Bangladeshi rural mothers prepare safer rice oral rehydration solution
Molla, A.M.; Bari, A.; Greenough, W.B.; Molla, A.M.; Budhiraja, P.; Sharma, P.N.
Acta Paediatrica 89(7): 791-794
2000
ISSN/ISBN: 0803-5253 PMID: 10943959 DOI: 10.1111/j.1651-2227.2000.tb00387.xDocument Number: 254575
Mothers in rural Bangladesh were trained to prepare and use either Rice-oral rehydration therapy (ORS) (R-ORS) or Glucose-ORS (G-ORS) solutions to treat children with diarrhoea. Families were provided with either G-ORS or R-ORS of the same electrolyte composition through a depot holder. Subsequently, random samples of solutions actually used for treatment by the mothers were collected from homes by field workers. A total of 227 R-ORS and 239 G-ORS samples were analysed. The sodium concentration in about 90% of the samples had a safe range (50-120 mmol/litre). Only 4% of R-ORS solutions were above 120 mmol/litre in sodium concentration, while 12% of G-ORS solutions exceeded these limits (p<0.0025). R-ORS (after acid hydrolysis) provided significantly higher glucose (257+or-42 mmol/litre) for active but safe absorption compared to G-ORS (115+or-39 mmol/litre). To make R-ORS liquid enough to drink requires addition of sufficient water, preventing the risk of higher sodium concentration. Unlike rich starch, glucose is a highly soluble substance. It is thus possible to prepare a drinkable solution containing dangerously high concentrations of both sodium and glucose, but this can be minimized by more intensive training of the mothers.