Village-Based Distribution of Oral Rehydration Therapy Packets in Bangladesh

Lincoln C. ChenInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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Robert E. BlackInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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A. M. SarderInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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Michael H. MersonInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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Shushum BhatiaInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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Md. YunusInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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J. ChakrabortyInternational Centre for Diarrheal Disease Research, Bureau of Epidemiology, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, Altanta, Georgia 30333, Bangladesh

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The distribution of sucrose-electrolyte oral therapy packets (1 liter) by community-based workers in a rural Bangladesh population of 157,000 was evaluated. A similar population of 134,000 served as a comparison group. The locally-produced packets showed satisfactory chemical composition with a shelf-life of up to 3 months and a cost of U.S. $0.05. After 4 months the workers were distributing an average of 70 packets/1,000 population per month. Most patients used one packet for each episode of diarrhea; 13% of children used two packets, and 15% and 8% of adults used, respectively, two and three packets. The electrolyte composition of the oral fluids prepared by field workers and mothers showed substantial variation, but no hyperconcentrated solutions were noted. A comparison of the hospitalization rate from the two study areas suggested a 29% reduction in hospitalization for diarrhea during the 4 months of distribution.

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