Infantile Diarrhea and Dehydration: Ambulatory Treatment in a Hydration Center

Abstract

Infantile diarrhea is a serious public health problem in Chile, and is an important factor in the postneonatal mortality rate. The disease is not only endemic, but assumes epidemic proportions during the summer. The epidemiologic factors are poor sanitation, inadequate hygiene, and the climate. Morbidity and mortality are high in those groups of the population whose social and economic status is low. The infants in this segment of the population are in a chronic state of malnutrition, which is a complicating factor of infantile diarrhea. We have found that a therapeutic program consisting of antibacterial drugs for the intestinal infection, cautious feeding with acidified half-skimmed milk, and administration of solutions which correct the water and electrolyte losses is effective in treating infantile diarrhea with acute dehydration. The problem of adequate personnel and of hospital and clinic facilities is especially acute in the summer, when the incidence of infantile diarrhea rises sharply. To cope with this problem, Hydration Centers are being set up to treat acutely ill infants on an ambulatory basis. The Center at the Manuel Arriarán Hospital in Santiago was established in 1955, and has treated a total of 4,124 infants through the summers 1955 to 1959. Two-thirds of the cases were successfully treated and did not have to be hospitalized. Fluid replacement was accomplished by indwelling gastric catheter, and occasionally intravenously. The former is a simple technic, and is especially valuable in areas where nursing personnel and more elaborate equipment are not readily available. Hydration Centers can be easily set up wherever there is need for them, but the essential follow-up requires an administrative coordination of various health agencies. However, Hydration Centers are merely emergency measures; the problem of infantile diarrhea can be solved only by adequate prevention and immediate treatment of intestinal infections.