DEATH DUE TO ACUTE DIARRHEA IN CHILDREN - A STUDY OF PROGNOSTIC FACTORS

Objective. To identify, prognostic factors of death due to acute diarr hea related to the process disease-health care death in the State of T laxcala, Mexico. Material and methods, A case-control design was used. Cases were defined as children who died between the ages of seventy-t wo hours and five years between 1992 and 1994. An event of acute diarr hea was the main cause of death stated in the death certificate, Case ascertainment was done through the verbal autopsy method. Controls wer e children who had suffered acute diarrhea with at least one sign of d ehydration or alarm and had overcome the diarrheal episode. Controls w ere randomly selected from the population at large and were matched by age with cases. Results, One hundred and six cases and the same numbe r of controls were taken. Using a logistic regression procedure in whi ch severity of illness and days of evolution were controlled for, the prognosis-worsening predictors were: visit provided by private physici an (OR 8.9); inappropriate treatment (OR 10.4), a working mother (OR 8 .7); mothers' lack of knowledge to identify dehydration signs (OR 8.1) ; siblings' malnutrition (OR 28.2); and malnutrition prior to the diar rheal event (OR 7.5). Conclusions, These findings suggest that factors worsening the outcome of the diarrheal episode are: malnutrition, the inappropriate treatment provided by private physicians, and the defic ient household care of the diarrheal episode.