BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

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ChapterVIII. Infectious Diseases 143 and in the interior city of Franca the rate was higher than in the city of Ribeirfo Pr~to. Possible explanations for these differ ences are the inadequate supplies of drinking water, poor feeding practices, and insuffici ent medical services in the rural areas. The differences were less clear in Chaco Prov ince. A distinctly different pattern of diarrheal disease mortality was found in the three cities of Colombia, in Bolivia, and in ing to size of the total infant death rate, with the El Salvador project appearing first. In six projects the concentration of diarrheal disease deaths in the first six months is clear, though there is variation. Among the cities, Sdlo Paulo had an unusually high rate in the first month, with lower rates in the remainder of infancy. In two projects, El Salvador and San Juan Province, the rates in rural areas where higher than in the cities, TABLE 73. Mortality from Diarrheal Disease by Month of Age in First Year of Life in 19 Areas of 13 Latin American Projects. Deaths per 100.000 live births by month of age Project No. of deaths by month of age ,,0.27.21.3..1498 1.32 . Total-1 1234 5 7,80,01Total-1 1 2 3 4 5 6 7 8 9 1011t ARGENTINA Chaco Province Ruraldepartmente.. 245 20 21 32 30 22 1 7 0 52530.0 275.5j2l4.3357.3489.8310.3205.3224.5112.2 71.4 92.8 61.2 51.0 Ruraldep:truets ... 24 26 1 31 32 1223 14 9 9 3.141.0333.3 269.2 397.4 384.0 282.1 230.8 333.3205.12914.9179.5225.4226.4 SanJuan Province San Juan (city). 21 2. 120 7 8 527 2--1 2- 1.05332.5171.8120.3137.5 85.9 34.4120.3 34.4 - - 34.4 Suburban departments. 170 4919 27 24 16 12 W, 4 32,146.5618.7 239.9214.0 303.0 202.0 138.9 3151.5 126.3 5 37.0 3.5 25.3 37.9 Rural departrnents . . 278 65 24 41 34 3:1 16It 12 8 1 82889.8675.7 240.5420.2 353.4343.0 197.5 200.3134.3 124.7 83.2 72.8 83.2 BOLIVIA project . 0....... 85 51 5 54443 47 43 0 2,123.022033 2.8.9 35. 235.9102.0 243.0214.31143 225.0 14.3 200. DRAZ"I. Recife ............ ,141162 203 175 1479 897255 52422223 3753.3532.9167.8575.7 483.0 325.7 292.8 230.8 180.9 171.1138.2 724 75.7 Ribeir-o Preto Ribeirlo Pr~to (city)... 115 23 22 21 15 0 4 10 7 1 2 13- 3,235.2247.0 230.3225.0 33.3 00.7 43.0 107.4 75.2 10.7 21.5 10.7 - Franca .......... 13432 18 16 19 23 3 0 7 3 21 4 1 2,032.6 028.7 353.0314.373.3 255.4255.4 117.9237.5 58.9 39.3 78.0 19. 559 6 13 11 11 3 3 4- 2 - 1.,530.5130.2 156.3 338.5 286.5 286.5 78.1 78.1 204.2 - 52.A 20.0 - Communitie... BAoPaulo ...... .. 1,49 370 203 163 140 800327 3521 13 13 111,975.6646.5349.0 280,3 240.7 147.9 104.9 46.4 60.2 36.1 22.4 22.4 18.9 CHILE project .......... 408 70 87 70 05 5534 2413 13 7 131,142.7 281.3139.G 00. 149.2 120.2 78.0 87.2 5.5. 29.8 29.8 10. 29.8 Call.................. 302 20 34 31 37 3 35,3731 203023 12 1715. 0 123.2 101.1 140.9 175.4 170.60 5.0175.4 140.9 123.2 142.2 10.0 75.8 Cartagena............. 222 26 28 9 17 23 21 2219 14 13 111.240.2 145.3 156.4 50.3 95.0 128.5 100. 117.3 122.9 100.1 78.2 72.6 61.5 Medelli n............... 289 24 35 30 23 273021 1 222738713489.7 323.7280.4 285.0338.0339.2154.0108.2 97.0 13.4 87.6 02.8 87.6 EL SALVADOR San Salvador .......... 061111102 102116109 1 . 67 657244 4232 3.75.0433.3398. 398. 452.8 425.4 30.4 20 5 253.7 281.0 171.7163.9124.9 555.60425.0 032.1 029.05258.5 Rural muniripios... 337 30 23 33 34 2838302424 3 931401,240.7 703.7555.0444.4555.0 444.4 351.0 444.4 JAMAICA Klington-6t. Andrew.. 334 52 24 28 25 24 27 25 27 20 1829 20 815.4 127.0 58.1368.4 (11.0 58.6 65.9 01.0 65.0 70.8 43.9 70.8 63.5 MEXICO Monterrey ............. 950 140 323 76117 7 61 49034 20 312u 1.792.1 264.1232.0 332.01220.7180.8 147.1 115.1 84.0 64.1 40.0 58.5 37.7
144 ,Patterna of Mortality in:Childhood Fio. 72. Mortality' from Diarrheal Disease by Kingston-6t. Andrew, Which had relatively Month of Age in First Two Years of Life in TWO low rates through the first year of life. These Areas of El Salvador. a00 are areas where mothers continue breast feeding for a longer time than in the Brazilian and El Salvador areas. Although deaths in the Chile project were concen 600 trated in early life, the death rates were low. A In El Salvador diarrheal disease mortality continued to be very high even at 11 - 40 .months of age. Only by the end of the -. second year did the rates become lower. 4 Figure 72 shows the rates for the rural mu 0 \nicipios and for San Salvador in the first 200 - two years of age (smoothed averages were SAN SALVAo.. plotted to eliminate the variation by month of age due to small numbers in the municipios). The excessive mortality in the 01 1 1 rural municipios indicates that diarrheal -1 3 6 9 12 I5 Is 21 24 AGE IN MONTHS disease constitutes a very serious health 'Smoothed 61.. .9of death t....ends, I yea pto , 100,000 lve blhs .ad 12.23moths pot 100,000 popolot,. . problem in children throughout two years of life. the first AMEBIASIS AND OTHER INFECTIOUS INTESTINAL DISEASES Amebiasis was the underlying cause of the neonatal period) indicates the serious 303, deaths (Table 70). These occurred in need for sanitation measures and health eduonly nine of the 25 areas, and half of them cation in those areas. In Monterrey, eight were in Monterrey, Mexico (where the rate deaths from amebiasis occurred in the ncowas 71.6 per 100,000 population). The rates natal period and 60 in the age period 28 were also high in the rural inunicipiosof El days-5 months (Table 74). Salvador (102.7) and in San Salvador As shown in Table 75, there were four (62.6). Deaths from amebiasis occurred in projects (Siio Paulo, Chile, El Salvador, and all three cities in Colombia. Monterrey) in which at least 40 deaths oc- Although water-borne outbreaks occur, curred due to other intestinal infectious amebic infection is usually spread from diseases (typhoid fever, paratyphoid, other person to person through food handling. In salmonellosis, bacillary dysentery, and the amebiasis deaths in the Investigation enteritis due to other specified organisms). serious complications were noted, particu- In these projects, typhoid fever (001) was larly of the hepatic-abscess type. Also the the underlying cause of only six deaths, fact that infants died early in life (even in three of which occurred in Chile. Other
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A'.1 ii,', r" lWAH', T , .NA ON i I
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PATTEiNS OF MORTALITY IN CHILnnooll
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PrincipalCollaborators Dr. Adela Le
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vi Patternsof Mortality in Childhoo
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DEDICATED TO ROBERT GOODWIN FIELD A
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CONTENTS (cont.) Page Comparisons w
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CONTENTS (cont.) Distribution of Li
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xvi Patternsof Mortality in Childho
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xviii Patternsof Mortalityin Childh
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1200 1100 1000 900 800 700 600 500
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30 Patterns 01Aortalil inChildhood
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34 Patterms of Mortality in Childho
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*56 Patterniof Mortality in Childho
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Chapter IV Mortality in Childhood T
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86 Patterns of Mortality in Childho
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Chapter:XI Other Diseases and Exter
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226 Patterns of Mortalityin Childho
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228i Patterniof Mirtalityin Childho
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.234 i:Patternsof MortalityiwChildh
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238 Patternh of Mortalityin Childho
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242 Pattern of Mortality in Childho
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260 Paiterns of Mortality in Childh
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262 Pattern,of Mortalityin Childhoo
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.2,4 Pattensof Mortality in Childho
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270 patternsofMortality in Childhoo
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Chater XI.v Socioeconomic and Relat
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276 PatternsofMortality.inChildhood
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278 Patterna of Mortalityin Childho
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286 PatternA of Mdrtality in Childh
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298 Patternsof -Mord ity in Childho
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300 Patterni. of'Mortlity n C.hildh
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322 Potterne of Mortality,in Childh
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3421. Patterp of.MortalityImnuntano
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348 Patterna,Oe4MortalityinChildhoo
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352 Paternsof Mortalityin Childhood
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354 . patteens of Mortality*in Chil
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APPENDICES
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APPENDIX 1 STANDARD FORM OF QUESTIO
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Appendix 1 363 Confidential INTER-A
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Appendix 1 365 INTER-AMERICAN INVES
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o- ~-: ' 4vApendix'1 367 Confidenti
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Appendiz 1 369 Confidential INTER-A
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APPENDIX 2 UNDERLYING AND ASSOCIATE
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Appendix 2 373 DEATH RATES Chaco Pr
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Appendix 2 375 DEATH RATES Resisten
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Appendix 8 377 DEATH RATES Rural De
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DEATH RATES San Juan Province-ARGEN
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Appendii 2 381 DEATH RATES City of
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4ppendiz2 383 DEATH RATES Suburban
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Appendiz 2 385 DEATH RATES Rural De
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ppendix 2 087 DEATH-RATES La Paz-BO
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Appendix 8 389 DEATH RATES Viacha-B
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Appendix 2 391 DEATH RATES Recife-B
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Appendix 9 393 DEATH RATES City of
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dppendix 8 395 DEATH RATES Franca,
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Appendix'$ :397 DEATH RATES Ribeiri
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Appendix B 399 Cause DEATH RATES S
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Appendix . 401 DEATH RATES Sherbroo
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Appendiz 8 403 DEATH RATES Santiago
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Appendix 9 405 nfective and parasit
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Appendiz 2 407 DEATH RATES Cali-COL
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Appendix 2 409 DEATH RATES Cartagen
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Appendiz, 411 DEATH RATES MedellIn-
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Appendix 2 413 DEATH RATES San Salv
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Appendix 2 415 DEATH RATES Rural
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Appendix 9 417 DEATH RATES Kingston
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1pPendix2 419 Cause 5 years Total D
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Appendix 8 421 DEATH RATES Rural St
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Appendirs 423 DEATH RATES Monterrey
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AppendixlB 425 DEATH RATES San Fran
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Appmdx 427 DEATH RATES Suburban Cou
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APPENDIX 4 HOME INTERVIEWS OF FAMIL
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Appenam a Sol APPENDIX 5 (cont.) NU
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-Appendix 6 433 Miguel A. Garcia Ce
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Appenae uO Denise Bernier Cleuza Ma
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REFERENCES-' American Society of Cl
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References, 439 rof,Differing Socio
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References 441 Pan American Health
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References 4 Verhoestuaete, L.J. an
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Index Accidents, 234-238 Age of mo
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447 Bolivia project, La Paz (cont.)
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Index 449 California project, Unite
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Index 451 Chaco Province project, A
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Index 453 'bile, City of Santiago (
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El Salvador project (cont.) Nutrit
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Inter American Investigation (cont.
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Index 459 Maternal infection, 99-10
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ItidI 481 Monterrey project, mexico
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irurcx 463 Recife project, Brazil (
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Index 465 Ribeirfo Pr~to, communiti
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Index 467 San Juan Provin,e project
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Index- 469 Sheehy, T. W., 149, 442
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