La enfermedad diarreica aguda en los países en vías de desarrollo : I. Base epidemiológica de su control / Acute diarrheal disease in lesser developep countries : I. An epidedemiologic basis for control

In most populations, a continuum of clinical severity from inapparent infection to fatal disease characterizes the acute diarrheas, independently of whether or not a recognized microbial pathogen is involved. In lesser developed regions of the world, average severity is greater and the clinical course longer and more irregular than in more favored areas. Generally, the same kinds of infectious agents are recognized in the two situations, although they differ in relative and absolute frequency. The observed differences in clinical effect, especially among children, appear related primarily to nutritional state of the host and to an unsanitated environment with resultant larger doses of infecting agent. In any single situation, endemic or epidemic, clinical entities cannot be distinguished with certainty, although etiologically distinct diseases can be demonstrated. A mixture of diseases is usual and mutiple infections of an individual relatively frequent. Clinical differences do not provide a basis for community control

Specific enteric agents, including Shigella, Salmonella, enteropathogenic Esch. coli, or Entamoeba histolytica, ordinarily can be domonstrated in about 20 percent of diarrheas of lesser developed countries, Shigella being commonest. A total of 40 percent is occasional and 60 percent exceptional. Many cases apparently are related to enteric microorganisms ordinarily not ... (AU)

Difunciones por gastritis y enteritis por 100.000 habitantes

La enfermedad diarreica aguda en los países en vías de desarrollo : Sus cracterísticas epidemiológicas en la población rural de Guatemala / Acute diarheal disease in lesser developed countries : Patterns of epidemiological behavior in Rural Guatemalan Villages

A field study of acute undifferentiated diarrheal disease in three villages of rural Guatemala demonstrated maximum incidence to be among infants and younger preschool children, especially those aged 6 to 24 months. Death rates in the second year of life were 36 per 1000 children per year, in the first year, 17, and in the fifth year, 9. The initial or index case in 72 percent of 390 family outbreaks was a preschool child; more than a third were less than a year old. Multiple index cases, indicative of common source infection, were rare. Secondary attack rates among family contacts were 1.4 percent; when the infection spread in families it was mainly to other preschool children

The characteristic behavior in open village populations was a series of about 3 epidemics per decade, each of long durantion, a year or two and sometimes three, with short intervals between. These and other circumstances revealed direct and personal contact as the dominant mode of spread. Contaminated food, especially for younger children, was also an important means of spread. Less significant were water, milk because the supply was limited, and irregularly flies

The existing state of nutrition was an important influence among infants and preschool children. Incidence increased progressively with increasing degrees of malnutrition as did severity in somewhat less definite fashion. The outstanding demonstration of ...(AU)

Difuciones por gastritis y enteritis por 100.000 habitantes

La enfermedad diearreica aguda en los países en vías de desarrollo : Métodos de prevención y control / Acute diarrheal disease in Lesser Developed Countries

The proposed program for community control of acute undifferentiated diarrheal disease is for the three-fourths of the world where incidence is high and facilities meagre. Community control has two elements, measures within the responsibility of the organized health agencies of society and those which the individual himself must undertake. General methods therefore resolve into environmental sanitation, maternal and child health procedures, medical care and health education of the public

Priorities are realistic only if based on epidemiological evaluation of the particular situation, and not if reached through assumption that one method is always better than another or that one procedure suffices to the exclusion of others. Environmental sanitation, an essential means for protecting a general populatin or for achieving long term effect, gives a poor result without health education of the public to assure that facilities are utilized. Diarrheal disease in early childhood requires the specialized approach of health education, improved nutrition and medical care

Report of epidemics rather than reporting of individual cases is the practical procedure in areas lacking good public health organization. Even under the best conditions required report of individual cases by etiologic agent fails because it discourages notification

Preventive measures, aimed toward fewer cases find greatest emphasis ...(AU)

Difuciones por gastritis y enteritis por 100.000 habitantes