Evidence map›Paper›PMID 39641334›Full record

SynthesisJournal of global health2024

Low-osmolarity oral rehydration solution for childhood diarrhoea: A systematic review and meta-analysis.

Mustafa Bin Ali Zubairi, Syeda Kanza Naqvi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K Das

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

10 authors.

Mustafa Bin Ali ZubairiInstitute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
Syeda Kanza NaqviInstitute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
Ayesha Arshad AliInstitute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
Ashraf SharifUniversity Library, Aga Khan University, Karachi, Pakistan.
Rehana Abdus SalamThe Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
Zain HasnainInstitute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
Sajid SoofiCentre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Shabina AriffDepartment of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan.
Yasir Bin NisarDepartment of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
Jai K DasInstitute for Global Health and Development, Aga Khan University, Karachi, Pakistan.

Funding

World Health Organization 001
6 · The paper itself

Abstract

Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS. With this systematic review, we aimed to assess the effectiveness of LORS compared to standard ORS for the treatment of acute and persistent diarrhoea. Methods: We comprehensively searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus until 20 July 2023 for studies published after 1990 assessing the efficacy of LORS in acute and persistent diarrhoea in children under 10 years of age. Meta-analysis was conducted using the RevMan software. We performed log approximation for all the values for an outcome when studies reported arithmetic and geometric means per the Cochrane Handbook. We otherwise used the Cochrane Risk of Bias II tool to assess the risk of bias in individual studies, and assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations approach. This review was commissioned by the WHO for revision of guidelines for childhood diarrhoea. Results: For the comparison of LORS to standard ORS in acute diarrhoea, our findings suggest that there was a significant decrease in the duration of diarrhoea (mean difference (MD) = -0.28; 95% confidence interval (CI) = -0.41, -0.15; moderate certainty of evidence), stool output (MD = -0.25; 95% CI = -0.35, -0.16; very low certainty of evidence), and ORS intake (MD = -0.18; 95% CI = -0.28, -0.07; moderate certainty of evidence) in patients receiving LORS. There was a comparable effect on the number of patients cured within five days, treatment failure, and frequency of unscheduled intravenous therapy (risk ratio (RR) = 0.77; 95% CI = 0.72, 9.38; low certainty of evidence). For persistent diarrhoea, there was a significant decrease in duration of diarrhoea (MD = -30.60; 95% CI = -48.95, -12.25), stool output (MD = -14.00; 95% CI = -26.63, -1.37), and ORS intake (MD = -21.40; 95% CI = -41.01, -1.79), while there was a comparable effect on the number of patients cured. Conclusion: Our findings suggest that LORS should continue to be recommended in children under the age of 10 years with acute watery or persistent diarrhoea and upholds the current WHO recommendations. Registration: PROSPERO: CRD42023438762.

Indexed as

DiarrheaFluid TherapyRehydration SolutionsChildChild, PreschoolHumansInfantOsmolar ConcentrationRehydration Solutions

Identifiers

PMID39641334
PMCPMC11622343

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.