Factors associated with rotavirus diarrhoea in children living in a socially diverse urban centre in Brazil.

A case-control study, aimed at identifying factors associated with rotavirus diarrhoea cases presenting to health facilities, was conducted in children from low-income and middle-low-income families in Brazil. Cases were 390 children with diarrhoea and rotavirus in stools; controls were 1674 children without diarrhoea presenting to the same facilities. Data were collected by questionnaire and observations during home visits. Explanatory variables were grouped according to a conceptual model of causation. The ORs by non-conditional logistic regression and population-attributable fractions were calculated. Socioeconomic factors contributed a third of cases, followed by contact with diarrhoea cases and by not being breast fed. In cases aged <1 year, not being breast fed was the main determinant, followed by socioeconomic factors, and crowding and contact outside the home; in older children, socioeconomic factors followed by contact inside and outside the home were the main determinants. Environmental and sanitation variables were not associated with diarrhoea in the final model, and socioeconomic factors were only partly mediated by proximal variables. Transmission of rotavirus appears to be mostly by person-to-person contact, and shows marked social differentials not explained by the biological factors studied. The rotavirus vaccine is unlikely to protect against the full range of circulating genotypes of rotavirus, and understanding rotavirus epidemiology remains essential to the development of control policies.

Avaliação da atividade antimicrobiana de duas espécies de Rutaceae do Nordeste Brasileiro / Evaluation of the antimicrobial activity of two Rutaceae species from the Brazilian Northeast

Com o aumento da resistência bacteriana aos antibióticos disponíveis, tornou-se imprescindível a busca por novos fármacos ou protótipos. Os metabólitos secundários produzidos por alguns vegetais como cumarinas, alcaloides e terpenoides podem apresentar várias atividades biológicas, dentre elas, atividade antibiótiotica. O objetivo deste trabalho foi avaliar a atividade antimicrobiana in vitro, pelo método de difusão em disco, das diferentes partes de duas espécies pertencentes à família Rutaceae coletadas na Chapada Diamantina, Bahia, Brasil: Spiranthera odoratissima A. St.-Hil. e Zanthoxylum stelligerum Turcz., bem como do alcaloide diidroqueleritrina, isolado do extrato metanólico de Z. stelligerum frente a cepas padrão de microrganismos e isolados clínicos. Os resultados apresentados indicam que o extrato da raiz da espécie Z. stelligerum e o alcaloide extraído desta apresentaram propriedades antimicrobianas contra as cepas Gram positivas e leveduras. A E. coli foi a única cepa Gram negativa que se mostrou sensível ao extrato e ao alcaloide.

With the increase in bacterial resistance to available antibiotics, it became imperative to search for new drugs or prototypes. The secondary metabolites produced by some plants as coumarins, alkaloids and terpenoids have several biological activities, among them, antibiotic activity. The objective of this study was to evaluate the antimicrobial activity in vitro by the disk diffusion method, from different parts of two species belonging to the family Rutaceae, collected in the Chapada Diamantina, Bahia, Brazil: Spiranthera odoratissima A. St Hil. and Zanthoxylum stelligerum Turcz., and the alkaloid dihydrochelerythrine, isolated from the methanolic extract of Z. stelligerum front of standard strains of microorganisms and clinical isolates. The results indicate that the extract from the roots of Z. stelligerum and the alkaloid had antimicrobial properties against Gram positive and yeast strains. The E. coli was the only Gram negative strain that was sensitive to extract and the alkaloid.

A hierarchical model for studying risk factors for childhood diarrhoea: a case-control study in a middle-income country.

OBJECTIVE: To identify factors associated with diarrhoea occurrence in children in a city in a middle-income country, with high access to water and sanitation. METHODS: A case-control study in the city of Salvador, north-eastern Brazil was conducted from November 2002 to August 2004. The study population consisted of children presenting at a health facility. A total of 1688 cases of diarrhoea and 1676 controls were selected. Data collection was by a questionnaire and structured observation during home visits. The explanatory variables were grouped according to a conceptual model defined previously. Analysis was done using a hierarchical approach, to provide a more dynamic view of the transmission characteristics of childhood diarrhoea. Non-conditional logistic regression was used, and odds ratio and population-attributable fractions were estimated. RESULTS: Socioeconomic factors contributed most to determining diarrhoea occurrence, followed by interpersonal contact, while factors related to food preparation, the environment and water and sanitation made a smaller contribution. CONCLUSION: The findings indicate that the transmission of diarrhoea is influenced by factors from all hierarchical levels, with interpersonal transmission playing a relatively higher role than previously thought. This is compatible with a predominance of viruses and other agents spread by interpersonal routes including Shigella, Giardia and Cryptosporidium. Diarrhoea control strategies in similar settings (middle-income countries in which a large proportion of the population has access to water and sanitation) must give greater emphasis to policies geared towards reducing person-to-person transmission for the prevention of diarrhoea.