Mukokinya Kailemia1,2, Nyambura Kariuki1, Ahmed Laving1, Ambrose Agweyu1,3, Dalton Wamalwa1. 1. Department of Paediatrics and Child Health, University of Nairobi, Kenya. 2. Department of Paediatrics and Child Health, Nairobi Hospital, Nairobi, Kenya. 3. Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya.
Abstract
Background: Diarrhoea is a major cause of child mortality. Although oral rehydration solution (ORS) is an efficacious intervention for correcting dehydration, inadequate monitoring may limit its effectiveness in routine settings. We evaluated the effect of using a caregiver-administered chart to monitor oral fluid therapy on hydration status among children with some dehydration. Methods: An open-label randomized controlled trial was conducted among children 2-59 months of age. ORS fluid monitoring charts were given to caregivers in the intervention arm to record the hourly intake of ORS. ORS was administered without charting in the control arm. The primary outcome was dehydration defined by the presence of clinical signs of some dehydration, severe dehydration or shock assessed 4 h after initiation of treatment. We also assessed the acceptability of the charts among caregivers. Results: We evaluated 252 patients for the primary endpoint. Among those who received the intervention, 7/122 (5.7%) were still dehydrated following 4 h of ORS administration vs 20/130 (15.4%) in the control group (risk ratio 0.37 [95% confidence interval 0.16-0.85]). Caregivers in the intervention arm reported positive experiences using the fluid charts. Conclusions: The use of fluid monitoring charts reduced the frequency of dehydration and was well accepted by caregivers, representing a promising innovation for the management of diarrhoea and dehydration in resource-limited settings.
RCT Entities:
Background: Diarrhoea is a major cause of child mortality. Although oral rehydration solution (ORS) is an efficacious intervention for correcting dehydration, inadequate monitoring may limit its effectiveness in routine settings. We evaluated the effect of using a caregiver-administered chart to monitor oral fluid therapy on hydration status among children with some dehydration. Methods: An open-label randomized controlled trial was conducted among children 2-59 months of age. ORS fluid monitoring charts were given to caregivers in the intervention arm to record the hourly intake of ORS. ORS was administered without charting in the control arm. The primary outcome was dehydration defined by the presence of clinical signs of some dehydration, severe dehydration or shock assessed 4 h after initiation of treatment. We also assessed the acceptability of the charts among caregivers. Results: We evaluated 252 patients for the primary endpoint. Among those who received the intervention, 7/122 (5.7%) were still dehydrated following 4 h of ORS administration vs 20/130 (15.4%) in the control group (risk ratio 0.37 [95% confidence interval 0.16-0.85]). Caregivers in the intervention arm reported positive experiences using the fluid charts. Conclusions: The use of fluid monitoring charts reduced the frequency of dehydration and was well accepted by caregivers, representing a promising innovation for the management of diarrhoea and dehydration in resource-limited settings.
Authors: Li Liu; Shefali Oza; Dan Hogan; Yue Chu; Jamie Perin; Jun Zhu; Joy E Lawn; Simon Cousens; Colin Mathers; Robert E Black Journal: Lancet Date: 2016-11-11 Impact factor: 79.321
Authors: Brett Keller; Elizabeth McCarthy; Kathryn Bradford Vosburg; Mutinta Musonda; Jere Mwila; Jan Willem van den Broek; Fiona J Walsh Journal: PLoS One Date: 2017-08-02 Impact factor: 3.240