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Deaths due to dysentery, acute and persistent diarrhoea among Brazilian infants
C G Victora1, S R Huttly, S C Fuchs
1Departamento de Medicina Social, Universidade Federal de Pelotas, RS, Brazil.
Insights
Diarrhea caused 75% of infant deaths in a Brazilian study. Persistent diarrhea was the most common type, and hospital infections contributed to many deaths, but breastfeeding offered protection.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Diarrheal diseases are a significant cause of infant mortality globally.
- Understanding the specific types and contributing factors of diarrheal deaths is crucial for intervention.
Purpose of the Study:
- To investigate the causes and characteristics of infant deaths associated with diarrhea in metropolitan areas of southern Brazil.
- To assess the role of different diarrhea types, hospital-acquired infections, and breastfeeding in infant mortality.
Main Methods:
- Population-based study of infant deaths over a one-year period in Porto Alegre and Pelotas, Brazil.
- Analysis of 227 infant deaths where diarrhea was present during the fatal illness.
- Comparison with neighborhood controls to evaluate protective factors.
Main Results:
- Diarrhea was the underlying cause of death in 75% of 227 studied infant deaths.
- Persistent diarrhea (62%) was more common than acute diarrhea (28%) or dysentery (10%).
- Hospital-acquired infections likely contributed to 66-75% of deaths from dysentery and persistent diarrhea; breastfeeding showed a protective effect.
Conclusions:
- Diarrheal diseases, particularly persistent diarrhea, represent a major cause of infant mortality in the studied region.
- Hospital-acquired infections are a significant concern in managing severe diarrhea cases.
- Breastfeeding is a critical protective factor against diarrhea-related infant deaths.
Abstract:
In a population-based study, all infant deaths occurring in a one-year period in the metropolitan areas of Porto Alegre and Pelotas, in southern Brazil, were studied. There were 227 infants who presented diarrhoea during the fatal illness, and in 75% of these diarrhoea was considered to be the underlying cause of death. Acute diarrhoea (< 14 days' duration) accounted for 28% of the deaths, persistent diarrhoea for 62% and dysentery for a further 10%. Approximately one-half of the children with persistent diarrhoea were admitted to a hospital in the first two weeks of the episode. Hospital-acquired infections were likely to have contributed to one- to two-thirds of deaths due to dysentery and persistent diarrhoea. A comparison with neighbourhood controls showed that breast milk provided substantial protection against deaths due to either acute or persistent diarrhoea.