Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/13753
Title: Risk factors for hospital admission of Brazilian children with non-rotavirus diarrhoea: a case control-study
Authors: Ichihara, Maria Yury Travassos
Rodrigues, Laura C
Santos, Carlos Antonio de Souza Teles
Teixeiraa, Maria da Glória Lima Cruz
Barreto, Maurício Lima
Affilliation: Universidade Federal da Bahia. Instituto da Saúde Coletiva. Salvador, BA, Brasil
London School of Hygiene & Tropical Medicine. London, United Kingdom
State University of Feira de Santana. Feira de Santana, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Universidade Federal da Bahia. Instituto da Saúde Coletiva. Salvador, BA, Brasil
Universidade Federal da Bahia. Instituto da Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Abstract: Background: Rotavirus has been the leading cause of severe cases of acute diarrhoea (AD) among children worldwide, 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 (n¼1178) were children admitted with diarrhoea who tested negative for rotavirus in a stool sample. Controls (n¼2515) were children admitted without diarrhoea, frequency matched to cases by sex 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 (PAF¼12%), untreated drinking water (PAF¼11%) and a history of previous hospitalization due to AD (PAF¼21%). 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 further expansion of primary healthcare coverage to reduce the occurrence of non-rotavirus severe diarrhoea and subsequent hospitalization of Brazilian children.
Keywords: Child hospitalization
Diarrhoea
Non-rotavirus diarrhea
Risk factors for diarrhea
DeCS: Diarreia
Hospitalização
Brasil/epidemiologia
Estudos de Casos e Controles
Criança
Pré-escolar
Diarreia/epidemiologia
Feminino
Hospitalização/estatística & dados numéricos
Humanos
Lactente
Modelos Logísticos
Masculino
Razão de Chances
Fatores de Risco
Saneamento/normas
Issue Date: 2015
Publisher: Oxford University Press
Citation: ICHIHARA, M. Y. T. et al. Risk factors for hospital admission of Brazilian children with non-rotavirus diarrhoea: a case control-study. Transactions of The Royal Society of Tropical Medicine and Hygiene, v. 109, n. 7, p. 454-461, 2015.
ISSN: 0035-9203
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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