DHAKA Score for Paediatric Dehydration Assessment
DHAKA Dehydration Score (Levine 2015) for children under 5 with acute diarrhoea: general appearance, respirations, skin pinch and tears (0–12). Derived and externally validated in Dhaka, Bangladesh.
Score interpretation
DHAKA 0–1: no dehydration (< 3 % weight loss).
→ Continue feeding and fluids at home with oral rehydration solution (WHO Plan A / NICE CG84); safety-net advice.
DHAKA 2–3: some dehydration (3–9 % weight loss).
→ Oral rehydration solution in the volume set by weight over 4 hours (WHO Plan B / NICE CG84); reassess; nasogastric or IV fluids if oral rehydration fails.
DHAKA ≥ 4: severe dehydration (> 9 % weight loss).
→ Urgent IV rehydration per WHO Plan C / NICE CG84 and the local paediatric fluid protocol; check glucose and electrolytes; senior paediatric review.
Interpretation bands for the DHAKA Score. Apply clinical judgement and local guidance.
References
- Levine AC et al. Empirically derived dehydration scoring and decision tree models for children with diarrhea: assessment and internal validation in a prospective cohort study in Dhaka, Bangladesh. Glob Health Sci Pract. 2015;3(3):405-418.
- Levine AC et al. External validation of the DHAKA score and comparison with the current IMCI algorithm for the assessment of dehydration in children with diarrhoea: a prospective cohort study. Lancet Glob Health. 2016;4(10):e744-e751.
Related
Curated clinical cross-links plus same-class fallbacks.
- Potassium chloride with rice powder, sodium chloride and sodium citrate · Oral rehydration salts
- Disodium hydrogen citrate with glucose, potassium chloride and sodium chloride · Oral rehydration salts (ORS)
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Diazepam (Paediatric) · Benzodiazepine — Status Epilepticus / Febrile Convulsions (Community)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
