Preparation Of Oral Rehydration Solution Research Articles

AMBA CUP: Ensuring Accuracy in Measurement of Volume of Water for Salt Sugar Solution or Oral Rehydration Solution Preparation in Diarrhea Management.

Diarrhea remains a major cause of under-five mortality globally. In 2016, it accounted for 8% of under-five mortality worldwide. Most of these deaths occur in developing countries. Fluid replacement using Oral Rehydration Solution (ORS) or Salt Sugar Solution (SSS), has been the mainstay of diarrhea management. Gaps in knowledge and practice regarding the preparation of these solutions have been identified by various researchers. One challenge encountered by healthcare providers and caregivers of under-five children has been lack of a standard, easy to clean cup for measurement of accurate volume of water for ORS or SSS preparation. Soft drink bottles, which are currently being used, are difficult to clean because of their narrow necks. More so, the size and volume of these bottles change so often that non-numerate caregivers get easily confused. The aim of this paper is to introduce the AMBA CUP, an easy-to-clean cup that can be used to accurately measure one litre of water for SSS or ORS preparation.

To assess the knowledge and skill regarding oral rehydration solution preparation among the mother having under five children

Background: Oral rehydration solution (ORS) is the most significant development in the management of acute diarrheal disease in children. Aims and Objectives: The aim of the study was to assess the knowledge and skill regarding ORS preparation among the mothers having under five children. Methodology: The cross-sectional study was done among 100 mothers of under five children from rural areas of Selsura, Wardha district. Results: The results showed that 15% of the mothers had the knowledge of taking a clean glass of water, 76% of the mothers knew to add a spoonful of sugar and to add a pinch of salt, 21% knew to stir it till all dissolves, 18% mothers tasted the solution, and 2% replaced the caps of salt and sugar bottle.

Comparison between 200 ml and 1 liter packages of oral rehydration solution prepared by mothers of patients with diarrhea in the oral rehydration room

To have a comparison between the preparation of oral rehydration solution (ORS) of 200 ml and 1 liter packages, a study had been done in 30 mothers of children under five years of age suffering from diarrhea who treated their children in oral rehydration room (group I) and 30 mothers of non diarrheal children under five years sampled in the out-patient Department of Child Health, Dr. Sardjito General Hospital (group II).
 No significant difference was found (p <0.05) concerning the sodium concentration in th ORS of 200 ml and in the 1 liter package (group I: 85.95 ± 16.07, and 81.52 ± 16.21, group II 98.11 ± 24.67 and 97.02 ± 21.87) (mEq/L, Mean ± SD). Of 30 mothers group 11, 5 mothers (19.23%) made mistakes in preparing the I liter packages of ORS and the sodium concentration in this package was higher compared to the concentration in the 200 ml package. There was no significant difference concerning diluted volume and the sodium concentration between group I and the recommended method, but there was a significant difference (p < 0.005) between group II and recommended method.
 A significant difference was also found (p ( 0.001) between group I and group 11 about the mothers knowledge of the effect of diarrhea, the use of ORS, the amount of ORS that must be given lo !he patients and !he indications to refer the patients to !he health center or hospital.

Assessment of Sahiyya (Accredited Social Health Activist) in Relation to Child Health in Ranchi, Jharkhand

Background: Accredited social health activist (ASHA) is one of the key components of national rural health mission (NRHM) who can play an important role in identifying child morbidity at the earliest and help in improving their health status. Objectives: (1) To describe the sociodemographic profile of Sahiyyas (ASHAs) working in the field practice area of Ormanjhi, Ranchi, (2) to assess the knowledge of Sahiyyas regarding her job responsibilities related to child health, and (3) to assess their functioning related to child health practices by interviewing the beneficiaries. Materials and Methods: This was a community-based cross-sectional study. All Sahiyyas (26) and women having children under 3 years of age (196) in the study area were interviewed through pre-tested semi-structured questionnaire. Assessment of child health services delivered by ASHAs was done by interviewing these Sahiyyas, which was cross-checked by interviewing the beneficiaries. Results: Of 26 Sahiyyas, only 10 (38.5%) of them had the correct knowledge of oral rehydration solution (ORS) preparation and also had knowledge about homemade preparation of ORS and 16 (61.5%) of them could not tell the correct method of ORS preparation. Knowledge of Sahiyyas about pneumonia depicted that 16 (61.5%) could identify a child with pneumonia, but 10 (38.5%) had no idea about it. All the Sahiyyas (26) were aware about their job responsibilities regarding immunization such as listing of eligible newborn and children, counseling mothers for immunizing their child and mobilizing mothers to health center, and VHND camps. Conclusion: The study has pointed out that there are lacunae in knowledge of Sahiyyas regarding childhood illness and their referral. Thus, frequency and quality of training for Sahiyyas must be strengthened.

Effectiveness of an Indonesian model for rapid training of Guatemalan health workers in diarrhea case management

The aim of this study was to assess the effectiveness of a newly developed method for rapid tiered training of health workers in improving community health worker knowledge and case management skills. The interactive "Kader" method, developed in West Java, Indonesia, was compared with traditional didactic training in a prospective trial with rural health workers ("Tecnicos") and village health promoters ("Promotores") for the Public Health Department in the state of Alta Verapaz, Guatemala. Twenty-five tecnicos received one day of training concerning diarrhea and dehydration. One group was trained using the interactive Kader method of Indonesia; the other with didactic methods. A sample of these tecnicos then trained 49 randomized promotores utilizing the same training method with which they were trained. The tecnicos and promotores in each group completed a case-based pre-test and post-test before and after their training sessions. Both tecnicos and promotores trained using the Kader tiered training approach demonstrated significantly greater improvement in their ability to correctly diagnose and recommend treatment for diarrhea of varying type and severity. Non-significant differences favoring the experimental groups were found in the tecnicos' and promotores' general knowledge regarding diarrhea prevention practices, signs of dehydration and preparation of oral rehydration solution. This pilot study suggests that the Kader method for rapid tiered training of health workers has applicability to the populations of other developing nations and can be recommended for large scale implementation and evaluation in the training of public health workers, village health promoters and families in Guatemala.

Development of Culturally Appropriate Educational Material to Improve Home Case Management of Diarrhea in Rural Lombok, Indonesia

In order to develop a culturally sensitive health education campaign on appropriate home case management of diarrhea, we first conducted formative research with mothers of young children and health care providers in West Lombok, Indonesia. This research showed that the people recognize four different types of diarrhea according to signs and symptoms and perceived etiology. Based on the results of the formative research, a flipchart was designed incorporating five messages. The flipchart was then revised on the basis of two pretests. The pretest results showed that visual messages about child health, the course and treatment of diarrheal diseases, and the preparation of oral rehydration solutions were often misinterpreted or not considered in accordance with local cultural norms. Most of the respondents understood the messages but felt that several of the illustrations did not accurately reflect their ways of living. After changes were made, the materials were easily understood and accepted by respondents. To maximize the benefit of educational materials, the national health education sector should be more flexible in the adaptation of materials to local customs and perceptions.

Composition and contamination of oral rehydration solutions prepared with well water by village mothers in Burma

A field study was carried out at Htaukkyant village in Burma to assess (i) whether village mothers could use condensed milk tins to measure one litre of water with reasonable accuracy for the preparation of oral rehydration solutions (ORS) and (ii) whether the extent of bacterial contamination of well water was serious and if this affected the bicarbonate content of the ORS solution. Empty condensed milk tins have a fairly uniform volume around 330 ml and using three condensed milk tins full of water mothers made up one litre quite consistently. Mothers also proved capable of preparing ORS solution by dissolving one packet of oral rehydration salt (ORS) in three condensed milk tins full of water to obtain solutions which contained acceptable and safe concentrations of sodium and potassium. Contamination of well water with faecal coliforms was present. Both storing water in domestic vessels and boiling water reduced the coliform count. Storing could be a good way of reducing the risk of infection if repeated contamination from dipping in to the water could be avoided. The counts on coliforms and faecal coliforms in ORS both increased by aboaut 1 log per day over the first and second 24 hours after the preparation with contaminated well water. Despite this the bicarbonate content of ORS remained stable. In the absence of boiled water, ORS solution can be made using the cleanest available water and using it within 24 hours.

Implementation of oral rehydration therapy in villages.

Oral rehydration therapy was implemented amongst 6410 population in four villages through six locally recruited volunteers, who were trained for preparation of oral rehydration solution and treatment of diarrheas with mild and moderate degrees of dehydration. The volunteers acted as depot holders for ORS packets as well treatment providers. No monetary incentive was provided to any of them. A two year-period of observation showed that on an average 59·1 per cent of the diarrhea cases received ORS treatment from these volunteers (having a quarterly range of coverage from 41·7–81·0%). There was no diarrhea-associated death and no case needed referral to hospital. None of the volunteers dropped out from the study during the above period.

Decontamination of Drinking Water by Alum for the Preparation of Oral Rehydration Solution

Decontamination of Drinking Water by Alum for the Preparation of Oral Rehydration Solution

Preparation of sugar-salt solutions

Correct measurement techniques are essential for the preparation of oral rehydration solutions but dangerous or ineffective solutions may also result from the inherent variability of the method and ingredients. This paper describes an experimental study conducted in Zimbabwe to compare the reliability of three methods for measuring sugar and salt in a 750 ml bottle of water: (i) 6 level teaspoons of sugar and half a level teaspoon of salt, (ii) 3 heaped teaspoons of sugar and half a level teaspoon of salt and (iii) 3 level measures of sugar and salt with a double-ended spoon. The teaspoon and 750 ml bottle methods produced reliable results. Heaped teaspoons of sugar gave more reproducible sucrose concentrations than level teaspoons. The double-ended spoon was not more reliable and gave disquietingly high sodium concentrations with refined salt. Under field conditions the level teaspoon method gave more variable results but still within acceptable limits. It is concluded that a domestic teaspoon and a standard 750 ml bottle can be recommended for the preparation of home-based oral rehydration solutions in rural Zimbabwe.

A comparison of bottle tops, teaspoons and WHO glucose-electrolyte packets for home made oral rehydration solutions in The Gambia

Three methods of preparation of oral rehydration solution were taught to Gambian mothers and the sodium concentration and osmolality of the solutions prepared were estimated. Most of the solutions made up using WHO glucose-electrolyte mix had a satisfactory sodium content (70 to 120 mmol/l) and osmolality (200 to 350 mosmoles/kg). Of the sugar and salt mixtures using a teaspoon as a measure, 17% were hypertonic (>120 mmol sodium/l) and 24% were hyperosmolar (>350 mosmol/kg). Nearly all the sugar and salt solutions prepared using a soft drink bottle top as a measure had sodium contents of 30–88 mmol/l and none was hyperosmolar. We suggest that wider trials of this simple, widely available measure are indicated.

Some economic aspects of planning health interventions among malnourished populations

The development of effective health or nutrition interventions can be facilitated by cxamining briefly the process whereby basic research in agriculture is translated into the appropriate technologies that are adapted by farming households. Basic agricultural research creates the production potential for technological development through the use of plant genetics, phytopathology and soil science. The basic scientist works at the frontier within which the applied scientist works, with the possibility of innovation at all levels. Applied scientists or “biological architects”the plant breeders, agronomists, and othersuse this basic research to develop the specific varieties which are adapted to a set of geoclimatic and socioeconomic conditions. Thus, applied wheat research in the United States has developed varieties that fit this specific climate and land-extensive mechanized planting process but cannot be readily transferred to either temperate or tropical zones in low-income nations. The end product ofresearch is a technology appropriate for a given agricultural region defined in geoclimatic, economic, and other terms. One anobogy in health is the adaptation of the oral rehydration technology for acute diarrhea to Haitian socioeconomic conditions. Spoons and glasses, such as those successfully used in Bangladesh for preparation of oral rehydration solutions by the mother, were not found in poor households in Haiti. However, in Haiti salt could be purchased in chunks and a coarse sugar was available. Drs. Gretchen and Warren Berggren developed a rehydration formula for the mother consisting of two pea-sized cubes of salt, five Coca Cola caps of panda (sugar), a rum bottle of boiling water and a little lime Zvi Griliches to provide potassium. The Coca Cola caps and the rum bottles were common in the average household, and because the technology was appropriate, the formula worked. This appropriate technology needs to be adoptable by the ultimate user; in agriculture it is the farmer, in health it is usually the mother. A farmer bases his decision to change techniques of production on the available technology, the type of delivery system including the appropriate social infrastructure, and the profitability of the changes in techniques. This may require credit to provide the farmer with inputs complementary to the new seed varieties (such as fertilizer and insecticides), marketing for his increased output or other factors that minimize risk and maximize returns. Minimization of risk appears to be especially critical for the poorer farmer, who often requires additional knowledge along with the seeds, irrigation, and other changes in the social circumstances to affect his production decisions. Similarly, in nutrition and health, the needs of the household must be carefully considered. This is especially critical for poorer households for whom economic and other constraints clearly affect their ability to change the way they determine their health status. Surveillance of agricultural productivity or health status inputs, outputs and outcomes are useful in understanding the distortions in this delivery system (1). Of course the best surveillance systems are those in which consumers have the power to