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Oral Rehydration Therapy (ORT)

17 Dec 2024
3 min

Why in the News?

Richard Cash, physician and global health scholar, died who was instrumental in the development of Oral Rehydration Therapy (ORT).

About ORT

  • Oral rehydration therapy (ORT) is the administration of appropriate solutions (glucose, sodium chloride, sodium bicarbonate, and potassium chloride or citrate) by mouth to prevent or correct dehydration. 
  • ORT consists of:
    • Rehydration—water and electrolytes are administered to replace losses.
    • Maintenance fluid therapy to take care of ongoing losses once rehydration is achieved (along with appropriate nutrition)
  • Richard conducted the first clinical trials of Oral Rehydration Therapy (ORT) in cholera patients in Bangladesh in the late 1960s.
  • It demonstrated that this low-cost intervention could effectively and safely reduce intravenous fluid needs.
  • Dilip Mahalanabis was an Indian pediatrician, scientist, and public health specialist who pioneered the use of oral rehydration solution (ORS) to treat diarrheal diseases. 
  • Potent in Treatment of Diarrhea and Cholera:
    • Diarrhea:
      • Reduction in Child Mortality: ORT has significantly reduced deaths from diarrheal diseases, with child mortality declining by two-thirds since 1990.
      • Nutritional Impact: ORT mitigates the nutritional effects of diarrhea in children, helping preserve their growth and development.
    • Cholera: ORT is highly effective in managing cholera patients, reducing mortality from over 50% to less than 0.2%.
  • Efficacy in Adults: The patients receiving the oral solution required 80% less intravenous fluids for cure in comparison to other techniques.

How ORT works?

  • ORT works because of the molecular mechanisms that govern sugar and sodium absorption inside the gut. 
  • The cells that make up the lining of the gut have special receptors on their surfaces that allow them to actively absorb sugar molecules. 
  • The increase in sugar and sodium inside the cells leads to increased absorption of water and chloride ions. 

Indian Initiatives

  • National Oral Rehydration Therapy Programme (1985):
    • Launched to promote the use of ORT to combat child mortality due to diarrhea.
    • Focused on awareness campaigns and training healthcare workers to administer ORT effectively.
  • National Health Mission (NHM): ORT is a critical component of NHM programs targeting childhood illnesses like diarrhea and dehydration.
  • STOP Diarrhoea Campaign

Global Initiatives

  • Oral rehydration solution (ORS) and zinc are recommended by the WHO and UNICEF to be used collectively to ensure the effective treatment of diarrhea 
  • Global Task Force on Cholera Control (GTFCC): Roadmap 2030
  • GAVI, the Vaccine Alliance: GAVI supports initiatives to prevent and treat diarrheal diseases, including the promotion of ORT.

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