Gastro-enteritis in Dominica: from major cause of morbidity and mortality to minor primary care condition

ABSTRACT

Gastro-enteritis continues to be a major health problem in the developing world, especially in children. We studied morbidity and mortality rates of gastro-enteritis in the past 50 years in Dominica. All cases of gastro-enteritis registered during one year at the different levels of the primary health care services in the Marigot Health district were analysed. In a total district population of 8,554, 296 cases of gastro-enteritis (incidence 3,460/100,000) presented to the Casualty Department of the Marigot District Hospital and the district health centres. Of these, 143 were referred to the District Medical Officer. A total of 44 cases were admitted to the Marigot district hospital for short term observation and oral rehydration therapy. Only one child needed to be referred to the secondary level of care at the Princess Margaret Hospital. From being a major cause of morbidity and mortality, as well as a major reason for admission to hospital wards in the past 50 years, gastro-enteritis has become a minor condition which is generally treated at primary levels of health care. In addition to increased affluence and socio-economic conditions, this enormous improvement is attributed to the introduction of oral rehydration therapy and the development of easily accessible primary health care services.(AU)