title: Comparison of safety of glucose oral rehydration solution and maize oral rehydration therapy for home management of diarrhoea in Kenya.
abstract: Safety margins and variability in the composition of glucose and maize-based oral rehydration therapy (ORT) prepared by mothers in a rural district of Western Kenya, are reported here. In a 2-year longitudinal field study, packets containing glucose ORS and a home solution made with maize and table salts, were provided to the mothers of 6180 children in Kakamega District in two separate sub-locations. Experienced and trained field workers supported by community registered nurses provided training for the preparation and use of ORT during weekly visits to every household. On four occasions separated by 4-6 months, a 5 per cent random sampling was done of the home-prepared solutions actually used for the treatment of children with diarrhoea. The water used for preparing ORT was also sampled. Samples of 174 glucose-based ORT, 148 maize-salt ORT, and 201 samples of water were analysed. Only 2 per cent of the maize-based ORT were above 120 meq/1 sodium (i.e., the safe range of sodium concentration) compared to 17.8 per cent for glucose solutions (p < 0.001). Home water samples contained substantial amounts of salt, which could unpredictably affect the final composition of the ORT solutions. We conclude that maize-salt ORT had a better margin of safety than glucose-based ORS.
authors.affiliation: Global Programme on Aids, WHO, Geneva, Switzerland.
authors.forename: P R
authors.initials: PR
authors.lastname: Kenya
authors.forename: J N
authors.initials: JN
authors.lastname: Muttunga
authors.forename: H
authors.initials: H
authors.lastname: Mwenesi
authors.forename: A M
authors.initials: AM
authors.lastname: Molla
authors.forename: A
authors.initials: A
authors.lastname: Bari
authors.forename: R
authors.initials: R
authors.lastname: Juma
authors.forename: B
authors.initials: B
authors.lastname: Were
authors.forename: A
authors.initials: A
authors.lastname: Molla
authors.forename: P N
authors.initials: PN
authors.lastname: Sharma
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000628:therapy*; D004573:Electrolytes / Q000008:administration & dosage; D005440:Fluid Therapy; D005947:Glucose; D006701:Home Nursing; D006801:Humans; D007223:Infant; D007630:Kenya; D003313:Zea mays
chemical_list: D004573:Electrolytes; D005947:Glucose