Abstract
ABSTRACTOBJECTIVE To analyze the contributions of the socioeconomic, hygienic, and sanitation improvements in reducing the prevalence of diarrhea in a city of the Amazon.METHODS In this population-based cross-sectional study, we analyzed data from surveys conducted in the city of Jordão, Acre. In 2005 and 2012, these surveys evaluated, respectively, 466 and 826 children under five years old. Questionnaires were applied on the socioeconomic conditions, construction of houses, food and hygienic habits, and environmental sanitation. We applied Pearson’s Chi-squared test and Poisson regression to verify the relationship between origin of water, construction of homes, age of introduction of cow’s milk in the diet, place of birth and the prevalence of diarrhea.RESULTS The prevalence of diarrhea was reduced from 45.1% to 35.4%. We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow’s milk in the first month after birth, and in those living in houses made of paxiúba. Children born at home presented lower risk of diarrhea when compared to those who were born in hospital, with this difference reversing for the 2012 survey.CONCLUSIONS Sanitation conditions improved with the increase of bathrooms with toilets, implementation of the Programa de Saúde da Família (PSF – Family Health Program), and water treatment in the city. The multivariate regression model identified a statistically significant association between use of water from the public network, construction of houses, late introduction of cow’s milk, and access to health service with occurrence of diarrhea.
Highlights
Sanitation, recognized as an important health promotion strategy, figures on the international agenda among the eight Millennium Development Goals, whose aim to halve the population without access to drinking water was reached in advance
The prevalence of diarrhea was reduced from 45.1% to 35.4%
We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow’s milk in the first month after birth, and in those living in houses made of paxiúba
Summary
Sanitation, recognized as an important health promotion strategy, figures on the international agenda among the eight Millennium Development Goals, whose aim to halve the population without access to drinking water was reached in advance. 11.0% of the world’s population still remains without access to drinking water. In Brazil, basic sanitation is a right ensured by the Constitution and defined by the Law 11,445/2007, which establishes the national guidelines for sanitation, defined as the set of services, infrastructure, and facilities of water supply, sewage system, urban cleaning, urban drainage, solid waste and rainwater managementa. These services promote the improvement of the quality of life of the population, reflecting directly on child health, with reduction of child mortality and of diarrheal, parasitic, and skin diseases. They protect the health of the population, minimizing the consequences of poverty and protecting the environmentb
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