RESUMO
The impact of oral rehydration therapy (ORT) on the recent decline in diarrhoea mortality in the northeast of Brazil was studied. Proportionate infant mortality fell from 32% in 1980 to 17% in 1989 and infant deaths attributed to diarrhoea dropped from 41% to 25%, resulting in an overall reduction of 57%. Similar decreases were observed for children aged 1-4 years. Diarrhoea admissions also fell from 57% of infant hospitalizations in 1980 to 30% in 1990. None of the other major causes of death or admissions showed such decline. ORT was introduced in the early 1980s, being used in 35% of all episodes in 1991 and in 62% of those regarded as severe by the mother. Other changes included a worsening of socioeconomic conditions and increases in water supply, vaccine coverage, breastfeeding duration and nutritional status. A simulation model estimated that changes in factors other than ORT would lead to a 21% reduction in infant diarrhoea mortality, or about one-third of the actual decline. Finally, an ecological analysis showed that ORT use rates were inversely correlated to infant diarrhoea mortality (r=-0.61; p=0.04). Despite the shortcomings of the available data, these findings suggest an important impact of ORT on diarrhoea mortality.
PIP: Proportionate infant mortality in the northeast of Brazil fell from 32% in 1980 to 17% in 1989, with infant deaths attributed to diarrhea falling from 41% to 25%; these declines comprise an overall reduction of 57%. Similar decreases were observed for children aged 1-4 years. Diarrhea admissions also fell from 57% of infant hospitalizations in 1980 to 30% in 1990. No such decline was observed in any of the other major causes of death or admissions. The authors explored the impact of oral rehydration therapy (ORT) upon this recent decline in diarrhea mortality in the region. ORT was introduced in the early 1980s, being used in 35% of all episodes in 1991 and in 62% of those regarded as severe by the mother. Socioeconomic conditions worsened during the 1980s, but the levels of water supply, vaccine coverage, breastfeeding duration, and nutritional status increased. A simulation model estimated that changes in factors other than ORT would lead to a 21% reduction in infant diarrhea mortality, or approximately one third of the actual decline. An ecological analysis found ORT use rates to be inversely correlated with infant diarrhea mortality. These findings suggest that the introduction and use of ORT in northeastern Brazil had an important impact upon diarrhea mortality.
Assuntos
Diarreia/epidemiologia , Hidratação/normas , Mortalidade Infantil , Brasil/epidemiologia , Diarreia/mortalidade , Diarreia/terapia , Humanos , Incidência , Lactente , Modelos Lineares , Admissão do Paciente/estatística & dados numéricos , Fatores de Risco , Fatores SocioeconômicosRESUMO
"The paper presents the Latin American demographic situation and trends since 1950, with special emphasis on differential mortality across and within countries.... The large declines in mortality, specially those at young ages, are linked to changes in epidemiological profiles which imply a greater relative importance of non-transmissible diseases and a lesser role of infectious and parasitic diseases. Population ageing also contributes to these changes due to the increased fraction of adult and elderly population. In the majority of countries, excessive mortality due to avoidable causes is still present among the poor." (SUMMARY IN ENG)
Assuntos
Causas de Morte , Mortalidade , Dinâmica Populacional , Demografia , Países em Desenvolvimento , América Latina , População , PesquisaRESUMO
PIP: This introduction to a detailed study of fertility change in Mexico assesses the available fertility data and describes the sources used, traces the beginning and course of the demographic transition in Mexico, and describes the work. Mexico's demographic transition began around 1930 with the acceleration of mortality decline. The considerable time lag between the mortality decline and the beginning of the fertility decline resulted in a period of very rapid growth. Between 1955 and 1975, the growth rate exceeded 3% annually. The start of the fertility decline dated to about 1970, the time of a major reform of population policy and creation of institutions to reduce growth. But the fertility decline was not solely the result of population programs. An incipient fertility decline could be observed in the metropolitan and more educated population sectors beginning in the early 1960s. The onset of the mortality decline in the 1930s resulted from the sustained social and economic progress made possible after the conclusion of the Mexican Revolution. Between 1930 and 1980, the adult illiteracy rate declined from 61.2% to 17%, while life expectancy increased from 33 years to 63.2 years. In Mexico as in other Latin American countries, the mortality decline, which disturbed the traditional balance between high mortality and high fertility, was the force setting off the demographic transition and the necessary precursor to fertility decline. The first of two main sections of the book focuses on examination of fertility variations in Mexico since around 1900 using cross-sectional and longitudinal methods of analysis. The second part describes the origins, history, and institutions involved in Mexico's population policies and the demographic programs and their principal results. The influence of population policies in demographic change is assessed, especially in the case of fertility changes induced by family planning programs. Both the first and second parts sought to place Mexican fertility trends in the context of the demographic transition and to observe the functioning and effects of demographic programs.^ieng