Does ORT reduce diarrhoeal mortality?

Trends in infant and child mortality from all diarrhoea-related causes and from acute watery diarrhoea were examined in a rural community in Bangladesh, during the three years preceding and the 10 years following the introduction of an oral rehydration therapy (ORT) programme. A significant increase in infant mortality due to acute watery diarrhoea was observed throughout the study period. Child mortality due to acute watery diarrhoea did not decrease during this period. The programme ensured universal knowledge of the oral rehydration solution and the availability of glucose-electrolyte sachets in every household. Yet the in adequate formulation of messages concerning the role of oral rehydration may have caused its incorrect use - oral solutions being administered to too few infants, in too small quantities, and for too short periods. The decline in infant mortality from other causes may also explain the increased contribution of diarrhoea as a cause of death through a replacement effect. The findings suggest that efforts should be continued to ensure appropriate formulation of messages promoting ORT for its correct use. ORT should also be viewed as one component among others in diarrhoeal diseases control programmes if diarrhoea mortality is to be reduced.