of child survival technologies which are currently being utilised to reduce morbidity and mortality on account of common illnesses. ORT has made it possible to undertake a global effort to reduce deaths from dehydration and diarrhea associated malnutrition. Appropriate case management can also combat deaths from dysentery and persistent diarrhea. During the last decade considerable success has been achieved by incorporating this simple, effective and economic therapeutic intervention in the primary health care package. However, the ultimate objective of improved case management of diarrhea including the use of ORT at all levels of health care system is yet to be achieved. Patients with dysentery need antimicrobial therapy apart from ORT. Clinical experience has shown that with ORT and appropriate dietary therapy, most patients with persistent diarrhea can be managed effectively. Unfortunately, injudicious use of intravenous fluids and irrational prescription of antibiotics and anti-diarrheal agents is quite common even in the hands of pediatricians. The training of mothers visiting health facilities is poor for ORT and feeding. Establishment of diarrhea training and treatment units (DTUs) is aimed to improve current practices in the teaching hospitals and to promote appropriate case management of diarrhea by all health personnel.