A diarrheal diseases control program among Nicaraguan refugee children in Campo Luna, Honduras.

A pilot study was planned and carried out in a Nicaraguan refugee camp in Honduras during November and December 1978 in an effort to reduce the incidence of severe dehydration among diarrheal patients arriving at the health center and to determine whether or not an auxiliary with limited training could correctly triage and supervise oral rehydration of children with diarrheal diseases. 71 refugee children arriving at the Camp Luna Health Center with mild or moderate diarrhea were admitted to the study. Diagnoses and assessments of dehydration were performed by a trained nurse auxiliary solely on the basis of the following clinical signs: decreased skin turgor; sunken eyes or fontanel; rapid, faint, or irregular radial pulse; diminished urine output; dry mucosa; and general appearance. Mothers were provided with 2 liters of "Oralyte" solution and were instructed to administer as much solution to the children as they could tolerate, beginning with an initial regimen of 200cc every 3-4 hours. Breastfeeding was encouraged. The auxiliary demonstrated how to correctly prepare and use the solution. 83% of the cases occurred in children younger than age 2, 66 of the 71 children completed the course of treatment, and 52 (80%) were completely asymptomatic at discharge. 12 were fully rehydrated but had persistent mucoid stools; 1 was discharged despite continued vomiting; and 1 was referred to a hospital. Overall, the study underscored the need to educate mothers regarding diarrheal disease and the proper use of oral rehydration. The study demonstrated that with proper instruction and supervision mothers can successfully deliver oral rehydration therapy to their children in a field setting.