Pre-hospital Use of Oral Rehydration Therapy and Zinc and the Risk of Dehydration in Childhood Diarrhoea

Background: Diarrhoea is a leading cause of childhood mortality globally. The use of oral rehydration therapy (ORT) with zinc supplementation is recommended in the treatment of childhood diarrhoea.

Objective: To determine the pattern of pre-hospital use of ORT and zinc among children with diarrhoea at the secondary levels of health care in Nigeria.

Methods: A cross-sectional survey was conducted over a six-month period at two secondary health facilities among children with diarrhoea. A structured questionnaire was administered on consenting caregivers and the level of dehydration was also determined.

Results: Out of 109 under-five children, 93 (85.3%) were aged < 24 months; 79 (72.5%) mothers were aware of ORT use but only 56 (51.4%) actually used ORT. Fifty (45.9%) mothers were aware of zinc use but 33 (30.3%) actually administered it. Fifty-nine (54.1%) children had dehydration; 60.9% of children who had ORT with zinc and 60.5% of those who received neither ORT nor zinc were dehydrated. ORT use was significantly associated with zinc use but had no association with dehydration, rather vomiting was significantly associated with dehydration (p = 0.03).

Conclusion: More than half of the children studied presented at the secondary level of care with dehydration despite high maternal awareness and use of ORT. Zinc use was low in this population. Due to vomiting and feed refusal, the impact of ORT and zinc in the prevention of dehydration was obscure.