Management of childhood diarrhoea at the household level: a population-based survey in

The management of childhood diarrhoea at the household level was studied in a population-based survey in four states in north-east Brazil. Of a representative sample of 6524 children under 5 years of age, 982 (15. 1 %) had diarrhoea on the day of the interview or had had diarrhoea at some time during the previous 15 days. A total of 66 % of the children were not taken for treatment, while government health services were used by 14%, private doctors by 1%, and traditional healers (rezadeiras) by 24%. Oral rehydration therapy was given to 24.3 % of the children as follows: solutions of oral rehydration salts (ORS) were received by 6.8%, salt-and-sugar solutions by 14.7%, and solutions of commercial ORS brands by 4.3%. Although 95 % of the caretakers knew about rehydration solutions, only 18 % prepared them correctly, the most common error being the use of insufficient water. Of the rehydration solutions used, 39 % had a sodium concentration that was potentially dangerous (> 120 mmol/l), and 8 % had a sodium concentration that was very low. Of those solutions prepared using ORS, 38 % had too high a sodium concentration, while 14 % of the salt-and-sugar solutions prepared using either the "scoop-and-pinch " approach or a plastic spoon were too concentrated. However, potentially the most dangerous were the salt-and-sugar solutions prepared using nonstandard recipes. More than half of these had an unacceptably high sodium concentration or osmolarity