Assessing the Severity of Dehydration of Children in Low-Resource Settings

Abstract

Introduction: Diarrhoea is currently the second major cause of child mortality, which mostly affects children in developing countries. Dehydration is the major risk involved with diarrhoea, which is therefore the actual cause of death in most cases. Currently there are no cheap and reliable methods for assessing dehydration, while dehydration assessment is key for determining proper treatment. In this research two digitally measured diagnostic variables will be investigated: skin turgor and capillary refill time. Research Question: Does the severity of dehydration significantly correlated with increased capillary refill time and decreased skin turgor, when these variables are measured objectively using digital methods? Methods: To objectively measure skin turgor and capillary refill time, two experimental devices were used: the Cutometer and a prototype using green-light photoplethysmography (respectively). An experiment was conducted where subject volunteers were dehydrated. The loss of body-mass was used as the gold-standard for measuring dehydration. A regression analysis was conducted to determine the adjusted coefficients of determination R^2. Results: R^2 for most parameters of interest show arbitrary results. One parameter that stood out was R2 of the Cutometer, which represents skin elasticity. This parameter showed relatively high consistency in terms of high $\bar{R^2}$ and trends, although still it seems to be subject to noise. Discussion: Most results showed to be quite unexpected and arbitrary. It is believed that this might be primarily due to some considerable limitations of the experiment and equipment. Most importantly, it is believed that the dehydration achieved with the subjects was not high enough to have effect on the measurements. Conclusions: In general, no significant relations have been detected between the variables of interest and the severity of dehydration. The results should be interpreted with care, due to the major limitations of the experiment and the equipment. Recommendations: Future research should focus on building a set prototypes based on different technological principles and diagnostic variables. Also, using these prototypes, a data-collection study in the field should be conducted in areas where child-dehydration is frequent. Data collected will be much more representative. All collected data should be used for building a regression model for future diagnostic devices.