Can ketchup packets promote Diarrhea treatment?

Zinc is converted from tablets to liquid for delivery in ketchup-like packets. Image: Orianna DeMasi.
Zinc is converted from tablets to liquid for delivery in ketchup-like packets. Image: Orianna DeMasi.

By Ali Hussain

What does a ketchup pack have to do with a lifesaving treatment for childhood diarrhea in the developing world?

Quite a lot, it turns out.

According to the World Health Organization, every year 1.5 million people die from diarrheal diseases. The Global Center of Food Systems Innovation at Michigan State University funded a team of students at the University of California, Berkeley, to participate in a course called ‘Eat.Think.Zinc!’ They explored health products-packaging solutions to address critical public health challenges.

Orianna DeMasi, one of the students, designed prototypes similar to ketchup containers to promote the use of zinc for treating diarrhea. Then she went to Uganda to see if it worked.

Zinc packets prototypes. Image: Orianna DeMasi.
Zinc packets prototypes. Image: Orianna DeMasi.

Zinc, usually available as tablets in blister packs, is given for 10-14 days to treat diarrhea, said DeMasi. Typically it is given by dissolving one 20 mg tablet in one tablespoon of water.

Zinc can reduce by 25 percent the time a child is afflicted with diarrhea. It reduces the likelihood of a re-occurrence for up to three months. It treats the rotavirus, the root cause of childhood diarrhea in rural areas.

DeMasi proposed that zinc in ketchup-like packs could improve treatment because it is simpler to administer. She travelled to Uganda in the spring of 2014 to conduct a focus group with seven mothers and discovered four major problems related to diarrhea treatment:

  • Zinc is unavailable
  • There is a lack of education about correct treatment
  • Zinc is too expensive for many people
  • There is a lack of clean water in rural areas

DeMasi designed and field-tested a suite of ways to deliver the medicine. Zinc tablets were crushed and mixed with edible substances of different flavors. Different ketchup packets were tested to explore their ease of carry and use.

The mothers provided feedback.

AdministeringZincOne said the medicine was too thick, like mucous, DeMasi said. Others objected to the shape of a container, saying it looked more like a condom than children’s medicine. Packaging the medicine in a little bottle was well-received, but it was designed to last for single use. Mothers wanted to last it longer for multiple uses, DeMasi said.

She discovered that people are more familiar with syrup as medication and preferred the zinc in flavored syrup rather than in tablets. They also liked the transparent package more because they could see the material being administered to their child.

The project looked at how to get mothers in rural Uganda to use zinc for treating diarrhea in their infants. The student found that although the prototype packaging wasn’t ideal, the mothers did want a different package than what was available to them to ease their adoption of the correct treatment, DeMasi said.

The project was funded by the Global Center of Food Systems Innovations at Michigan State University. The University of California, Berkeley, project team was comprised of Jennifer Chaussee, a master’ student in the Graduate School of Journalism; Emily Claymore, a masters student in Health & Social Behavior and Orianna DeMasi, a doctoral student in Electrical Engineering & Computer Science.

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