Acta Paediatr. 2000 Jul; 89(7): 791-4.

Bangladeshi rural mothers prepare safer rice oral rehydration solution.

Molla AM, Bari A, Greenough WB, Molla AM, Budhiraja P, Sharma PN.

Department of Paediatrics, Faculty of Medicine, Kuwait University, Safat. majid@hse.kuniv.edu.kw

Mothers in rural Bangladesh were trained to prepare and use either Rice-ORS (R-ORS) or Glucose-ORS (G-ORS) solutions to treat children with diarrhoea. Families were provided with either G-ORS or R-ORS of the same electrolyte composition through a depot holder. Subsequently, random samples of solutions actually used for treatment by the mothers were collected from homes by field workers. A total of 227 R-ORS and 239 G-ORS samples were analysed. The sodium concentration in about 90% of the samples had a safe range (50-120 mmol/l). Only 4% of R-ORS solutions were above 120 mmol/l in sodium concentration, while 12% of G-ORS solutions exceeded these limits (p < 0.0025). R-ORS (after acid hydrolysis) provided significantly higher glucose (257 +/- 42 mmol/l) for active but safe absorption compared to G-ORS (115 +/- 39 mmol/l). To make R-ORS liquid enough to drink requires addition of sufficient water, preventing the risk of higher sodium concentration. Unlike rice starch, glucose is a highly soluble substance. It is thus possible to prepare a drinkable solution containing dangerously high concentrations of both sodium and glucose, but this can be minimized by more intensive training of the mothers.