Almost 1.6 million people died from diarrheal diseases in 2017.
1.6 million individuals.
And one-third of them were children under five.
Diarrheal disease, which is predominantly caused by contaminated food and water, strips the body of the water and salts necessary for normal function, resulting in the severe dehydration and fluid loss that are responsible for most diarrhea deaths. The cause of the disease may be viral, bacterial, or parasitic.
For pregnant women and young children, the potential risks of diarrheal disease are greater. For young children, diarrhea has the ability to exact more harm as they more easily can become dehydrated due to their smaller bodies and fluid reserves. For pregnant women, fluid needs increase “in order to support fetal circulation, amniotic fluid, and a higher blood volume.” Adequate fluid supply helps ensure that a mother can withstand blood loss during delivery. In fact, blood volume increases by 45% on average during pregnancy. Therefore, diarrheal diseases that lead to dehydration can make it impossible for a woman to maintain a healthy pregnancy or ensure a healthy delivery.
Oral Rehydration Solution or Therapy (ORS or ORT) was the product of years of research done in the mid-1900s to alleviate the burden of diarrheal deaths, especially during outbreaks of diseases like cholera. A mixture of water, sugar and salt, ORS helps replace water and electrolytes lost during the course of diarrheal disease. The solution works by taking advantage of what is known as glucose-coupled sodium transport in the small intestine, a system in which glucose aids the transport of sodium, and secondarily, water, out of the intestine and into the body.
A far cheaper alternative to the traditional IV treatment for diarrhea, ORS has been the "cornerstone of treatment programs to prevent life-threatening dehydration associated with diarrhoea” since the late 1970s.
However, not all ORS products are the same. Charlene Riikonen, founder of Cera Products Inc., a company that sells ORS products, wanted to produce a more effective ORS. In the early 1990s, after years of working in the field promoting traditional ORS products made with simple sugars, she started Cera Products Inc.
Riikonen’s work with other ORS pioneers in Bangladesh found that rice-based ORSs, as compared to simple sugar ORSs, were far more effective at treating dehydration. She went on to patent her rice-based ORS formula - a formula now used in products sold by Cera around the world, including Ceralyte, Cera’s clinical ORS product line.
Rice-based ORS products have a number of benefits compared to the traditional simple-sugar ORS products. Rice-based products have a lower osmolarity, or particles in the solution, which reduces irritability in the gastrointestinal tract and increases the rate at which fluids are reabsorbed into the body. In addition, rice is absorbed throughout the entire small intestine - as opposed to just the top two-thirds with simple sugars - meaning more water and electrolytes can be absorbed into the body. Through research and field studies, Ceralyte has been shown to be effective in decreasing fluid loss and shortening acute diarrheal sickness. Ceralyte is also certified low FODMAP, making the product accessible to people with irritable bowel syndrome (IBS) and other gastrointestinal issues.
Ceralyte complies with and exceeds the World Health Organization’s standards as an ORS and is currently being used around the world.
Innovations like Ceralyte that are built on a commitment to further research and improvement of existing technologies to improve global health are critical to the fight that continues today to eliminate sources of morbidity and mortality that still touch the lives of millions around the globe.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.