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  • Title: Some aspects of Diarrhoea Training and Treatment Unit in Infectious Diseases Hospital, Calcutta.
    Author: Kumar S, Debnath A, Goswami A.
    Journal: Indian J Public Health; 1994; 38(2):81-6. PubMed ID: 7836003.
    Abstract:
    An analysis of hospital admission records and case histories from 1989 to 1993 and interviews with hospital administrators, physicians, and mothers of hospitalized patients were conducted to examine the benefits of establishing the Diarrhoea Treatment and Training Unit (DTU) in June 1991 at the Infectious Diseases Hospital in Calcutta, India. The case fatality rate of all diarrhea patients fell between 1989 and 1993 from 4.5% to 2.5%. Among patients less than 5 years old, it ranged from 12.7% in 1989 to 2.1% in 1992. The proportion of total cases successfully managed by using oral rehydration therapy (ORT) increased from 37% to 78.9% between 1991 and 1993. In 1989-1990, the hospital used 12,740 and 14,640 units of intravenous (IV) fluids. By 1993, it used only 7200 units of IV fluids. The use of packets of oral rehydration salts increased from 6000 in 1989 to 24,000 in 1993 (23,000 in 1993). Antibiotic use fell considerably (1989-1993, 100-31.5% of cases). The cost of treating each diarrhea patient decreased from Rs.84.50 to Rs.19.10. Before the DTU, the hospital did not allow mothers and other family members to stay with children who had diarrhea. Thus, young children could not be breast fed. Now, mothers stay with the children to administer ORT and to continue breast feeding. DTU staff train mothers in how to administer ORT and to continue it at home, to feed during and after diarrhea, and to recognize danger signs. These findings show that setting up the DTU reduced the case fatality rate of diarrhea patients and the cost of diarrhea treatment. They indicate the need to establish DTUs in major hospitals and ORT corners in all block primary health centers in the state.
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