Analysis of mortality from diarrheic diseases in under-five children in Brazilian cities with more than 150,000 inhabitants

Abstract

This study analyzes mortality from infectious diarrheic diseases in children under 5 years of age in Brazilian municipalities with more than 150,000 inhabitants, excluding State capitals. The annual mortality rates by municipality from 1990 to 2000 were analyzed using a multilevel model, with years as first level units nested in municipalities as second level units. The dependent variable was the yearly mortality rate by municipality, on the log scale. Polynomial time trends and indicator variables to account for differences in geographic regions were used in the modeling. Time trends were centered on 1995, so they could be modeled differently before and after 1995. From 1990 to 1995 there was a sharp decrease in mortality rates by diarrheic diseases in most Brazilian municipalities, while from 1995 to 2000 the decrease was more heterogeneous. In 1995 the North and Northeast of Brazil had higher mortality rates than the Southeast, and the differences were statistically significant. Most importantly, the study concludes that there was an important difference in the pattern of mortality rate decreases over time, comparing the country's five geographic regions.

Spatial distribution for diarrhea hospitalization in São Paulo State

“…17 Other studies show that maternal schooling presents a direct relation to the quality of care offered to the children, specifically about the prevention of gastroenteritis, such as hygiene, immunization and breastfeeding, 18,19 thus, the interruption of exclusive breastfeeding up to 6 months of age increases the risk of acquiring infectious diarrheal diseases. 4,20 The relation also suggests a greater ignorance about the transmission of diarrheal disease through the mothers. 21 In addition, maternal schooling is related to the capacity for apprehension of knowledge provided by the health professionals, knowledge that collaborate in preventing childhood diarrhea.…”

“…3 Studies estimate that about onethird of the Brazilian pediatric hospital beds are occupied by children with diarrheal diseases. 4 Infectious diarrhea is associated with infant morbidity and mortality and is considered a frequent syndrome 5 and places in bad condition to live and schooling are also related to a high incidence of hospitalizations due to diarrhea. 6 Spatial analysis is a great importance for the public health since it helps in the diagnosis and the planning in the affected areas through the geographic characteristic of the disease.…”

Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

“…106(3): 330-334, May 2011 Acute diarrhoea is one of the main causes of childhood morbidity and mortality worldwide (Bishop 2009). Although major improvements in sanitation and the availability of oral rehydration therapy have reduced childhood diarrhoea mortality in recent decades, Brazil included, these reductions vary from region to region (Sergio & Leon 2009). Rotavirus is the main cause of severe diarrhoea, causing 600,000 deaths and two million hospitalizations annually worldwide (Parashar et al 2006).…”

Evolution of disease mortality burden in Cuba: 1990-2005

“…Numerous recent studies on the evolution of mortality and burden of disease tend to concentrate on specific conditions or specific population subgroups 19,20,21,22,23,24 ; on the other hand, most studies covering a wide range of conditions are usually conducted at specific years 25,26 . We have not been able to find studies addressing the patterns of evolution of a wide range of conditions at a national or regional level, so the possibilities we have of comparing the results of this study are quite limited.…”