Effectiveness of forced rehydration and early re-feeding in the treatment of acute diarrhoea in a tropical area.

BACKGROUND

The administration of oral re-hydration solution (ORS) via continuous infusion through a nasogastric (NG) tube and early refeeding facilitates delivery in hospitalised children and the return back home.

METHODS

METHODS

the observation was made during a one-year stage in the Camillian Medical Centre (CMC) of Ouagadougou in Burkina Faso. 4,131 infants and children under 5 years old, affected by acute diarrhoea and severe dehydration (loss of weight > 10%) were studied. Those children having difficulties for oral re-hydration were hydrated by continuous infusion through naso-gastric (NG) tube; the NG tube was put in by the nurses and connected to a 500 ml bottle, in which a mixture of glucose and electrolytes was dissolved according to the formula (glucose 20 g + NaCl 3.5 g + NaHCO3 2.5 g KCl 1.5 g in 1 litre of water). The infusion rate was 20-30 drops/minute. No sedative or anti-emetic drug was given, unless in the presence of uncontrolled vomiting. At the end of infusion, flour of millet (60%), soy bean (20%), peanut butter (10%), sugar (10%) and salt (1%) was administered and continued at home or in the nearby areas available for the night.

RESULTS

After 4-5 hrs of infusion 3,717 children (90%) showed a significant gain of weight, although the weight prior to the acute event preceding hospitalisation was never reached during their stay at the CMC. Only 413 children (10%) required a longer period of forced infusion: at the end of the day, however, they were fed with this flour.

CONCLUSIONS

A simple strategy, based on a NG infusion plus an oral administration of flour has proven safe and effective in encompassing those difficulties encountered in the treatment and prevention of dehydration in developing countries where the therapy, in children affected by diarrhoea, still represents a major daily occupation.