Diarrhea was the leading cause of child mortality in 1980. Several powerful interventions have been implemented simultaneously, more or less over the past decade, to control diarrhea.

Oral rehydration therapy (ORT), introduced in 1979, rapidly acquired the prime place in programmes for controlling diarrhoeal diseases.

The present report highlighted the strategy for controlling diarrhea through case management, with special reference to ORT, and the relationship between its implementation and reduced mortality. Population-based data on the scope and quality of facility-based use of ORT is inadequate, despite its potential significance in lowering mortality, especially for severe cases. 

We have very little data on ORT use rates during the 1980s; however, this improved by the mid-1990s. The study of time trends is limited by using several different definitions of ORT. Still, the available data indicate positive trends in diarrhea management globally. 

ORT is now prescribed to the majority of children with diarrhea. The annual number of deaths from diarrhea among children under five years fell nearly three times from 1980 to today. Reports from Brazil, Egypt, Mexico, and the Philippines confirm an increase in ORT use and a significant decline in mortality.

Experience with ORT will help guide child survival programmes. Adequate political and financial support will help successfully deliver cost-effective interventions other than that of immunization by national programmes. There is a need for establishing standard indicators and measurement methods for diarrhea, as it is available for other childhood diseases.

Victora CG, Bryce J, Fontaine O, Monasch R. Reducing deaths from diarrhea through oral rehydration therapy. Bulletin of the World Health Organization, 2000, 78: 1246–1255