Etiology of childhood diarrhea and oral rehydration therapy in northeastern Brazil.

This study was conducted from January 1977 to June 1978 in Fortaleza, Brazil, to evaluate the oral rehydration treatment recommended by the World Health Organization for children admitted with acute diarrhea; admission peaked in January-March of both years and children treated came from the lowest socioeconomic strata of the popultion. Initial treatment consisted of intravenous administration of normal saline or 5% glucose with saline solution; intravenous therapy was continued until objective signs of improvement were evident. Of the 53 children observed 24 continued with intravenous therapy, and 29 were administered oral rehydration therapy with a glucose-electrolyte solution containing 90 milliequivalent per liter of sodium ion. Mean age in the intravenous and in the oral groups were 10 and 8 months, respectively. The major symptoms were feverishness and vomiting. Stools from 37 patients were examined for disease agents; enterotoxigenic E. coli were identified in stools from 27% of these patients; ST-producing E. coli in 21.6%, and LT-producing E. coli in the remaining 5.4%. During the initial rehydration period there were no significant differences between the 2 groups as to duration of therapy or amount of fluid given. During the subsequent study period members of the oral treatment group required significantly less fluid and less treatment than members of the intravenous group, average amount of fluid required per kg of body weight being 67.3 ml in the intravenous group, and 32.3 ml in the oral group. Progress toward a normal level of consciousness was significantly greater among members of the oral rehydration group; the mothers of the children were able to administer the oral therapy quite effectively, thus saving time for physicians and nurses.