The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality

Background Most diarrhoeal deaths can be prevented through the prevention and treatment of dehydration. Oral rehydration solution (ORS) and recommended home fluids (RHFs) have been recommended since 1970s and 1980s to prevent and treat diarrhoeal dehydration. We sought to estimate the effects of these interventions on diarrhoea mortality in children aged <5 years

Early life patterns of common infection: a latent class analysis

Early life infection has been implicated in the aetiology of many chronic diseases, most often through proxy measures. Data on ten infectious symptoms were collected by parental questionnaire when children were 6 months old as part of the Avon Longitudinal Study of Parents and Children, United Kingdom. A latent class analysis was used to identify patterns of infection and their relationship to five factors commonly used as proxies: sex, other children in the home, maternal smoking, breastfeeding and maternal education. A total of 10,032 singleton children were included in the analysis. Five classes were identified with differing infectious disease patterns and children were assigned to the class for which they had a highest probability of membership based on their infectious symptom profile: ‘general infection’ (n = 1,252, 12.5%), ‘gastrointestinal’ (n = 1,902, 19.0%), ‘mild respiratory’ (n = 3,560, 35.5%), ‘colds/ear ache’ (n = 462, 4.6%) and ‘healthy’ (n = 2,856, 28.5%). Females had a reduced risk of being in all infectious classes, other children in the home were associated with an increased risk of being in the ‘general infection’, ‘mild respiratory’ or ‘colds/ear ache’ class. Breastfeeding reduced the risk of being in the ‘general infection’ and ‘gastrointestinal’ classes whereas maternal smoking increased the risk of membership. Higher maternal education was associated with an increased risk of being in the ‘mild respiratory’ group. Other children in the home had the greatest association with infectious class membership. Latent class analysis provided a flexible method of investigating the relationship between multiple symptoms and demographic and lifestyle factors

Relationship Between Physical, Environmental and Sociodemographic Factors and School Performance in Primary Schoolchildren

Poor primary school performance is a risk factor for low high-school and university graduation, as well as poverty in later life. In this case-control study, the relation between a variety of physical, environmental and sociodemographic factors, and primary school performance was investigated. Grade one students with good and poor school achievement, from different socioeconomic levels were studied. A questionnaire about the sociodemographic characteristics and child's medical history, together with a Child Behavior Checklist, was filled out by parents. Physical examination, visual and hearing screening were performed. Blood count and blood lead levels were determined. Wechsler Intelligence Scale for Children-Revised (WISC-R) was performed to determine the IQ. A total of 177 students participated in the study. Stepwise logistic regression revealed an independent positive relation between duration of study (OR, 2.69; Cl, 1.19-6.05; p = 0.016), maternal education (OR, 1.47; Cl, 1.14-1.87; p = 0.002), full scale score of WISC-R (OR, 1.08; Cl, 1.03-1.3; p = 0.002) and school performance. Multinomial logistic regression revealed that the risk of having a below average full scale WISC-R score was higher among children having a hearing loss, uncorrected vision loss, heating house with stove, cigarette smoking of both parents, and low paternal education (less than 8 years). The chance of having an above average full scale WISC-R score was lower among children whose either parent smoked cigarettes, height-for-age percentile was below 10, and maternal education was less than 8 years. Policies for increasing male and female education, growth monitoring, appropriate feeding (breastfeeding and weaning), well-baby and child followup and clean environment (indoor and outdoor) will not only promote the physical health but also promote the cognitive development of the new generations.WoSScopu

Is a 2 : 1 Ratio of Standard Who Ors to Plain Water Effective in the Treatment of Moderate Dehydration

Increased amounts of plain water have been recommended ad libitum during rehydration treatment with oral rehydration solutions (ORS) in moderately dehydrated cases in order to decrease the hypertonicity of ORS. However, we could not encounter any study demonstrating its effectiveness objectively. In this study, moderately dehydrated children admitted to Hacettepe University Ihsan Dogramaci Children's Hospital Diarrheal Disease Training and Treatment Unit were administered either standard WHO ORS treatment or two parts of standard WHO ORS and one part of plain water alternately at a dose of 100 ml/kg, according to the period they were admitted to the center. The frequency of vomiting, stool purging rate, and unscheduled intravenous treatment rate of the two different regimens were compared. There were 51 children in the standard ORS group and 79 children in the 2 : I ratio ORS group. The admission characteristics of the children were similar. The children with a stool purging rate over one per hour during treatment was higher in the standard ORS group (29.4 vs. 15.2 per cent, p = 0.051), as well as the children with vomiting (56 vs. 30 per cent, p = 0.007). The children who required unscheduled intravenous treatment was also higher in the standard ORS group (20 vs. 14 per cent, p = 0.2). A regimen of two parts of WHO ORS and one part of plain water may be an alternative treatment for moderately dehydrated children with non-cholera diarrhea in areas where hypotonic ORS is not yet available.WoSScopu