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[Risk factors for hospitalization due to acute diarrhea in children under two years old: a case-control study]
Lygia Carmen de Moraes Vanderlei1, Gisélia Alves Pontes da Silva, José Ueleres Braga
1Núcleo de Epidemiologia, Instituto Materno-Infantil de Pernambuco, Recife, PE, 50070-550, Brasil. lygiacarmen@hotmail.com
Insights
Hospitalization for acute diarrhea (AD) in young children is linked to housing conditions and maternal factors. Unfavorable socioeconomic status, younger child age, and severe diarrhea increase hospitalization risk.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Context:
- Acute diarrhea (AD) remains a significant cause of hospitalization in children under two years old, particularly in developing regions.
- Understanding the multifactorial determinants of AD-related hospitalizations is crucial for targeted public health interventions.
- This study addresses the need for localized data on risk factors for childhood AD in Brazil.
Purpose:
- To investigate the socioeconomic, demographic, and biological factors associated with hospitalization due to acute diarrhea (AD) in children under two years old.
- To identify key risk factors contributing to severe AD requiring hospitalization.
- To develop a hierarchical risk factor model for AD hospitalization.
Summary:
- A hospital-based case-control study in Recife, Brazil, analyzed 185 children hospitalized for AD and 185 controls.
- Multiple logistic regression identified packed earth/plank floors, higher multiparity, infant age under six months, and diarrhea severity as associated factors.
- A significant interaction was observed between poor socioeconomic conditions, young child age, and diarrhea severity in predicting hospitalization.
Impact:
- Findings highlight the importance of housing quality and maternal factors in pediatric AD.
- Identifies vulnerable subgroups (infants <6 months, children in poor socioeconomic conditions) requiring focused preventive strategies.
- Provides evidence for public health policies aimed at reducing childhood morbidity and mortality from acute diarrhea.
Abstract:
The aim of this study was to investigate the socioeconomic, demographic, and biological determinants of hospitalization due to acute diarrhea (AD) in children under two years old. The hospital-based, case-control study was conducted from May to October 1997 in a pediatric hospital in Recife, Pernambuco, Brazil. Cases (n = 185) were children hospitalized due to AD, and controls (n = 185) were children with various diseases (except AD) presenting in the previous 15 days in the same area and time period. Data analysis used the Epi Info and Stata software. Odds ratios and 95% confidence intervals were calculated by multiple logistic regression to control confounding factors, considering a hierarchical risk factor model. Investigation using the proposed model showed an association between hospitalization due to AD and packed earth or plank floors in the house, greater multiparity, age of child under six months, and severity of bouts of diarrhea, which depended on the interaction between unfavorable socioeconomic conditions, younger age of the child, and severity of the diarrhea.