AN ANALYSIS OF HOME-BASED ORAL REHYDRATION THERAPY IN THE KINGDOM OF LESOTHO

Mothers in developing countries are being successfully taught to give an oral rehydration solution (ORS) at home. The quantity of oral rehyd ration fluid that mothers administer to their child remains a critical question. Inadequate quantities render oral rehydration therapy (ORT) ineffective. The primary focus of our investigation was direct measur ement of the quantity of fluid unsupervised mothers gave their childre n at home. This study validates a methodology that provides precise in formation on ORS administration in the home, information essential for evaluating the effectiveness of home-based therapy and for planning p rogrammes to influence unsupervised mothers to correctly administer OR S to their sick children. This study, conducted in the Kingdom of Leso tho, assessed the impact on home care of the national control of diarr hoeal disease (CDD) programme. Direct observations in the home establi shed each child's status and the quantity of fluid used 24 hr after ch ildren left the ORT unit where mothers were instructed to give ORS at home. Data were gathered on natural consequences that might discourage use of ORS, such as vomiting, increased frequency of watery stools an d distaste for the solution. The health status of most of the 197 chil dren followed improved. The average volume of ORS administered was 544 ml. A full liter was given by 21% of the mothers. Only 3% of the moth ers gave no ORS. The average dose was 65 ml/kg. Younger children got a bout the same volume as older children, thus. they received a higher m l/kg dose. Mothers gave more ORS to children who had more symptoms of diarrhoeal disease at the time they were brought to the clinic. Mother s who said that their child liked the taste of ORS gave more than thos e who reported that their children did not like the taste. There was n o relationship between loose stool frequency reported by mothers and q uantity of ORS given. Interviewers were able to obtain acceptable volu me estimates from mothers by identifying the container used to adminis ter ORS in the home and asking how often it was filled. Using this app roach, 81% of the mothers accurately recalled how much ORS they had ad ministered. This technique may make it possible to obtain accurate est imates of quantities of supplementary liquids such as juice, tea and s oup given in the home.