Changes in Diarrheal Disease and Treatment Among Brazilian Children from 1986 to 1996

Caregiver Decision-Making: Household Response to Child Illness in sub-Saharan Africa

We draw upon a framework outlining household recognition and response to child illness proposed by Colvin and colleagues (2013) to examine factors predictive of treatment sought for a recent child illness. In particular, we model whether no treatment, middle layer treatment (traditional healer, pharmacy, community health worker, etc.), or biomedical treatment was sought for recent episodes of diarrhea, fever, or cough. Based on multinomial, multilevel analyses of Demographic and Health Surveys from 19 countries in sub-Saharan Africa, we determine that if women have no say in their own healthcare, they are unlikely to seek treatment in response to child illness. We find that women in sub-Saharan Africa need healthcare knowledge, the ability to make healthcare decisions, as well as resources to negotiate cost and travel, in order to access biomedical treatment. Past experience with medical services such as prenatal care and a skilled birth attendant also increase the odds that biomedical treatment for child illness is sought. We conclude that caregiver decision-making in response to child illness within households is critical to reducing child morbidity and mortality in sub-Saharan Africa.

BREASTFEEDING AND ACUTE DIARRHEA AMONG CHILDREN ENROLLED IN THE FAMILY HEALTH STRATEGY

This study's objectives were to identify the prevalence of breastfeeding in children younger than 12 months of age enrolled in the Family Health Strategy and identify cases of reported acute diarrhea, associating them with breastfeeding categories and factors that interfere in the practice of breastfeeding. This descriptive and cross-sectional study, based on statistical analysis, was conducted with 854 children living in a municipality in Northeastern Brazil. The prevalence of exclusive breastfeeding among children under six months of age was 32%. Exclusively breastfed children under the age of six months were less likely to experience diarrhea compared to mixed-breastfeeding children. Children using pacifiers, bottles or consuming water were less likely to be breastfed, while those consuming porridge were more likely to experience diarrhea. Strategies to promote, protect and support breastfeeding require continuous improvement, especially in regard to factors leading to early weaning, in order to achieve better indicators and improve prevention of acute diarrhea and promote child health.

Diarrhea and health inequity among Indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition

BACKGROUND

Globally, diarrhea is the second leading cause of death among children under five. In Brazil, mortality due to diarrhea underwent a significant reduction in recent decades principally due to expansion of the primary healthcare network, use of oral rehydration therapy, reduced child undernutrition, and improved access to safe drinking water. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first survey based on a nationwide representative sample to study the prevalence of diarrhea and associated factors among Indigenous children in the country.

METHODS

The survey assessed the health and nutritional status of Indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for Indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Interviews were based on a seven day recall period. Prevalence rates of acute diarrhea were calculated for independent variables and hierarchical multivariable analyses were conducted to assess associations.

RESULTS

Information on diarrhea was obtained for 5,828 children (95.1% of the total sample). The overall prevalence of diarrhea was 23.5%. Regional differences were observed, with the highest rate being in the North (38.1%). Higher risk of diarrhea was observed among younger children and those who had less maternal schooling, lower household socioeconomic status, undernutrition (weight-for-age deficit), presence of another child with diarrhea in the household, and occurrence of upper respiratory infection.

CONCLUSIONS

According to results of the First National Survey of Indigenous People's Health and Nutrition, almost a quarter of Indigenous children throughout the country had diarrhea during the previous week. This prevalence is substantially higher than that documented in 2006 for Brazilian children < 5 years generally (9.4%). Due to its exceedingly multicausal nature, the set of associated variables that remained associated with child diarrhea in the final multivariable model provide an excellent reflection of the diverse social and health inequities faced by Indigenous peoples in contemporary Brazil.

Utilizing Healthcare Developments, Demographic Data with Statistical Techniques to Estimate the Diarrhoea Prevalence in India

Diarrhoea is one of the leading causes of morbidity and mortality in developing countries in Africa and South Asia such as India. Prevalence of diarrheal diseases in those countries is higher than developed western world and largely has been associated with socio-economic and sanitary conditions. However, present available data has not been sufficiently evaluated to study the role of other factors like healthcare development, population density, sex and regional influence on diarrheal prevalence pattern. Study was performed to understand the relationship of diarrheal prevalence with specific measures namely; healthcare services development, demographics, population density, socio-economic conditions, sex, and regional prevalence patterns in India. Data from Annual national health reports and other epidemiological studies were included and statistically analyzed. Our results demonstrate significant correlation of the disease prevalence pattern with certain measures like healthcare centers, population growth rate, sex and region-specific morbidity. Available information on sanitation like water supply and toilet availability and socioeconomic conditions like poverty and literacy measures could only be associated as trends of significance. This study can be valuable for improvisation of appropriate strategies focused on important measures like healthcare resources, population growth and regional significances to evaluate prevalence patterns and management of the diarrhoea locally and globally.

Domperidone with ORT in the treatment of pediatric acute gastroenteritis in Japan: a multicenter, randomized controlled trial

Domperidone is an antiemetic that is often prescribed for children with acute gastroenteritis in Japan. In this study, the authors assessed the efficacy of domperidone prescription in combination with oral rehydration treatment (ORT) in the treatment of vomiting during acute gastroenteritis in children during the early period. They performed a prospective multicenter randomized trial in Japan. Patients received either ORT or ORT and domperidone prescription. The primary outcome was the proportion of patients who had vomiting during the first 2 hours after randomization. A total of 56 children were eligible; 24 received ORT alone, and 32 received ORT and prescribed domperidone suppository. Results showed that 27.3% of children in the ORT group vomited as compared with 20.7% of children in the ORT and domperidone group (P = .41). In this study, it appears that domperidone in combination with ORT in the treatment of acute gastroenteritis does not reduce vomiting in the early period.