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

Abstract

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

PIP: In the 1st 2 years following refresher training of pediatric 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% decrease in the number of children admitted to the pediatric ward with the diagnosis of diarrheal diseases, a 56% decrease in the use of intravenous fluid to rehydrate such children, a 3-fold increase in the use of oral rehydration salts exclusively to rehydrate children with mild or moderate dehydration, and a 39% decrease in the number of pediatric deaths associated with diarrheal diseases. Over the same period, there was a 32% decrease in recurrent hospital costs attributable to pediatric diarrheal diseases. As use of ORT continues to increase in Malawi, where diarrheal diseases account for 9% of pediatric hospital admissions, there should be considerable decreases in mortality from such diseases and concomitant increases in cost savings attributable to them. (author's)