title: Oral rehydration therapy in Malawi: impact on the severity of disease and on hospital admissions, treatment practices, and recurrent costs.
abstract: In the first 2 years following refresher training of paediatric staff in oral rehydration therapy (ORT) and the establishment of an oral rehydration unit at the Kamuzu Central Hospital, Lilongwe, Malawi, there was a 50% decrease in the number of children admitted to the paediatric ward with the diagnosis of diarrhoeal diseases, a 56% decrease in the use of intravenous fluid to rehydrate such children, a threefold increase in the use of oral rehydration salts (ORS) exclusively to rehydrate children with mild or moderate dehydration, and a 39% decrease in the number of paediatric deaths associated with diarrhoeal diseases. Over the same period, there was a 32% decrease in recurrent hospital costs attributable to paediatric diarrhoeal diseases. As use of ORT continues to increase in Malawi, where diarrhoeal diseases account for 9% of paediatric hospital admissions, there should be considerable decreases in mortality from such diseases and concomitant increases in cost savings attributable to them.
authors.affiliation: Childhood Communicable Diseases Programme, Ministry of Health, Malawi.
authors.forename: D L
authors.initials: DL
authors.lastname: Heymann
authors.forename: M
authors.initials: M
authors.lastname: Mbvundula
authors.forename: A
authors.initials: A
authors.lastname: Macheso
authors.forename: D A
authors.initials: DA
authors.lastname: McFarland
authors.forename: R V
authors.initials: RV
authors.lastname: Hawkins
mesh_terms: D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003968:Diarrhea, Infantile / Q000401:mortality / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000191:economics; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008295:Malawi; D008297:Male; D011379:Prognosis