[Death caused by acute diarrhea in children: a study of prognostic factors]

To identify prognostic factors of death due to acute diarrhea related to the process disease-health care-death in the State of Tlaxcala, Mexico.

A case-control design was used. Cases were defined as children who died between the ages of seventy-two hours and five years between 1992 and 1994. An event of acute diarrhea was the main cause of death stated in the death certificate. Case ascertainment was done through the verbal autopsy method. Controls were children who had suffered acute diarrhea with at least one sign of dehydration or alarm and had overcome the diarrheal episode. Controls were randomly selected from the population at large and were matched by age with cases.

One hundred and six cases and the same number of controls were taken. Using a logistic regression procedure in which severity of illness and days of evolution were controlled for, the prognosis-worsening predictors were: visit provided by private physician (OR 8.9); inappropriate treatment (OR 10.4); a working mother (OR 8.7); mother's lack of knowledge to identify dehydration signs (OR 8.1); siblings' malnutrition (OR 28.2); and malnutrition prior to the diarrheal event (OR 7.5).

These findings suggest that factors worsening the outcome of the diarrheal episode are: malnutrition, the inappropriate treatment provided by private physicians, and the deficient household care of the diarrheal episode.