From Barriers to Best Practices: Enhancing Oral Rehydration Therapy Utilization for Diarrhea Management in India.

Q3 Medicine
Janani Shankar, Rahul Nagpal, Amol Patil, Harshad Malve, Vijay Chamle
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引用次数: 0

Abstract

Diarrheal diseases are the third leading cause of childhood mortality in India. Oral rehydration therapy (ORT) remains the cornerstone of diarrheal disease management, especially as first-line treatment for acute diarrhea. However, ORT faces significant barriers that compromise its effectiveness in India. Children with diarrheal dehydration frequently fail to receive recommended treatment, primarily due to knowledge gaps among caregivers and preparation inaccuracies. These are further compounded by water safety concerns, poor palatability of home-based preparations, and the practical challenges of handling 1 L volumes. A critical factor determining ORT effectiveness is osmolarity optimization, with current World Health Organization (WHO) [also known as the reduced-osmolarity oral rehydration solution (ORS)]-recommended low-osmolarity ORS demonstrating superior efficacy than the earlier standard-osmolarity formulations that increased risks of hypernatremia and stool output. However, many caregivers deviate from the recommended osmolality in ORS solutions. Creating awareness among caregivers and healthcare providers and training them on proper reconstitution of ORT is essential for optimizing ORT outcomes and reducing preventable dehydration-related morbidity and mortality, especially in resource-constrained settings. Ready-to-drink ORS (RTD-ORS) can be considered as a viable alternative, especially in specific scenarios where convenience and adherence are prioritized. This review aims to examine the challenges and barriers impeding diarrheal disease management in India and address the identified gaps in healthcare delivery and improve treatment outcomes.

从障碍到最佳实践:加强口服补液疗法在印度腹泻管理中的应用。
腹泻病是印度儿童死亡的第三大原因。口服补液疗法(ORT)仍然是腹泻疾病管理的基石,特别是作为急性腹泻的一线治疗。然而,ORT在印度面临重大障碍,影响了其有效性。腹泻性脱水的儿童经常不能接受推荐的治疗,主要是由于护理人员之间的知识差距和准备不准确。水安全问题、家庭配制的适口性差以及处理1升体积的实际挑战进一步加剧了这些问题。决定ORT有效性的一个关键因素是渗透压优化,目前世界卫生组织(WHO)[也称为降低渗透压口服补液(ORS)]推荐的低渗透压口服补液(ORS)比早期标准渗透压配方更有效,后者增加了高钠血症和粪便排出的风险。然而,许多护理人员偏离了ORS溶液中推荐的渗透压。提高护理人员和卫生保健提供者的认识,并对他们进行适当重建口服体液补充治疗的培训,对于优化口服体液补充治疗结果和减少可预防的与脱水有关的发病率和死亡率至关重要,特别是在资源有限的环境中。即食ORS (RTD-ORS)可以被认为是一种可行的替代方案,特别是在优先考虑便利性和依从性的特定情况下。本综述旨在研究阻碍印度腹泻病管理的挑战和障碍,并解决医疗保健服务中已确定的差距,并改善治疗结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
509
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