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Meta-Analysis
. 2006 Jul 19;2006(3):CD004390.
doi: 10.1002/14651858.CD004390.pub2.

Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children

L Hartling, S Bellemare, N Wiebe, K Russell, T P Klassen, W Craig
Meta-Analysis

Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children

L Hartling et al. Cochrane Database Syst Rev. .

Abstract

Background: Dehydration associated with gastroenteritis is a serious complication. Oral rehydration is an effective and inexpensive treatment, but some physicians prefer intravenous methods.

Objectives: To compare oral with intravenous therapy for treating dehydration due to acute gastroenteritis in children.

Search strategy: We searched the Cochrane Infectious Diseases Group Specialized Register (March 2006), CENTRAL (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to March 2006), EMBASE (1974 to March 2006), LILACS (1982 to March 2006), and reference lists. We also contacted researchers, pharmaceutical companies, and relevant organizations.

Selection criteria: Randomized and quasi-randomized controlled trials comparing intravenous rehydration therapy (IVT) with oral rehydration therapy (ORT) in children up to 18 years of age with acute gastroenteritis.

Data collection and analysis: Two authors independently extracted data and assessed quality using the Jadad score. We expressed dichotomous data as a risk difference (RD) and number needed to treat (NNT), and continuous data as a weighted mean difference (WMD). We used meta-regression for subgroup analyses.

Main results: Seventeen trials (1811 participants), of poor to moderate quality, were included. There were more treatment failures with ORT (RD 4%, 95% confidence interval (CI) 1 to 7, random-effects model; 1811 participants, 18 trials; NNT = 25). Six deaths occurred in the IVT group and two in the ORT groups (4 trials). There were no significant differences in weight gain (369 participants, 6 trials), hyponatremia (248 participants, 2 trials) or hypernatremia (1062 participants, 10 trials), duration of diarrhea (960 participants, 8 trials), or total fluid intake at six hours (985 participants, 8 trials) and 24 hours (835 participants, 7 trials). Shorter hospital stays were reported for the ORT group (WMD -1.20 days, 95% CI -2.38 to -0.02 days; 526 participants, 6 trials). Phlebitis occurred more often in the IVT group (NNT 50, 95% CI 25 to 100) and paralytic ileus more often in the ORT group (NNT 33, 95% CI 20 to 100, fixed-effect model), but there was no significant difference between ORT using the low osmolarity solutions recommended by the World Health Organization and IVT (729 participants, 6 trials).

Authors' conclusions: Although no clinically important differences between ORT and IVT, the ORT group did have a higher risk of paralytic ileus, and the IVT group was exposed to risks of intravenous therapy. For every 25 children (95% CI 14 to 100) treated with ORT one would fail and require IVT.

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Conflict of interest statement

None declared.

Figures

1
1
Influence plot: meta‐analysis using random‐effects model (linear form)
2
2
Galbraith plot
3
3
Funnel plot for primary outcome (failure to rehydrate) based on fixed‐effect model
4
4
Cumulative plot: failure cumulative by year
1.1
1.1. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 1 Failure to rehydrate (by inpatient/outpatient).
1.2
1.2. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 2 Weight gain (g) at discharge (by inpatient/outpatient).
1.3
1.3. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 3 Per cent weight gain (g) at discharge (by inpatient/outpatient).
1.4
1.4. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 4 Length of hospital stay (days).
1.5
1.5. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 5 Incidences of hyponatremia.
1.6
1.6. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 6 Incidences of hypernatremia (by inpatient/outpatient).
1.7
1.7. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 7 Duration of diarrhea (h) (by inpatient/outpatient).
1.8
1.8. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 8 Total fluid intake (mL/kg) at 6 h (by inpatient/outpatient).
1.9
1.9. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 9 Total fluid intake (mL/kg) at 24 h (by inpatient/outpatient).
1.10
1.10. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 10 Total fluid intake (mL) at 6 h (by inpatient/outpatient).
1.11
1.11. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 11 Complications.
1.12
1.12. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 12 Sodium intake (mmol/kg) at 6 h (by inpatient/outpatient).
1.13
1.13. Analysis
Comparison 1 Oral rehydration therapy (any solution) versus intravenous therapy, Outcome 13 Sodium levels (mmol/kg) at 24 h (by inpatient/outpatient).
2.1
2.1. Analysis
Comparison 2 Oral rehydration therapy (any solution) versus intravenous therapy: subgroup analyses, Outcome 1 Failure to rehydrate: review authors' definition.
2.2
2.2. Analysis
Comparison 2 Oral rehydration therapy (any solution) versus intravenous therapy: subgroup analyses, Outcome 2 Failure to rehydrate: intention‐to‐treat analysis.
2.3
2.3. Analysis
Comparison 2 Oral rehydration therapy (any solution) versus intravenous therapy: subgroup analyses, Outcome 3 Failure to rehydrate: by osmolarity.
2.4
2.4. Analysis
Comparison 2 Oral rehydration therapy (any solution) versus intravenous therapy: subgroup analyses, Outcome 4 Failure to rehydrate: by vomiting.
2.5
2.5. Analysis
Comparison 2 Oral rehydration therapy (any solution) versus intravenous therapy: subgroup analyses, Outcome 5 Failure to rehydrate: by route.
See this image and copyright information in PMC

Comment in

References

References to studies included in this review

Atherly‐John 2002 {published data only}
    1. Atherly‐John YC, Cunningham SJ, Crain EF. A randomized trial of oral vs intravenous rehydration in a pediatric emergency department. Archives of Pediatrics & Adolescent Medicine 2002;156(12):1240‐3. - PubMed
Brown 1988 {published data only}
    1. Brown KH, Gastanaduy AS, Saavedra JM, Lembcke J, Rivas D, Robertson AD, et al. Effect of continued oral feeding on clinical and nutritional outcomes of acute diarrhea in children. Journal of Pediatrics 1988;112(2):191‐200. - PubMed
de Pumarejo 1990 {published data only}
    1. Pumarejo MM, Lugo CE, Alvarez‐Ruiz JR, Colon‐Santini JL. Oral rehydration: experience in the management of patients with acute gastroenteritis in the emergency room at the Dr. Antonio Ortiz pediatric hospital [Rehidratacion oral: experiencia en el manejo de pacientes con gastroenteritis auguda en la sala de emergencia hospital pediatrico Dr. Antonio Ortiz]. Boletin de la Asociacion Medica de Puerto Rico 1990;82(5):227‐33. - PubMed
el‐Mougi 1994 {published data only}
    1. el‐Mougi M, el‐Akkad N, Hendawi A, Hassan M, Amer A, Fontaine O, et al. Is a low‐osmolarity ORS solution more efficacious than standard WHO ORS solution?. Journal of Pediatric Gastroenterology and Nutrition 1994;19(1):83‐6. - PubMed
Gonzalez 1988 {published data only}
    1. Gonzalez‐Adriano SR, Valdes‐Garza HE, Garcia‐Valdes LC. Oral hydration versus intravenous hydration in patients with acute diarrhea. Boletin Medico del Hospital Infantil de Mexico 1988;45(3):165‐72. - PubMed
Gremse 1995 {published data only}
    1. Gremse DA. Effectiveness of nasogastric rehydration in hospatilized children with acute diarrhea. Jouranl of Pediatric Gastroenterology and Nutrition 1995;21(2):145‐8. - PubMed
Hernandez 1987 {published data only}
    1. Hernandez A, Jaramillo C, Ramirez R, Gomez G, Franco D. Treatment of acute diarrhea in children. Comparative study of three oral rehydration solutions and I.V. therapy in Colombia [Tratamiento de diarrea aguda en ninos. Estudio comparativo de tres soluciones de rehidratacion oral y venoclisis en Colombia]. Boletin de la Oficina Sanitaria Panamericana 1987;102(6):606‐16. - PubMed
Issenman 1993 {published data only}
    1. Issenman RM, Leung AK. Oral and intravenous rehydration of children. Canadian Family Physician 1993;39:2129‐36. - PMC - PubMed
Listernick 1986 {published data only}
    1. Listernick R, Zieserl E, Davis AT. Outpatient oral rehydration in the United States. American Journal of Disease in Childhood 1986;140(3):211‐5. - PubMed
Mackenzie 1991 {published data only}
    1. Mackenzie A, Barnes G. Randomised controlled trial comparing oral and intravenous rehydration therapy in children with diarrhoea. BMJ 1991;303(6799):393‐6. - PMC - PubMed
Nager 2002 {published data only}
    1. Nager AL, Wang VJ. Comparison of nasogastric and intravenous methods of rehydration in pediatric patients with acute dehydration. Pediatrics 2002;109(4):566‐72. - PubMed
Santosham 1982i {published data only}
    1. Santosham M, Daum RS, Dillman L, Rodriguez JL, Luque S, Russell R, et al. Oral rehydration therapy of infantile diarrhea: a controlled study of well‐nourished children hospitalized in the United States and Panama. New England Journal of Medicine 1982;306(18):1070‐6. - PubMed
Santosham 1982ii {published data only}
    1. Santosham M, Daum RS, Dillman L, Rodriguez JL, Luque S, Russell R, et al. Oral rehydration therapy of infantile diarrhea: a controlled study of well‐nourished children hospitalized in the United States and Panama. New England Journal of Medicine 1982;306(18):1070‐6. - PubMed
Sharifi 1985 {published data only}
    1. Sharifi J, Ghavami F, Z Nowrouzi, Fouladvand B, Malek M, Rezaeian M, et al. Oral versus intravenous reheydration therapy in severe gastroenteritis. Archives of Disease in Childhood 1985;60(9):856‐60. - PMC - PubMed
Singh 1982 {published data only}
    1. Singh M, Mahmoodi A, Arya LJ, Azamy S. Controlled trial of oral versus intravenous rehydration in the management of acute gastroenteritis. Indian Journal of Medical Research 1982;75:691‐3.
Spandorfer 2005 {published data only}
    1. Spandorfer PR, Alessandrini EA, Joffe MD, Localio R, Shaw KN. Oral versus intravenous rehydration of moderately dehydrated children: a randomized, controlled trial. Pediatrics 2005;115(2):295‐301. - PubMed
Tamer 1985 {published data only}
    1. Ross MB. Erratum: Oral rehydration. Journal of Pediatrics 1986;108(1):160. - PubMed
    1. Tamer AM, Friedman LB, Maxwell SRW, Cynamon HA, Perez HN, Cleveland WW. Oral rehydration of infants in a large urban U.S. medical center. Journal of Pediatrics 1985;107(1):14‐9. - PubMed
Vesikari 1987 {published data only}
    1. Vesikari T, Isolauri E, Baer M. A comparative trial of rapid oral and intravenous rehydration in acute diarrhoea. Acta Paediatria Scandanavia 1987;76(2):300‐5. - PubMed

References to studies excluded from this review

Alam 1987 {published data only}
    1. Alam AN, Sarker SA, Molla AM, Rahaman MM, Greenough III WB. Hydrolysed wheat based oral rehydration solution for acute diarrhoea. Archives of Disease in Childhood 1987;62(5):440‐4. - PMC - PubMed
Carpenter 1982 {published data only}
    1. Carpenter CC. Oral rehydration: is it as good as parenteral therapy?. New England Journal of Medicine 1982;306(18):1103‐4. - PubMed
Gavin 1996 {published data only}
    1. Gavin N, Merrick N, Davidson B. Efficacy of glucose‐based oral rehydration therapy. Pediatrics 1996;98(1):45‐51. - PubMed
Hirschhorn 1972 {published data only}
    1. Hirschhorn N, Cash RA, Woodward WE, Spivey GH. Oral fluid therapy of Apache children with acute infectious diarrhoea. Lancet 1972;2(7766):15‐8. - PubMed
Isolauri 1985 {published data only}
    1. Isolauri E, Vesikari T. Oral rehydration, rapid feeding, and cholestyramine for treatment of acute diarrhea. Journal of Pediatric Gastroenterology and Nutrition 1985;4(3):366‐74. - PubMed
Jan 1997 {published data only}
    1. Jan A, Rafi M, Mustafa S, Rasmussen ZA, Thobani S, Badruddin SH. Evaluation of dowdo (wheat‐milk gruel) in children with acute diarrhoea. Jouranl of Pakistan Medical Association 1997;47(1):12‐6. - PubMed
Kist‐van Holthe 1999 {published data only}
    1. Kist‐van Holthe JE, Heijden AJ. Dehydration due to gastroenteritis in children [Dehydratie ten gevolge van gastro‐enteritis bij kinderen]. Nederlands Tijdschrift Voor Geneeskunde 1999;143(4):193‐6. - PubMed
Klish 1985 {published data only}
    1. Klish WJ. Use of oral fluids in treatment of diarrhea. Pediatrics in Review 1985;7(1):27‐30.
Lexomboon 1994 {published data only}
    1. Lexomboon U, Harikul S, Lortholary O. Control randomized study of rehydration/rehydration with dioctahedral smectite in ambulatory Thai infants with acute diarrhea. Southeast Asian Journal of Tropical Medicine and Public Health 1994;25(1):157‐62. - PubMed
Mackenzie 1988 {published data only}
    1. Mackenzie A, Barnes G. Oral rehydration in infantile diarrhoea in the developed world. Drugs 1988;36 Suppl 4:48‐60. - PubMed
Mackenzie 1989 {published data only}
    1. Mackenzie A, Barnes G, Shann F. Clinical signs of dehydration in children. Lancet 1989;2(8663):605‐7. - PubMed
Mahalanabis 1972 {published data only}
    1. Mahalanabis P, Brayton JB, Mondal A, Pierce NF. The use of Ringer's lactate in the treatment of children with cholera and acute noncholera diarrhoea. Bulletin of the World Health Organization 1972;46(3):311‐9. - PMC - PubMed
Orenstein 1986 {published data only}
    1. Orenstein SR. Enteral versus parenteral therapy for intractable diarrhea of infancy: a prospective, randomized trial. The Journal of Pediatrics 1986;109(2):277‐86. - PubMed
Patra 1989 {published data only}
    1. Patra FC, Sack DA, Islam A, Alam AN, Mazumder RN. Oral rehydration formula containing alanine and glucose for treatment of diarrhoea: a controlled trial. BMJ 1989;298(6684):1353‐6. - PMC - PubMed
Rautanen 1993 {published data only}
    1. Rautanen T, el‐Radhi S, Vesikari T. Clinical experience with a hypotonic oral rehydration solution in acute diarrhoea. Acta Paediatricia 1993;82(1):52‐4. - PubMed
Reid 1996 {published data only}
    1. Reid SR, Bonadio WA. Outpatient rapid intravenous rehydration to correct dehydration and resolve vomiting in children with acute gastroenteritis. Annals of Emergency Medicine 1996;28(3):318‐23. - PubMed
Samadi 1983 {published data only}
    1. Samadi AR, Islam R, Huq MI. Replacement of intravenous therapy by oral rehydration solution in a large treatment centre for diarrhoea with dehydration. Bulletin of the World Health Organization 1983;61(3):471‐6. - PMC - PubMed
Sarker 1995 {published data only}
    1. Sarker SA, Majid N, Mahalanabis D. Alanine‐ and glucose‐based hypo‐osmolar oral rehydration solution in infants with persistent diarrhoea: a controlled trial. Acta Paediatria 1985;84(7):775‐80. - PubMed
Srivastava 1985 {published data only}
    1. Srivastava VK, Arya H, Uppal SS, Rath B, Laisram N. Comparison of oral and intravenous rehydration among hospitalized children with acute diarrhoea. Journal of Diarrhoea Disease Research 1985;3(2):92‐5. - PubMed
Tripp 1980 {published data only}
    1. Tripp JH, Harries JT. UNICEF/W.H.O. glucose electrolyte solution not always appropriate. Lancet 1980;2(8198):793. - PubMed
Weizman 1983 {published data only}
    1. Weizman Z, Schmueli A, Deckelbaum RJ. Continuous nasogastric drip elemental feeding. Alternative for prolonged parenteral nutrition in severe prolonged diarrhea. American Journal of Disease in Childhood 1983;137(3):253‐5. - PubMed

Additional references

AAP 1996
    1. American Academy of Pediatrics, Provisional committee on quality improvement, Subcommittee on acute gastroenteritis. Practice parameter: the management of acute gastroenteritis in young children. Pediatrics 1996;97(3):424‐35. - PubMed
Armon 2000
    1. Armon K, Elliott EJ. Acute gastroenteritis. In: Moyer VA, Elliott EJ, Davis RL, Gilbert R, Klassen T, Logan S, Mellis C, Williams K editor(s). Evidence based pediatrics and child health. 1st Edition. London: BMJ Books, 2000:273‐86.
Baldassano 1991
    1. Baldassano RN. Chronic diarrhea. A practical approach for the pediatrician. Pediatric Clinics of North America 1991;38(3):667‐86. - PubMed
Begg 1994
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50(4):1088‐101. - PubMed
Bern 1992
    1. Bern C, Martines J, Zoysa I, Glass RI. The magnitude of the global problem of diarrhoeal disease: a ten‐year update. Bulletin of the World Health Organization 1992;70(6):705‐14. - PMC - PubMed
Colditz 1989
    1. Colditz GA, Miller JN, Mosteller F. How study design affects outcomes in comparisons of therapy. I: Medical. Statistics in Medicine 1989;8(4):411‐54. - PubMed
DARE 2002
    1. Efficacy of glucose‐based oral rehydration therapy. [Abstract 961213] Database of Abstracts of Reviews of Effectiveness. Abstract of Gavin N, Merrick N, Davidson B. Efficacy of glucose‐based oral rehydration therapy. Pediatrics. 1996. 98(1). 45‐51. The Cochrane Library 2004, Issue 1. - PubMed
Deeks 2001
    1. Deeks JJ, Altman DG, Bradburn MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta‐analysis. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic reviews in health care: meta‐analysis in context. 2nd Edition. London: BMJ Books, 2001:300.
Duggan 1992
    1. Duggan C, Santosham M, Glass RI. The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention. MMWR. Recommendations and reports 1992;41(RR‐16):1‐20. - PubMed
Duval 2001
    1. Duval S, Tweedie R. Trim and fill: A simple funnel‐plot‐based method of testing and adjusting for publication bias in meta‐analysis. Biometrics 2001;56(2):455‐63. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Fonseca 2004
    1. Fonseca BK, Holdgate A, Craig JC. Enteral vs intravenous rehydration therapy for children with gastroenteritis: a meta‐analysis of randomized controlled trials. Archives of Pediatrics & Adolescent Medicine 2004;158(5):483‐90. - PubMed
Fontaine 2000
    1. Fontaine O, Gore SM, Pierce NF. Rice‐based oral rehydration solution for treating diarrhoea. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD001264.pub2] - DOI - PubMed
Gangarosa 1992
    1. Gangarosa RE, Glass RI, Lew JF, Boring JR. Hospitalizations involving gastroenteritis in the United States, 1985: the special burden of the disease among the elderly. American Journal of Epidemiology 1992;135(3):281‐90. - PubMed
Garland 1992
    1. Garland FS, Dunne WM Jr, Havens P, Hintermeyer M, Bozzette MA, Wincek J, et al. Peripheral intravenous catheter complications in critically ill children: a prospective study. Pediatrics 1992;89(6 Pt 2):1145‐50. - PubMed
Glass 1991
    1. Glass RI, Lew JF, Gangarosa RE, LeBaron CW, Ho MS. Estimates of morbidity and mortality rates for diarrheal diseases in American children. Journal of Pediatrics 1991;118(4 (Pt 2)):S27‐33. - PubMed
Goepp 1993
    1. Goepp JG, Katz SA. Oral rehydration therapy. American Family Physician 1993;47(4):843‐51. - PubMed
Hahn 2001
    1. Hahn S, Kim Y, Garner P. Reduced osmolarity oral rehydration solution for treating dehydration due to diarrhoea in children: systematic review. BMJ 2001;323(7304):81‐5. - PMC - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2005a
    1. Higgins JPT, Green S, editors. Measures of relative effect: the risk ratio and odds ratio. Cochrane Handbook for Systematic Reviews of Interventions 8.2.1.2 [updated May 2005]; Section 8. www.cochrane.org/resources/handbook/hbook.htm. Chichester, UK: John Wiley & Sons, Ltd., (accessed 14 February 2006).
Higgins 2005b
    1. Higgins J, Green S, editors. Highly sensitive search strategies for identifying reports of randomized controlled trials in MEDLINE. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]; Appendix 5b. www.cochrane.org/resources/handbook/hbook.htm (accessed 1 March 2006).
Jadad 1996
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12. - PubMed
Oxman 1991
    1. Oxman A, Guyatt GH. Validation of an index of the quality of review articles. Journal of Clinical Epidemiology 1991;44(11):1271‐8. - PubMed
Ozuah 2002
    1. Ozuah PO, Avner JR, Stein RE. Oral rehydration, emergency physicians, and practice parameters: a national survey. Pediatrics 2002;109(2):259‐61. - PubMed
Review Manager 4.2 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
Santosham 1991
    1. Santosham M, Greenough WB 3rd. Oral rehydration therapy: a global perspective. Journal of Pediatrics 1991;4(4 (Pt 2)):S44‐51. - PubMed
Schulz 1995
    1. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273(5):408‐12. - PubMed
Snyder 1991
    1. Snyder JD. Use and misuse of oral therapy for diarrhea: comparison of US practices with American Academy of Pediatrics recommendations. Pediatrics 1991;87(1):28‐33. - PubMed
Stata 7.0 [Computer program]
    1. Stata Corporation. Intercooled Stata 7.0. Version for Windows 98/95/NT. College Station, Texas: Stata Corporation.
UN Statistics
    1. United Nations Statistics Division. Economic trade and other groupings of countries or areas. New York, NY: United Nations Statistics Division. www.un.org/Depts/unsd/methods/m49groupe.htm#ldcs (accessed 14 November 14 2001).
WHO 1996
    1. World Health Organization. The challenge of diarrhoeal and acute respiratory disease control. Point of Fact No 77. Geneva: World Health Organization, 1996:1‐4.
WHO 2000
    1. World Health Organization, Child and Adolescent Health and Development. Child health epidemiology. www.who.int/child‐adolescent‐health/overview/child_health/child_epidemio... (accessed 6 May 2002).
WHO 2002
    1. World Health Organization, Dept. of Child and Adolescent Health and Development. Reduced osmolarity : oral rehydration salts (ORS) formulation : a report from a meeting of experts jointly organised by UNICEF and WHO : UNICEF house, New York, USA, 18 July 2001 [WHO/FCH/CAH/01.22]. Geneva: World Health Organization, 2002.

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