Oral fluid therapy for cholera and non-choleraic diarrhoeas in children.

Due to the lack of intravenous fluids and a shortage of physicians the mortality from cholera and non-cholera diarrheas has remained high. Even with the advent of oral fluid replacement pediatric cholera patients have not been able to take fluids adequately or retain them. A clinical trial was undertaken to compare the the effects of oral therapy with (IV) intravenous therapy in the treatment of pediatric cholera and allied diseases. 80 children weighing < or = to 15 kg and below 5 years of age were studied and cases were divided into 2 groups. Group A (N=44) received oral therapy and Group B (N=36) received intravenous infusions. The composition of the oral fluids was: sodium chloride--3.5 gm sodium bicarbonate--2.5 gm potassium choride 1.5 gm glucose--20.5 gm and water--1 liter. Oral therapy was administered frequently (every 10-15 minutes) and in small amounts (25-30 ml) and fluid intake corresponded to stool output. Ringer-lactate was used for the IV therapy. Results of the oral therapy showed it by and large to be almost as effective as the IV therapy. In Group A however there were 4 failures (9%) due to refusal to drink vomiting or severe diarrhea and IV therapy was resorted to with success. Generally watery diarrhea was controlled in an average of 12 hours and there were no deaths. Thus oral therapy under supervision can be effective in pediatric cholera in a majority of cases and is of great value in non-cholera diarrheas. The advantages of oral therapy are: cheap and readily available ingredients solution can be made with drinking water fluid can be administered by paramedical personnel and inexpensive transport and storage of fluid.