New parameters for evaluating oral rehydration therapy: one year's experience in a major urban hospital in Zaire.

Oral rehydration therapy (ORT) is a simple treatment for diarrhoeal dehydration that must be administered correctly to be effective. In August 1984 an ORT service was established at Mama Yemo Hospital in Kinshasa, Zaire. During the first 12 months, 5530 children with diarrhoea were treated, and their clinical history and treatment evaluated. We used indicators traditionally used for individual case management as operational tools to monitor the quality of treatment on the ORT service as a whole. These included quantity of liquids prescribed and given, time spent at the centre, weight gained during rehydration, and discharge status. Analysis using these indicators showed that adverse outcome (death or hospitalization), when it did occur, was not associated with inadequate ORT treatment. Instead, it was associated with clinical antecedents including fever, measles or 'other' complaint. We conclude that indicators reflecting quality of treatment are useful in identifying operational problems associated with oral rehydration services and that our frequent conferences with the pediatric personnel helped to rectify these problems. To our knowledge, this study represents the largest hospital-based ORT population yet reported, and the first of its kind from an African country.