Mothers can prepare and use rice-salt oral rehydration solution in rural Bangladesh

Abstract

A feasibility study of rice-salt solution for oral rehydration (OR) was conducted in a village in the Chandpur area of rural Bangladesh in 1983. 305 mothers of children aged 0-4 years were interviewed with a pretraining questionnaire to find out about the availability of rice. The mothers were then trained and encouraged to use rice-salt OR solution to treat patients with diarrhoea. Evaluation of training was assessed by means of field diarrhoea surveillance, case follow-up, rice-salt OR solution sample analysis, and a post-training survey. The study showed that mothers in rural areas could prepare rice-salt OR solution quite easily and use it to treat diarrhoea patients. Mothers considered that this method would increase the utilisation of OR treatment in rural homes. After training rice-salt OR solution was the most common method of treatment for diarrhoea.

PIP: A feasibility study of rice-salt solution for oral rehydration (OR) was conducted in a village in the Chandpur area of rural Bangladesh in 1983. 305 mothers of children aged 0-4 years were interviewed with a pretraining questionnaire to learn about the availability of rice. The mothers were then trained and encouraged to use rice-salt OR solution to treat patients with diarrhea. Evaluation of training was assessed by means of field diarrhea surveillance, case follow-up, rice-salt OR solution sample analysis, and a post-training survey. The pretraining questionnaire survey showed that rice was always available in all households and ready-made rice powder was available in 30% of households. For patients with diarrhea rice was very acceptable. "Chira," flat beaten rice soaked in water, was the 1st choice for 82% of mothers. "Luta," a thick boiled rice-powder fluid was the 2nd choice (15%), and "jao," a thick fluid preparation of boiled whole rice, was the least preferred. 78% of mothers did not consider the method of preparation of rice-salt OR solution a problem, but the remainder thought that the effort and time involved in preparation was sometimes difficult. 53% of mothers felt more people would use oral rehydration to treat diarrhea if they were trained to prepare the solution. During the 4-month surveillance period 945 diarrhea episodes were detected in the study population. 50% occurred in 479 children aged 0-4 years. Diarrhea with simple loose or watery stools was more frequent (70%) than bloody or mucoid diarrhea (30%). Mothers and family members used rice-salt OR solution, sugar-salt OR solution, and drugs in various combinations. Rice-salt OR solution by itself was used more frequently (30%) than sugar-salt OR solution (6%), even though the sugar-salt method was introduced earlier. After rice-salt OR solution the most frequent diarrheal treatment was with drugs, which included modern medicine and homeopathic, herbal, and indigenous preparations. Rice-salt OR solution was the commonest initial treatment (37% for diarrheal episodes), and the commonest end treatment (47% of episodes). The sodium content of 150 samples of home-made rice-salt OR solution is shown in a table. The mean sodium concentration was 97 mmol/1. Though the range of values varied from 2-250 mmol/1, in 57% of the sample the range was 71-110 mmol/1, 15% had 70 mmol/1 or less, and 28% had more than 110 mmol/1. In the post-training survey, 82% of the mothers considered rice-salt OR solution superior to sugar-salt OR solution, despite their long experience with the sugar-salt mixture.