A profile of children admitted to a rehydration unit.

Abstract

The first twelve months operation of a five-bed rehydration unit at Osindisweni Hospital is described and data related to admissions presented. Osindisweni hospital is situated in a rural area north of Durban and has approximately 300 general beds with 60 000 outpatient attendances per year. A profile of children admitted to this unit was obtained and results are analysed according to the objectives of this study. The main findings of the study showed that 269 children were admitted to the unit during the study year and the majority of children were black African children, below three years of age, coming from rural areas. The children presented with acute diarrhoeal dehydration mostly of mild to moderate degree and were normally managed by oral rehydration therapy. Eighty-four percent of these children were successfully managed on the rehydration unit and only 13,7% received IV fluids. The majority of children requiring transfer to the ward had either persistent dehydrating diarrhoea or other complications such as malnutrition or septicaemia. No child died on the unit and no child died as a result of dehydration but 4 children died later as inpatients on the children's ward. The mortality of children admitted to the unit was therefore 1,5%. One hundred and nine patients were followed up (41,6% of questionnaires) and of these only 76 (69,7%) actually came for review the others presenting for other illnesses or else interviewed on the wards after transfer. However, most of these children had either no or minor complaints on follow up. Seventeen and a half percent of children were below the 3rd centile for age on discharge. Children with marasmus and/or kwashiorkor were not admitted to the unit. The availability of health care was poorly assessed but indicated a general lack of facilities for the rural population served. Also it was noted that the principles of G.O.B.I. had been poorly taught at Osindisweni in the past, particularly growth . charts. Mothers received health education on the unit and were found to have a good understanding of G.O.B.I. after their stay on the unit. On the whole the unit was well accepted by the mothers. It is thought that this short-stay oral rehydration unit offers a more appropriate and more cost effective alternative to previous methods of in-patient management of children with diarrhoeal dehydration and that it offers an excellent opportunity for health education.