posts: 26820

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    "id": "wp-26820",
    "slug": "untitled-reusable-block-110",
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                        "text": "We are not benefiting from the full potential of ORT. The main reason for this is that it is not as widely used as it could be. As the map shows, the coverage of ORT is still low.",
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                        "text": "According to data from UNICEF, on average only 44% of children with diarrhea receive ORT (you can view this data on the Chart tab in the interactive visualization).{ref}",
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                        "url": "https://data.unicef.org/topic/child-health/diarrhoeal-disease/",
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                                "text": "https://data.unicef.org/topic/child-health/diarrhoeal-disease/",
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                        "text": "{/ref} In some countries the coverage is very low, at less than 1-in-5.",
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                        "text": "Of course, one has to ask: does every child with diarrhea need ORT? According to the current WHO guidelines, the need for ORT should be determined based on the degree of child\u2019s dehydration.{ref}World Health Organization.",
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                        "url": "https://apps.who.int/iris/handle/10665/43209",
                        "children": [
                            {
                                "text": " The treatment of diarrhoea: a manual for physicians and other senior health workers.",
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                        "text": " No. WHO/FCH/CAH/05.1. Geneva: World Health Organization, 2005.{/ref} If a child has diarrhea but is not dehydrated, home treatment with fluids that contain salt, such as rice water or chicken stock, is sufficient. If a packet of ORT salts is available it can be used but is not a necessary treatment. If a child has moderate or severe dehydration, ORT should be given. According to a study conducted in 2012, 35.2% of all diarrheal cases in children were classified as moderate or severe, suggesting that at least a third of diarrheal instances should have been treated with ORT: in 2012 that accounted for 588 million diarrheal episodes.{ref}Lamberti, Laura M., Christa L. Fischer Walker, and Robert E. Black. ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364857/",
                        "children": [
                            {
                                "text": "\"Systematic review of diarrhea duration and severity in children and adults in low-and middle-income countries.\"",
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                        ],
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                        "children": [
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                                "text": "BMC public health",
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                    {
                        "text": " 12.1 (2012): 276.{/ref}",
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                        "text": "Greater promotion and education about the use of ORT in healthcare facilities and community centers could potentially increase ORT coverage. In addition to increasing coverage, more lives could also potentially be saved by switching to a more effective 'low osmolarity' ORT formulation, that is currently recommended by the WHO.{ref}We don't yet know well the potential magnitude of the additional benefits of low osmolarity ORT solution. ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2755312/",
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                                "text": "The WHO recommends",
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                        "text": " switching to low osmolarity ORT formulation supplemented with zinc, which has been shown to shorten the duration of the diarrheal episode, reduce stool output, and lessen the likelihood of another diarrheal episode in the months following the treatment. Some ",
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                    {
                        "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)09528-4/fulltext",
                        "children": [
                            {
                                "text": "concerns were initially raised",
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                        "text": " about the magnitude of additional benefits of reduced osmolarity ORT, but the WHO recommendation cited above reflects the fact that the medical community has now generally adopted its wide promotion, while noting the importance of an ongoing update of the guidelines when new data becomes available.{/ref}",
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                "url": "https://ourworldindata.org/grapher/children-who-receive-ors",
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                "text": [
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                        "text": "How many more lives could ORT save?",
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                        "text": "An analysis from 2010 by Munos et ",
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                    {
                        "children": [
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                                "text": "al.",
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                        "text": " in the ",
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                    {
                        "children": [
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                                "text": "International Journal of Epidemiology ",
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                        "text": "is the most widely cited study that provides estimates for the number of potential lives a wider use of ORT could save. The study looked at all the available literature on ORT at the time and suggested that, if every child who needs ORT would receive it, 93% of child deaths caused by diarrhea could be prevented.{ref}Munos, Melinda K., Christa L. Fischer Walker, and Robert E. Black. \"",
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                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845864/",
                        "children": [
                            {
                                "text": "The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality.",
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                        ],
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                    },
                    {
                        "text": "\" ",
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                    },
                    {
                        "children": [
                            {
                                "text": "International Journal of Epidemiology",
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                    },
                    {
                        "text": " 39.suppl_1 (2010): i75-i87.{/ref}",
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                        "text": " This implies a huge potential for ORT.",
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                        "text": "We should be somewhat cautious, however. The study is the only currently available published research review that measures the effectiveness of ORT. And because there are only a few studies that have looked at how providing ORT directly affects child mortality, the 93% figure was determined based on a very small sample. Furthermore, it should be noted that children with diarrhea often have associated comorbidities, such as ",
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                    {
                        "url": "https://ourworldindata.org/hunger-and-undernourishment",
                        "children": [
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                                "text": "malnutrition",
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                        "text": " and viral or bacterial infections. These comorbidities may require treatments in addition to ORT, which was not assessed in the Munos et ",
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                    },
                    {
                        "children": [
                            {
                                "text": "al.",
                                "spanType": "span-simple-text"
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                        ],
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                    },
                    {
                        "text": " study.{ref}Kotloff, Karen L., et al. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60844-2/fulltext",
                        "children": [
                            {
                                "text": "\"Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study.\" ",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    {
                        "children": [
                            {
                                "text": "The Lancet",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": " 382.9888 (2013): 209-222.{/ref} {ref}Akech, Samuel, et al. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(18)30130-5/fulltext",
                        "children": [
                            {
                                "text": "\"Risk factors for mortality and effect of correct fluid prescription in children with diarrhoea and dehydration without severe acute malnutrition admitted to Kenyan hospitals: an observational, association study.\"",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    {
                        "children": [
                            {
                                "text": "The Lancet Child & Adolescent Health",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": " 2.7 (2018): 516-524.{/ref} {ref}Chhagan, Meera K., and Shuaib Kauchali. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pubmed/16567985",
                        "children": [
                            {
                                "text": "\"Comorbidities and mortality among children hospitalized with diarrheal disease in an area of high prevalence of human immunodeficiency virus infection.\"",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": "The Pediatric infectious disease journal",
                                "spanType": "span-simple-text"
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                        ],
                        "spanType": "span-italic"
                    },
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                        "text": " 25.4 (2006): 333-338.{/ref} Organizations including WHO, UNICEF and GiveWell cite the 93% figure, but also note its limitations.{ref}GiveWell. (2017). ",
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                    {
                        "url": "https://www.givewell.org/international/technical/programs/oral-rehydration-solution#footnote17_hx3aobz",
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                                "children": [
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                                        "text": "Oral Rehydration Solution",
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                            },
                            {
                                "text": ".",
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                    },
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                        "text": " [online] givewell.org [Accessed 24 Jun. 2019].{/ref}",
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                        "text": "World Health Organization, and Unicef. \"Ending preventable child deaths from pneumonia and Diarrhea by 2025: the integrated global action plan for pneumonia and Diarrhea (GAPPD).\" (2013).",
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                        "text": "Another notable study published in ",
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                        "children": [
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                                "text": "The Lancet",
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                        "text": " in 2003 estimated the potential of ORT and other treatments to prevent all-cause child mortality.{ref}Jones, Gareth, et al. \"How many child deaths can we prevent this year?.\" The Lancet 362.9377 (2003): 65-71.{/ref} This study concluded that, in the year 2000, 88% of deaths from diarrheal diseases could have been prevented if available treatments and interventions were used to their full extent. Full coverage of ORT, specifically, could have saved the lives of around 68% of children who died from diarrhea in that year.",
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                        "text": "More studies are clearly needed. But even if we are cautious and consider these figures overestimates, the evidence still suggests that ORT could be saving hundreds of thousands of more lives if its coverage was increased.",
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                        "text": "It is worth noting that the potential of ORT does not stop at saving the lives of children. ORT can be used to effectively treat adults as well.{ref}Manatsathit, Sathaporn, et al. ",
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                    {
                        "url": "https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-1746.17.s1.11.x?sid=nlm%3Apubmed",
                        "children": [
                            {
                                "text": "\"Guideline for the management of acute diarrhea in adults.\"",
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                        ],
                        "spanType": "span-link"
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                    {
                        "children": [
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                                "text": "Journal of Gastroenterology and Hepatology",
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                    },
                    {
                        "text": " 17 (2002): S54-S71.{/ref} People aged 70 and older are the ",
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                        "url": "https://ourworldindata.org/grapher/deaths-from-diarrheal-diseases-by-age",
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                                "text": "largest demographic",
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                        "text": " dying from diarrheal diseases. With ",
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                    {
                        "url": "https://ourworldindata.org/world-population-growth#the-global-population-pyramid-how-global-demography-has-changed-and-what-we-can-expect-for-the-21st-century",
                        "children": [
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                                "text": "increasing numbers of people",
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                        "text": " reaching older age today, the number of older people suffering from diarrhoeal diseases can be expected to grow.",
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                        "text": "The fact that we are not using ORT to its full potential becomes clear when we look at ",
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                        "url": "https://ourworldindata.org/grapher/number-of-children-dying-from-diarrheal-diseases",
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                                "text": "the distribution of deaths",
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                        "text": " from diarrheal disease among children in different regions: the vast majority of cases occur in South Asia and Sub-Saharan Africa where, as the map above shows, ORT coverage is very low at just 37 and 39 percent, respectively.{ref}UNICEF DATA. (2019). ",
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                        "url": "https://data.unicef.org/topic/child-health/diarrhoeal-disease/",
                        "children": [
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                                "text": "Diarrhoeal disease - UNICEF DATA.",
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                        "text": " [online] data.unicef.org [Accessed 24 Aug. 2019].{/ref}",
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                        "text": "What is so amazing about ORT is not only that it is simple, practical and effective, but, like so many scientific discoveries, once it has been discovered, everyone can benefit from this knowledge. It is what economists call a nonrival good. In fact, Paul Romer, the winner of the 2018 Nobel Memorial Prize in Economic Sciences, often uses ORT as his favourite example of a nonrival good \u2013 an idea which does not diminish in its value the more people adopt it and use it.{ref}Jones, C. (2018). ",
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                    {
                        "url": "https://voxeu.org/article/new-ideas-about-new-ideas-paul-romer-nobel-laureate",
                        "children": [
                            {
                                "text": "New ideas about new ideas: Paul Romer, Nobel laureate.",
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                        "text": " [online] Voxeu.org. [Accessed 24 Jun. 2019].{/ref}",
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                        "text": "Ideas that save millions are far and few between, and ORT is perhaps one of the simplest. We can use simple ideas to solve complex problems, such as how to save the lives of as many children as possible.",
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        "type": "article",
        "title": "ORT could ho further",
        "authors": [
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        "dateline": "November 1, 2019",
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    "createdAt": "2019-11-01T14:55:05.000Z",
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    "updatedAt": "2020-04-30T14:00:12.000Z",
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    "publishedAt": "2019-11-01T14:54:47.000Z",
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