Autor(es): Ichihara, Maria Yury T. ; Rodrigues, Laura C. ; Santos, Carlos Antonio de Souza Teles ; Teixeira, Maria da Glória Lima Cruz ; Barreto, Mauricio Lima ; Ichihara, Maria Yury T. ; Rodrigues, Laura C. ; Santos, Carlos Antonio de Souza Teles ; Teixeira, Maria da Glória Lima Cruz ; Barreto, Mauricio Lima
Data: 2016
Origem: Oasisbr
Assunto(s): Child Hospitalization; Diarrhoea; Non-rotavirus Diarrhea; Risk Factors for Diarrhea
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Made available in DSpace on 2016-05-03T19:53:45Z (GMT). No. of bitstreams: 1 Art Per Estrang Ichiara Maria. 2015.pdf: 361459 bytes, checksum: 8b82cfcb9d802616c42267a2bffbc2b2 (MD5) Previous issue date: 2015-07
Background: Rotavirus has been the leading cause of severe cases of acute diarrhoea (AD) among children world wide, however, in the same areas, a large reduction in AD related to rotavirus has been observed after the introduction of the rotavirus vaccine. In Brazil, where there is a high rotavirus vaccine coverage, AD caused by pathogens other than rotavirus is still a frequent cause of outpatient visits and hospitalizations among children under 5 years. Methods: A hospital-based case-control study enrolled children aged 4 to 24 months admitted to 10 hospitals from all five Brazilian Regions. Cases (n¼ 1178) were children admitted with diarrhoea who tested negative for rotavirus in a stool sample. Controls (n¼ 2515) were children admitted without diarrhoea, frequency matched to cases bysex and age group. We estimated odds ratios using logistic regression, in a hierarchical approach according to a previously defined conceptual framework. Population-attributable fractions (PAF) were estimated for each variable, each block and for all significant variables in the latter model adjusted. Results: The factors studied accounted for 41% of the non-rotavirus AD hospital admissions and the main risk factors included lack of adequate excreta disposal (PAF ¼12%), untreated drinking water (PAF ¼11%) and a history of previous hospitalization due to AD (PAF ¼ 21%). Low socio-economic conditions, no public water supply,crowding and low weight-for-age made smaller contributions. Conclusions: These findings further our knowledge of risk factors associated with severe AD in the post-rotavirus vaccination era. We recommend further increase in coverage of basic sanitation, improvements in water quality and furtherexpansion of primary healthcare coverage to reduce the occurrence of non-rotavirus severe diarrhoea and subsequent hospitalization of Brazilian children.
Oxford
