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Changes in Diarrheal Disease and Treatment Among Brazilian Children from 1986 to 1996

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Abstract

We examined changes in diarrhea prevalence and treatment in Brazil between 1986 and 1996. Over this 10-year period there was a small decline in diarrhea prevalence but treatment with oral rehydration therapy (ORT) increased greatly. Deaths due to dehydration were thus averted, although the costly burden of morbidity remained high. The decline in diarrhea prevalence was largely due to changes in the effects of several key covariates, such as breastfeeding, with only a modest role played by socioeconomic change, infrastructure improvements, and other behavioral factors. ORT treatment of diarrhea was essentially unrelated to child and family characteristics, suggesting that the large increase was due to the success of public health efforts to promote its use widely. Our results suggest that the most effective policies for reducing diarrhea prevalence are likely to be further increases in education and the promotion of breastfeeding. Persistent disparities in diarrhea prevalence mean that policies to prevent the disease should be targeted at disadvantaged socioeconomic groups.

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Notes

  1. One concern in applying this model is the endogenous nature of the intermediate factors, which may be reflected in the correlation between these covariates and the error components. However, the cross-sectional structure of the data and the absence of any plausible instrumental variables mean that there is no convincing approach to correct for endogeneity.

  2. Unmeasured child-specific factors may be present, but are unidentifiable with the single observation we have for each child.

  3. For reviews, see Cleland and van Ginneken (1988) and Strauss and Thomas (1995).

  4. For covariate effects based on the product of main and interaction effects, we report the statistical significance of this total effect in the text, not in the tables.

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Acknowledgments

Special thanks are due to Rachael Pierotti for research assistance. Support from NIH Grant HD38556 is gratefully acknowledged.

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  1. Population Studies Center, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48106, USA

    Narayan Sastry & Sarah Burgard

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  1. Narayan Sastry
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  2. Sarah Burgard
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Correspondence to Narayan Sastry.

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Sastry, N., Burgard, S. Changes in Diarrheal Disease and Treatment Among Brazilian Children from 1986 to 1996. Popul Res Policy Rev 30, 81–100 (2011). https://doi.org/10.1007/s11113-010-9179-9

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