During a conference on diarrhoeal diseases in Tanzania in 1984, 19 participants representing 16 countries in Africa gave the formulae for oral rehydration solutions therapy (ORS) which they recommended or instructed for home use in their own countries. There were gross variations in recommended quantities of sugar, salt and water. Theoretical calculations indicated that the glucose concentration ranged from 29 to 174 mmol/l (recommended 30-112 mmol/l) and that of sodium from 9 to 116 mmol/l (recommended 30-80 mmol/l). It is very important that countries should ensure that the recommendations for making up oral rehydration solutions be standardized, otherwise dangerous or ineffectual concentrations of salt and sugar solutions may be used for rehydrating children.
PIP: The composition of the salt and sugar solutions used for the treatment of diarrheal diseases varies considerably as a result of different methods for preparing the solution and the variety of measures and containers used. During a conference on diarrheal diseases in Tanzania in 1984, the 19 participants from 16 African countries were asked to give the formula for oral rehydration solutions therapy recommended for home use in their countries. The concentrations of glucose and sodium in some solutions varied widely from the World Health Organization (WHO) recommended formula. Reported glucose concentrations ranged from 29-174 mmol/liter and those of sodium ranged from 9-116 mmol/liter. WHO recommends that these homemade sugar-salt rehydration solutions should contain 8 level teaspoons of sugar and 1 level teaspoon of salt added to 1 liter of water. This results in a concentration of 116 mmol/liter of glucose and 86 mmol/liter of sodium. In many cases, errors arise from the use of a pinch of salt rather than a level teaspoonful and use of a tablespoonful rather than a teaspoonful of sugar. There is the danger that solutions that do not conform to the recommended composition will be either ineffectual or actually dangerous. Thus, special care should be taken to standardize the recommendations for the preparation of sugar-salt rehydration solutions. This process can be facilitated through the use of a standard teaspoon and bottle as measures.