Oral Rehydration Therapy: An Assessment of Mortality Effects in Rural Egypt

Abstract

A study assessing the effectiveness of a therapeutic intervention on child mortality in a number of delta villages in Menoufia Egypt where diarrheal disease is a major cause of death among young children. Oral rehydration therapy (ORT) was introduced in 2 sets of 6 villages having various levels of health care units; 1/2 of these villages programmed for implementation in the 3rd year of the project served as controls. Data was collected through a series of multiround surveys covering all the household residents in the 12 study villages. The core idea of the intervention was to promote home management of diarrhea through education of rural mothers regarding oral fluid therapy. A 1/3 to 1/2 decrease in mortality rate of children due to diarrhea was listed as the expected measurable program effect. Results show that the intervention did not reduce diarrheal mortality because mothers and medical practitioners did not fully appreciate the role of dehydration in causing death. They likewise were not easily weaned away from the practice of withholding food during diarrheal infection. ORT when used was utilized too late and too little to serve as a means of replacing vital fluids. More stringent follow up the selection of more creditable (older) volunteer instructors the promotion of preventive measures and greater attention to educating mothers in the care of diarrheal disease would have greatly increased the effectiveness of the program.