GASTROENTERITIS AND ACUTE RESPIRATORY-INFECTIONS AMONG CHILDREN UP TO5 YEARS OLD IN AN AREA OF SOUTHEASTERN BRAZIL, 1986-1987 .2. DIARRHEA

Introduction The decrease morbi-mortality gastroenteritis in is relate d to the factor responsible largely for the fall in infant mortality a nd mortality from communicable diseases in developing countries. Never theless, diarrhea is still a considerable public health problem in the se countries, especially among children under 5 years old. Objectives To describe some aspects of the of gastroenteritis epidemiology among children up to 5 years old, resident in areas of S. Paulo county. Mate rial and Method A probabilistic sample of children up to 5 years old w as studied ( n=468). The epidemiological survey was undertaken in five areas S. Paulo county (Brazil) from March 1986 to May 1987. Data were obtained through household interviews once a month over a year. Resul ts During the follow-up 139 diarrhea episodes were registered, with a mean duration of 5.5 days. Twenty percent of the diarrhea events were followed by at least one other case in the household The incidence of gastroenteritis was 2.78 episodes per 100 children/month. The highest incidence affected the children of up to 2 years of age. In 46.1% of t he gastroenteritis episodes medical assistance was not sought, the chi ldren were treated by their mothers or not at all; 51.8% of the diarrh ea events were attended to by the primary health care service, and onl y 2.1% were attended to by a hospital. No child died as a consequence of diarrhea. Of the therapeutical interventions used the most frequent were oral rehydration (25.2%) and oral rehydration with antibiotics ( 11.5%). Various socio-economic and personal background factors such as living conditions, water supply, sewarage, coverage;family income per capita and prior history of frequent gastroenteritis were associated with a higher incidence of gastroenteritis. Discussion The results see n to reflect the tendency of morbi-mortality by gastroenteritis to dec rease in S. Paulo county during the 1980's when hospital treatment of diarrhea presented a considerable reduction. This tendency must be obs erved closely, because it will influence the changes to be mode in the kind of demand for medical care.