Abstract
BackgroundGlobally, 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.MethodsThe 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.ResultsInformation 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.ConclusionsAccording 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.
Highlights
Diarrhea is the second leading cause of death among children under five
In Brazil, mortality due to diarrhea underwent a significant reduction during the last three decades principally due to expansion of the primary healthcare network, widespread use of oral rehydration therapy, reduced child undernutrition, and improved sanitation conditions largely associated with improved access to safe drinking water
The aim of this paper is to analyze the prevalence of reported diarrhea and associated factors among Indigenous children under 5 years of age in Brazil, based on data from the First National Survey of the Health and Nutrition of Indigenous Peoples in Brazil (“National Survey”), conducted in 2008–2009
Summary
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. In Brazil, mortality due to diarrhea underwent a significant reduction during the last three decades principally due to expansion of the primary healthcare network, widespread use of oral rehydration therapy, reduced child undernutrition, and improved sanitation conditions largely associated with improved access to safe drinking water. Basic health and sanitation services coverage have improved for the general population, but Indigenous peoples in Brazil suffer from significant accumulated deficits in access to services such as clean water, sewage treatment, and primary healthcare as compared to the non-Indigenous population [9,10,11]. Studies carried out in different regions of Brazil have reported that infectious and parasitic diseases are responsible for 20 to 40% of hospital admissions among Indigenous children under five years of age and diarrhea may account for up to 90% of total reported admissions in this group depending on region and ethnicity [12,13,14,15]
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