Risk and prognostic factors for diarrheal disease in Brazilian infants: a special case-control design application

Abstract

The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework. A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988. Three groups were investigated, with 192 children each. The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration. The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases. The third group consisted of controls without diarrhea. Mothers were interviewed by trained interviewers using a standardized questionnaire. Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression. Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea. Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea.

On-plot drinking water supplies and health: A systematic review

“…Children from households in Afghanistan lacking water on-plot were found to have higher risk of diarrhea than children from households with on-plot access in the univariate analysis, but not the multivariate analysis (HR=1.08, 95% CI: 0.95-1.23, p=0.239) (Aluisio et al, 2015). Findings from studies in Brazil and Malaysia were suggestive of an association between access to indoor on-plot water supply and diarrhea, but not significant ((p=0.08) (Fuchs and Victora, 2002) (OR=1.73, 95% CI: 0.58-5.17) (Knight et al, 1992)). In urban Morocco, children and adults in households who gained access to on-plot water did not experience significant changes in diarrhea incidence compared to the control group, who used public taps, neighbors' taps, informal connections, or other water sources (RR=0.84, p>0.05) (Devoto et al, 2011).…”

“…One study did not analyze differences between water sources (Knight et al, 1992) and the remaining seven studies found similar levels of contamination across on-and off-plot supplies (Devoto et al, 2011;Bailey and Archer, 2004;van der Hoek et al, 2001;Ryder et al, 1985;Rajasekaran et al, 1977;Hollister et al, 1955;Watt et al, 1953), including surface water (Bailey and Archer, 2004;Ryder et al, 1985;van der Hoek et al, 2001). Three additional studies including surface water in the referent group to on-plot access did not report water quality (Fuchs and Victora, 2002;Mason et al, 1986;van der Hoek et al, 2002). Two studies reported that households with on-plot water sources stored water in containers, where it was contaminated (Ryder et al, 1985;Rajasekaran et al, 1977).…”

Acute diarrhea in hospitalized children of the municipality of juiz de fora, MG, Brazil: prevalence and risk factors associated with disease severity

“…The risk factors associated with disease severity and the need of hospitalization may be explained by a multi-causal model of the inter-relation of socioeconomic, demographic, biological and cultural variables (13,14) . Identification of these factors can effectively contribute to a greater understanding of the eco-epidemiologic patterns of ADD, and for the adoption of preventive measures (30) .…”

Fatores de risco para internamento por diarréia aguda em menores de dois anos: estudo de caso-controle

“…Isso poderia ser explicado porque provavelmente a educação materna não é um fator de risco independente das condições de vida, sendo apontada por alguns autores como um indicador da situação socioeconômica da família (Desai & Alva, 1998;Fuchs & Victora, 2002;Fuchs et al, 1996;Guimarães, 1998). Neste estudo, o trabalho materno fora de casa e a existência de rede de suporte não apresentaram associação com o risco de internamento, concordante com outros estudos (Fuchs & Victora, 2002;Fuchs et al, 1996;Gonzalez, 1998). No entanto, sua importância recaiu na faixa etária do guardião da criança, como demonstrado pelo maior risco de internamento entre as crianças que ficavam sob a guarda de adolescentes na ausência das mães, por não terem legitimidade para exercer a tarefa a eles delegada.…”

“…O sinergismo existente entre evolução desfavorável do episódio diarréico e baixa idade conta com vasta documentação científica (Fuchs & Victora, 2002;Fuchs et al, 1996;Islam et al, 1996;Victora & Barros, 1989). As crianças menores de seis meses, por sua fragilidade bioló-gica, são o grupo mais vulnerável, especialmente em condições adversas, tanto ao adoecimento por diarréia quanto ao agravamento da doença que determina a hospitalização.…”