Comparison of safety of glucose oral rehydration solution and maize oral rehydration therapy for home management of diarrhoea in Kenya

Safety margins and variability in the composition of glucose and maize-base d oral rehydration therapy (ORT) prepared by mothers in a rural district of Western Kenya, are reported here. In a 2-year longitudinal field study, pa ckets containing glucose ORS and a home solution made with maize and table salts, were provided to the mothers of 6180 children in Kakamega District i n two separate sub-locations. Experienced and trained field workers support ed by community registered nurses provided training for the preparation and use of ORT during weekly visits to every household. On four occasions sepa rated by 4-6 months, a 5 per cent random sampling was done of the home-prep ared solutions actually used for the treatment of children with diarrhoea. The water used for preparing ORT was also sampled. Samples of 174 glucose-b ased ORT, 148 maize-salt ORT, and 201 samples of water were analysed. Only 2 per cent of the maize-based ORT were above 120 meq/1 sodium (i.e., the sa fe range of sodium concentration) compared to 17.8 per cent for glucose sol utions (p < 0.001). Home water samples contained substantial amounts of sal t, which could unpredictably affect the final composition of the ORT soluti ons. We conclude that maize-sult ORT had a better margin of safety than glu cose-based ORS.