Oral rehydration therapy in Malawi: impact on the severity of disease and on hospital admissions; treatment practices; and recurrent costs

RESUMO

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 percent decrease in the number of children admitted to the paediatric ward with the diagnosis of diarrhoeal diseases; a 56 percent 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 percent decrease in the number of paediatric deaths associated with diarrhoeal diseases. Over the same period; there was a 32 percent 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 percent of paediatric hospital admissions; there should be considerable decreases in mortality from such diseases and concomitant increases in cost savings attributable to them