Efetividade de uma intervenção educativa para a promoção da autoeficácia materna em prevenir a diarreia infantil

Objetivo: Avaliar o efeito do uso de uma cartilha educativa combinada com uma entrevista motivacional breve sobre autoeficácia materna na prevenção da diarreia infantil. Material e Método: Estudo quase experimental, realizado com 35 mães. Para a coleta de dados aplicou-se a Escala de Autoeficácia Materna para a Prevenção da Diarreia Infantil (EAPDI), e posteriormente uma intervenção educativa pautada na aplicação da cartilha "Você é capaz de prevenir a diarreia no seu filho!" associada a uma entrevista motivacional breve. Após um mês da intervenção, por contato telefónico, aplicou-se a EAPDI e um formulário para verificação da ocorrência de diarreia. Para a análise dos dados, aplicou-se testes estatísticos. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: Identificou-se aumento nos escores de autoeficácia materna em prevenir a diarreia infantil ao longo do estudo (p< 0,001), aumento progressivo no número de mães que apresentaram elevada autoeficácia (p< 0,001) e diminuição da ocorrência de casos de diarreia após um mês da intervenção (p= 0,021). Conclusões: A intervenção educativa ajudou no aumento da autoeficácia materna em prevenir a diarreia infantil e na diminuição de episódios diarreicos nas crianças, mostrando-se também como instrumento capaz de proporcionar o aumento da autonomia das mães no cuidado às crianças.

Objective: To evaluate the effect of using an educational booklet combined with a brief motivational interview on maternal self-efficacy in preventing childhood diarrhea. Materials and Methods: Quasi-experimental study carried out with 35 mothers. For data collection, the Maternal Self-Efficacy Scale for the Prevention of Childhood Diarrhea (EAPDI, em português) was applied, and later an educational intervention based on the application of the booklet "You are able to prevent diarrhea in your child!" associated with a brief motivational interview. One month after the intervention, the EAPDI and a form to verify the occurrence of diarrhea were applied by telephone. For data analysis, statistical tests were applied. The study was approved by the Research Ethics Committee. Results: There was an increase in maternal self-efficacy scores in preventing childhood diarrhea throughout the study (p< 0.001), a progressive increase in the number of mothers who showed high self-efficacy (p< 0.001) and a decrease in the occurrence of cases of diarrhea one month after the intervention (p= 0.021). Conclusions: The educational intervention helped to increase maternal self-efficacy in preventing childhood diarrhea and to reduce diarrheal episodes in children, also proving to be an instrument capable of increasing the autonomy of mothers in caring for their children.

Objetivo: Evaluar el efecto del uso de una cartilla educativa combinada con una breve entrevista motivacional sobre la autoeficacia materna en la prevención de la diarrea infantil. Material y Método: Estudio cuasiexperimental realizado con 35 madres. Para la recolección de datos se aplicó la Escala de Autoeficacia Materna para la Prevención de la Diarrea Infantil (EAPDI), y posteriormente una intervención educativa basada en la aplicación del cuadernillo "¡Tú eres capaz de prevenir la diarrea en tu hijo!" asociada a una breve entrevista motivacional. Un mes después de la intervención, mediante contacto telefónico, se aplicó la EAPDI y un formulario para verificar la ocurrencia de diarrea. Para el análisis de los datos se aplicaron pruebas estadísticas. El estudio fue aprobado por el Comité de Ética en Investigación. Resultados: Hubo un aumento en los puntajes de autoeficacia materna en la prevención de la diarrea infantil a lo largo del estudio (p< 0,001), un aumento progresivo en el número de madres que mostraron alta autoeficacia (p< 0,001) y una disminución en la ocurrencia de casos de diarrea al mes de la intervención (p= 0,021). Conclusiones: La intervención educativa ayudó a aumentar la autoeficacia materna en la prevención de la diarrea infantil y a reducir los episodios diarreicos en los niños, demostrando además ser un instrumento capaz de aumentar la autonomía de las madres en el cuidado de los hijos.

A investigation of pathogenic Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan / 中国热带医学

@#Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

Prematurity and functional gastrointestinal disorders in infancy: a cross-sectional study

ABSTRACT BACKGROUND: Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms that are not explained by structural or biochemical abnormalities. Their relationship with prematurity has been increasingly studied. OBJECTIVE: To compare the frequency of FGIDs in preterm and term infants and to evaluate whether invasive procedures during the neonatal period in preterm infants are associated with greater likelihood of FGIDs in the first two years of life. DESIGN AND SETTING: Controlled nested cross-sectional study conducted in a Brazilian university hospital. METHODS: This was a controlled nested cross-sectional study on a retrospective cohort of infants born preterm who were compared with infants born at term regarding the presence of FGIDs. Medical consultations were conducted by a single pediatric gastroenterologist to obtain information on the gestational and neonatal periods and on clinical manifestations of the digestive tract. The Rome IV criteria for the diagnosis of FGIDs were used. RESULTS: A total of 197 infants (< 24 months), including 99 preterm and 98 term infants, were studied. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%; P < 0.001). The frequencies of other FGIDs (infant colic, functional constipation, functional diarrhea and infant dyschezia) in preterm infants did not differ from those of term infants (P > 0.05). No relationship was found between invasive procedures during the neonatal period and development of FGIDs in preterm infants. CONCLUSION: Infants born preterm did not have higher frequency of FGIDs in the first two years of life.

Manejo ambulatorio de la diarrea aguda infantil: encuesta a pediatras de un hospital pediátrico de la Ciudad de Buenos Aires / Outpatient management of childhood acute diarrhea: survey among pediatricians from a children's hospital in the Autonomous City of Buenos Aires

Introducción. El tratamiento de la diarrea aguda se basa en prevenir la deshidratación, reducir la duración y gravedad de la enfermedad. El objetivo fue conocer los patrones de tratamiento ambulatorio de la diarrea aguda en <5 años. Métodos. Estudio observacional, analítico, mediante encuestas autoadministradas a pediatras de un hospital de niños de la Ciudad Autónoma de Buenos Aires. Se indagó: edad, sexo, lugar de trabajo, fuentes bibliográficas, indicación de tratamientos farmacológicos, no farmacológicos y medidas de prevención e higiene. Se evaluó la asociación entre prescripciones farmacológicas y características de los encuestados. Resultados. Respondieron 182/216 pediatras; la edad media fue 42,4 ± 10,24 años (el 78,6 %, mujeres); el 59,2 %, del sector público; el 22,4 %, de servicios de guardia. El 91,2 % consultaba guías/consensos. El 92,9 % prescribió fórmulas de rehidratación oral; el 46,2 %, antieméticos; el 43,4 %, antiácidos y/o protectores gástricos; el 35,7 %, probióticos, y el 30,7 %, cinc. El 91,7 % indicó realimentación precoz; el 96,7 %, lactancia materna y el 96-100 %, medidas de prevención e higiene. En el análisis multivariado, tener >40 años se asoció con prescribir antiácidos/protectores gástricos (odds ratio [OR] 2,6; 1,22-5,61), probióticos (OR 3,03; 1,34-6,83) y cinc (OR 0,39; 0,17-0,87); trabajar en el sector privado con prescribir probióticos (OR 3,05; 1,56-5,94) y en servicios de guardia, con prescribir antiácidos/ protectores gástricos (OR 2,60; 1,22-5,54). Conclusiones. El tratamiento se basó principalmente en hidratación, alimentación precoz y lactancia. La edad y el lugar de desempeño de los pediatras modifican el patrón de prescripción.

Introduction. The management of acute diarrhea is based on preventing dehydration and reducing disease duration and severity. The study objective was to establish the patterns for the outpatient management of acute diarrhea in children younger than 5 years. Methods. Observational, analytical study using a self-administered survey among pediatricians from a children's hospital in the Autonomous City of Buenos Aires. Age, sex, place of work, bibliographic sources, indication of drug and non-drug therapies, and preventive and hygiene measures were recorded. The association between drug prescription and the characteristics of surveyed pediatricians was assessed. Results. In total, 182/216 pediatricians completed the survey. Their mean age was 42.4 ± 10.24 years; 78.6% were females; 59.2% worked in the public sector; 22.4% worked in the emergency department; and 91.2% consulted guidelines and/or consensuses. Also, 92.9% prescribed oral rehydration solutions; 46.2%, antiemetics; 43.4%, antacids and/or gastric protectors; 35.7%, probiotics; and 30.7%, zinc. Early food reintroduction was indicated by 91.7%; breastfeeding, by 96.7%; and preventive and hygiene measures, by 96-100%. The multivariate analysis showed an association between age > 40 years and prescribing antacids/ gastric protectors (odds ratio [OR]: 2.6; 1.22-5.61), probiotics (OR: 3.03; 1.34-6.83), and zinc (OR: 0.39; 0.17-0.87); between working in the private sector and prescribing probiotics (OR: 3.05; 1.565.94); and between working in the emergency department and prescribing antacids/gastric protectors (OR: 2.60; 1.22-5.54). Conclusions. Treatment was mainly based on hydration, early food reintroduction, and breastfeeding. Age and work sector affected the prescription pattern.

Calidad microbiológica del agua subterránea como riesgo epidemiológico en la producción de enfermedad diarreica infantil. Revisión Sistemática / Microbiological quality of groundwater as an epidemiological risk in the production of Childhood Diarrheal Disease. Systematic review

El agua de consumo humano y su calidad son determinantes para la salud pública. Esta revisión pretende recopilar y analizar información acerca de la relación entre la enfermedad diarreica en niños menores de cinco (5) años y la contaminación de las fuentes de agua subterránea. Se consultaron las bases: PubMed, ScienceDirect, SpringerLink, SciELO y Google Scholar, sin limitación en fechas de publicación; utilizando los descriptores: agua subterránea, diarrea, enfermedad gastrointestinal infantil, contaminación microbiana, calidad del agua, diarrea infantil, agua potable, técnicas moleculares y técnicas bioquímicas, analizándose un total de ciento sesenta y nueve (169) publicaciones. Se encontró relación entre la contaminación microbiana del agua subterránea y la diarrea infantil. El agua subterránea se contamina debido a fugas de fosas sépticas, métodos inadecuados de manejo de desechos y escorrentías de agua de lluvia, determinando la prevalencia de diarrea infantil. De allí, la importancia de monitorear la calidad del agua como factor de riesgo, con la detección y cuantificación de bioindicadores, mediante métodos rutinarios y novedosos, e incorporar intervenciones dirigidas a mejorar la accesibilidad a fuentes de agua controladas y la educación sanitaria en la búsqueda de asegurar la protección del agua y la disminución en la prevalencia de la diarrea infantil. Esta revisión está registrada en PROSPERO bajo el número ID 129254

Water for human consumption and its quality are determinants for public health. This review aims to collect and analyze information about the relationship between diarrheal disease in children under five (5) years of age and contamination of groundwater sources. The bases: PubMed, ScienceDirect, SpringerLink, SciELO and Google Scholar, without limitation on publication dates, using the descriptors: groundwater, diarrhea, childhood gastrointestinal disease, microbial contamination, water quality, childhood diarrhea, drinking water, molecular techniques and biochemical techniques, were consulted, analyzing a total of one hundred sixty-nine (169) publications. A relationship was found between microbial contamination of groundwater and childhood diarrhea. Groundwater is contaminated due to septic tank leaks, inadequate methods of waste management and rainwater runoff, determining the prevalence of childhood diarrhea. From there, the importance of monitoring water quality as a risk factor, with the detection and quantification of bioindicators, through routine and novel methods, and incorporating interventions aimed at improving accessibility to controlled water sources and health education in the search to ensure water protection and the decrease in the prevalence of childhood diarrhea. This revision is registered in PROSPERO under the number ID 129254.

Validation of primer for promoting maternal self-efficacy in preventing childhood diarrhea / Validez de la cartilla para la promoción de la autoeficacia materna en la prevención de la diarrea infantil / Validação de cartilha para promoção da autoeficácia materna na prevenção da diarreia infantil

ABSTRACT Objective: to validate an educational primer, regarding content and design, for promoting maternal self-efficacy in preventing childhood diarrhea. Method: methodological study composed of 31 mothers of children under five years of age, in which the validation of the primer You can prevent diarrhea in your child! was carried out from the Content Validity Index (CVI), being evaluated as to the domains understanding, attractiveness, self-efficacy, cultural acceptance, and persuasion. Results: the primer was considered relevant and clear, with average concordance of 99.4% and 99.8%, respectively. The overall CVI was of 0.99, evidencing satisfactory level of agreement between the mothers. The assessment of domains generated satisfactory results. Conclusion: the primer was considered valid by the target audience; thus, it can be implemented for promoting maternal confidence to prevent childhood diarrhea.

RESUMEN Objetivo: validar una cartilla educativa, cuanto al contenido y la apariencia, elaborada para promocionar la autoeficacia materna en la prevención de la diarrea infantil. Método: Estudio metodológico con participación de 31 madres de niños menores de cinco años de edad, en el cual se ha procedido a la validez de la cartilla ¡Usted es capaz de prevenir la diarrea en su hijo! (en portugués: Você é capaz de prevenir a diarreia no seu filho!) desde el Índice de Validez de Contenido (IVC), siendo evaluada cuanto a los dominios comprensión, atracción, autoeficacia, aceptación cultural y persuasión. Resultados: La cartilla ha sido considerada clara y relevante, con el promedio de concordancia del 99,4% y del 99,8%, respectivamente. El IVC global ha sido de 0,99, evidenciando nivel satisfactorio de concordancia entre las madres. La evaluación de los dominios ha generado resultados satisfactorios. Conclusión: La cartilla ha sido considerada válida por el público-objetivo, pudiendo ser implementada para promoción de la confiabilidad materna en prevenir la diarrea infantil.

RESUMO Objetivo: validar uma cartilha educativa, quanto a conteúdo e aparência, elaborada para promover a autoeficácia materna na prevenção da diarreia infantil. Método: estudo metodológico com participação de 31 mães de crianças menores de cinco anos de idade, no qual se procedeu à validação da cartilha Você é capaz de prevenir a diarreia no seu filho! a partir do Índice de Validade de Conteúdo (IVC), sendo avaliada quanto aos domínios compreensão, atratividade, autoeficácia, aceitação cultural e persuasão. Resultados: a cartilha foi considerada clara e relevante, com média de concordância de 99,4% e 99,8%, respectivamente. O IVC global foi de 0,99, evidenciando nível satisfatório de concordância entre as mães. A avaliação dos domínios gerou resultados satisfatórios. Conclusão: a cartilha foi considerada válida pelo público-alvo, podendo ser implementada para promoção da confiança materna em prevenir a diarreia infantil.

Costos de hospitalización por diarrea en niños durante el período de circulación de rotavirus en el Noroeste Argentino / Hospitalization costs associated with diarrhea among children during the period of rotavirus circulation in the Northwest region of Argentina

Objetivo. Evaluar los costos médicos directos, gastos de bolsillo y costos indirectos en casos de diarrea aguda hospitalizada en <5 años, en el Hospital de Niños Héctor Quintana de la provincia de Jujuy, durante el período de circulación de rotavirus en la región Noroeste de Argentina. Métodos. Estudio de corte trasversal de costos de enfermedad. Fueron incluidos todos los niños hospitalizados <5 años con diagnóstico de diarrea aguda y deshidratación durante el período de circulación de rotavirus, entre el 1/5/2013 y el 31/10/2013. La evaluación de costos médicos directos se realizó mediante la revisión de historias clínicas, y los gastos de bolsillo y costos indirectos, mediante una encuesta. Para el intervalo de confianza del 95% del costo promedio por paciente, se realizó un análisis probabilístico de 10 000 simulaciones por remuestreo (boostraping). Resultados. Fueron enrolados 105 casos. La edad promedio fue de 18 meses (desvío estándar 12); 62 (59%) fueron varones. El costo médico directo, gasto de bolsillo y pérdida de dinero por lucro cesante promedio por caso fue de AR$ 3413, 6 (2856, 35-3970, 93) (USD 577, 59), AR$ 134, 92 (85, 95-213, 57) (USD 22, 82) y de AR$ 301 (223, 28380, 02) (USD 50, 93), respectivamente. El total del costo por evento hospitalizado fue de AR$ 3849, 52 (3298-4402, 25) (USD 651, 35). Conclusiones. El valor de costo total por evento hospitalizado se encuentra dentro de lo esperado para Latinoamérica. La distribución de costos presenta una proporción importante de costos médicos directos en relación con los gastos de bolsillo (3, 5%) y costos indirectos (7, 8%).

Objective. To assess direct medical costs, out-of-pocket expenses, and indirect costs in cases of hospitalizations for acute diarrhea among children <5 years of age at Hospital de Niños "Héctor Quintana" in the province of Jujuy during the period of rotavirus circulation in the Northwest region of Argentina. Methods. Cross-sectional study on disease-related costs. All children <5 years of age, hospitalized with the diagnosis of acute diarrhea and dehydration during the period of rotavirus circulation between May 1st and October 31st of 2013, were included. The assessment of direct medical costs was done by reviewing medical records whereas out-of-pocket expenses and indirect costs were determined using a survey. For the 95% confidence interval of the average cost per patient, a probabilistic bootstrapping analysis of 10 000 simulations by resampling was done. Results. One hundred and five patients were enrolled. Their average age was 18 months (standard deviation: 12); 62 (59%) were boys. The average direct medical cost, out-of-pocket expense, and lost income per case was ARS 3413.6 (2856.35-3970.93) (USD 577.59), ARS 134.92 (85.95-213.57) (USD 22.82), and ARS 301 (223.28380.02) (USD 50.93), respectively. The total cost per hospitalization event was ARS 3849.52 (32984402.25) (USD 651.35). Conclusions. The total cost per hospitalization event was within what is expected for Latin America. Costs are broken down into direct medical costs (significant share), compared to out-of-pocket expenses (3.5%) and indirect costs (7.8%).

Influence of socio-economic conditions and maternal knowledge in self-effectiveness for prevention of childhood diarrhea / Influencia de condiciones socioeconómicas y conocimientos maternos en la auto-eficacia para prevención de la diarrea infantil / Influência de condições socioeconômicas e conhecimentos maternos na autoeficácia para prevenção da diarreia infantil

Objective: To verify the association among socioeconomic conditions, maternal behaviors and knowledge with their self-efficacy to prevent childhood diarrhea. Method: Analytical, quantitative study. Interviews were conducted with 238 mothers of children under five admitted into a hospital from January to April 2016. Were collected Sociodemographic data, maternal knowledge on prevention and management of childhood diarrhea, and application of the Maternal Self-Efficacy Scale for Childhood Diarrhea. Results: Association between socioeconomic and maternal self-efficacy variables: family income (p = 0.049), child age (p = 0.010), house type (p = 0.042), garbage destination (p = 0.037), sewage (p = 0.016) and sanitary type (p = 0.006). Regarding knowledge about causes of diarrhea: warmth/heat (p = 0.021); dentition (p = 0.030). Association between self-efficacy and preventive behaviors: home hygiene (p = 0.023); breastfeeding practice (p = 0.028). Conclusion: Socioeconomic conditions and knowledge presented by mothers can influence the level of maternal self-efficacy for the prevention of childhood diarrhea.

Objetivo: Investigar la asociación entre condiciones socioeconómicas, conductas y conocimientos maternos con su auto-eficacia para la prevención de la diarrea infantil. Método: Estudio analítico, cuantitativo. Participaron 238 madres de niños menores de cinco años, ingresados en una unidad hospitalaria entre enero-abril de 2016. Fueron recolectados datos socio-demográficos, conocimientos sobre prevención y tratamiento de la diarrea infantil y aplicación de la Escala de Auto-eficacia Materna para Prevención de la Diarrea Infantil. Resultados: Asociación entre variables socioeconómicas y auto-eficacia materna: ingresos familiares (p = 0,049); edad (p = 0,010); tipo de casa (p = 0,042), destinación de basuras (p = 0,037); tipo de alcantarillado (p = 0,016); tipo de sanitario (p = 0,006). Referente al conocimiento de las causas de la diarrea: calor (p = 0,021); dentición (p = 0,030). Asociación entre autoeficacia y medidas preventivas: higiene del hogar (p = 0,023); práctica de la lactancia materna (p = 0,028). Conclusión: Condiciones socioeconómicas y conocimientos proporcionados por las madres pueden influir en el nivel de auto-eficacia materna para prevenir la diarrea infantil.

Objetivo: O objetivo do estudo foi verificar a associação entre condições socioeconômicas, condutas e conhecimentos maternos com a sua autoeficácia para prevenção de diarreia infantil. Método: Estudo analítico, com abordagem quantitativa, realizado em um hospital. Realizaram-se entrevistas com 238 mães de crianças menores de cinco anos internadas na unidade hospitalar, no período de janeiro a abril de 2016 abordando dados sociodemográficos, conhecimentos maternos sobre prevenção e manejo da diarreia infantil, e aplicação da Escala de Autoeficácia Materna para Prevenção da Diarreia Infantil. Resultados: Verificou-se associação entre as seguintes variáveis socioeconômicas e autoeficácia materna: renda familiar (p = 0,049), idade da criança (p = 0,010), tipo de casa (p = 0,042), destino do lixo (p = 0,037), tipo de esgoto (p = 0,016) e tipo de sanitário (p = 0,006). Referente aos conhecimentos sobre causas da diarreia verificou-se associação entre autoeficácia e as variáveis: quentura/calor (p = 0,021) e a dentição (p = 0,030). Houve ainda associação entre autoeficácia e as condutas preventivas: higiene do domicílio (p = 0,023) e prática do aleitamento materno (p = 0,028). Conclusão: Conclui-se que as condições socioeconômicas e os conhecimentos apresentados pelas mães podem influenciar o nível de autoeficácia materna para prevenção da diarreia infantil.

Fatores sociodemográficos na autoeficácia em prevenir a diarreia infantil: estudo longitudinal / Socio-demographic factors relating to mothers' self-efficacy in preventing childhood diarrhea: a longitudinal study / Factores sociodemográficos en la autoeficacia para prevenir la diarrea infantil: estudio longitudinal

OBJETIVO: Verificar associação entre dados sociodemográficos de mães residentes em microáreas de risco e sua autoeficácia em prevenir diarreia infantil. MÉTODO: Estudo longitudinal realizado em Fortaleza, com 90 mães de crianças menores de cinco anos. A coleta ocorreu utilizando-se a Escala de Autoeficácia Materna para Prevenção da Diarreia Infantil (EADPI) e por contato telefônico. Os dados analisados pelos testes qui-quadrado e razão de verossimilhança. RESSULTADOS: Constatou-se significância nos níveis de autoeficácia com as variáveis: idade entre 15 e 29 (ρ<0,001); casada (p=0,035), união consensual (ρ=0,039), solteira (p=0,033); mais de cinco anos de escolaridade (ρ<0,001); renda per capita menor que R$ 169,50 (ρ<0,001), acima de R$ 169,50 (ρ<0,001); dona de casa (ρ<0,001), outras ocupações (ρ<0,001) equantidade de filhos (ρ<0,001). CONCLUSÃO: O enfermeiro ao aplicar a EAPDI pode monitorar a autoeficácia e associá-la às condições socioeconômicas das mães que influenciam na ocorrência da diarreia, a fim de intervir com ações educativas.

AIM: To determine the links between socio-demographic data of mothers living in at-risk micro areas and their self-efficacy in preventing childhood diarrhea. METHODS: This is a longitudinal study conducted in Fortaleza, with 90 mothers of children under five years of age. Data collection was performed through the use of the Maternal Self-efficacy Scale for Childhood Diarrhea Prevention (EADPI) and by telephone. Data were analyzed by chi-square tests and likelihood ratio. RESULTS: Statistical significance in self-efficacy levels was found within the following variables: aged between 15 and 29 (ρ <0.001); married (p=0.035); consensual union (ρ=0.039); single (p=0.033); more than five years of schooling (ρ<0.001); per capita income lower than R$169.50 (ρ<0.001); per capita income more than R$169.50 (ρ<0.001); housewife (ρ<0.001); other occupations (ρ<0.001); and number of children (ρ<0.001). CONCLUSION: When nurses use the EAPDI they can monitor mothers' self-efficacy and use these results in conjunction with the socio-economic conditions of mothers that influence the occurrence of diarrhea in order to intervene with educational activities.

OBJETIVO: Comprobar la asociación entre los datos sociodemográficos de madres residentes en microáreas de riesgo y su autoeficacia para prevenir la diarrea infantil. MÉTODO: Estudio longitudinal realizado en Fortaleza, con 90 madres de niños menores de cinco años. La colecta ocurrió utilizándose la Escala de Autoeficacia Materna para Prevención de la Diarrea Infantil (EADPI) y por contacto telefónico. Los datos analizados por los testes qui-cuadrado y razón de verosimilitud. RESULTADOS: Se comprobó significancia en los niveles de autoeficacia con las variables: edad entre 15 y 29 (ρ<0,001); casada (p=0,035), unión consensual (ρ=0,039), soltera (p=0,033); más de cinco años de escolaridad (ρ<0,001); ingreso per cápita menor que R$ 169,50 (ρ<0,001), arriba de R$ 169,50 (ρ<0,001); dueña de casa (ρ<0,001), otras ocupaciones (ρ<0,001) y cantidad de hijos (ρ<0,001). CONCLUSIÓN: El enfermero al aplicar la EAPDI puede monitorar la autoeficacia y asociarla a las condiciones socioeconómicas de las madres que influencian en la aparición de la diarrea, con el fin de intervenir con acciones educativas.

Enteropathogensddetected in a daycare center, sutheastern Brazil: bacteria, viirus, and parasite research / Enteropatógenos detectados em crianças de creche no Sudeste do Brasil: pesquisa de bactérias, vírus e parasitos

Introduction: The objective of this study was to determine the prevalence and etiological profile of enteropathogens in children from a daycare center. Methods: From October 2010 to February 2011 stool samples from 100 children enrolled in a government daycare center in the municipality of São José do Rio Preto, in the state of São Paulo, were collected and analyzed. Results: A total of 246 bacteria were isolated in 99% of the fecal samples; 129 were in the diarrheal group and 117 in the non-diarrheal group. Seventy-three strains of Escherichia coli were isolated, 19 of Enterobacter, one of Alcaligenes and one of Proteus. There were 14 cases of mixed colonization with Enterobacter and E. coli. Norovirus and Astrovirus were detected in children with clinical signs suggestive of diarrhea. These viruses were detected exclusively among children residing in urban areas. All fecal samples were negative for the presence of the rotavirus species A and C. The presence of Giardia lamblia, Entamoeba coli, Endolimax nana and hookworm was observed. A significant association was found between food consumption outside home and daycare center and the presence of intestinal parasites. Conclusions: For children of this daycare center, intestinal infection due to pathogens does not seem to have contributed to the occurrence of diarrhea or other intestinal symptoms. The observed differences may be due to the wide diversity of geographical, social and economic characteristics and the climate of Brazil, all of which have been reported as critical factors in the modulation of the frequency of different enteropathogens.

Introdução: O objetivo deste estudo foi determinar a prevalência e o perfil etiológico de enteropatógenos em crianças de uma creche. Métodos: No período de outubro de 2010 a fevereiro de 2011 foram coletadas e analisadas amostras de fezes de 100 crianças matriculadas em creche do governo no município de São José do Rio Preto, Estado de São Paulo. Resultados: Um total de 246 bactérias foram isoladas em 99% das amostras de fezes; 129 eram diarreicas e 117 não-diarreicas. Foram isoladas setenta e três cepas de Escherichia coli, 19 de Enterobacter, uma de Alcaligenes e uma de Proteus. Foram detectados 14 casos de colonização mista com Enterobacter e de E. coli. Norovírus e Astrovirus foram detectados em crianças com sinais clínicos sugestivos de diarréia. Estes vírus foram detectados exclusivamente entre as crianças residentes em áreas urbanas. Todas as amostras fecais foram negativas para a presença das espécies de rotavírus A e C. Foi observada a presença de Giardia lamblia, Entamoeba coli, Endolimax nana e ancilostomídeos. Foi encontrada associação significativa entre o consumo de alimentos fora do centro da casa e creche e a presença de parasitos intestinais. Conclusões: Para as crianças desta creche, a infecção intestinal por patógenos não parece ter contribuido para a ocorrência de diarreia ou outros sintomas intestinais. As diferenças observadas podem ser atribuídas à grande diversidade de características geográficas, sociais e econômicas e o clima do Brasil, as quais tem sido relatadas como fatores críticos para a modulação da frequência de diferentes enteropatógenos.

Conductas, actitudes y prácticas de la madre o cuidador en el manejo de la enfermedad diarreica aguda en menores de cinco años / Behaviors, attitudes and practices of the mother or caregivers in the management of acute diarrhea in children under five years / Comportamentos, atitudes e práticas da mãe ou responsável na gestão da diarreia aguda em crianças menores de cinco anos

Objetivo: determinar las creencias de la madre y del cuidador sobre el manejo de la enfermedad diarreica aguda en menores de 5 años de edad en la ciudad de Bucaramanga en el año 2015. Materiales y Métodos: la investigación se enmarca en el paradigma cuantitativo mediante el desarrollo de estudio descriptivo de corte transversal; se encuestaron 200 madres o cuidadores de menores de cinco años en la ciudad de Bucaramanga, seleccionados mediante muestreo aleatorio estratificado con afijación proporcional, confiabilidad 95% y margen de error de 7%. Para la recolección de la información se empleó una encuesta elaborada por la autora con validación estadística y por expertos. Resultados: se obtiene información sobre conocimientos y tradiciones acerca del manejo de la diarrea y la identificación de los signos de deshidratación por parte de los cuidadores, que son analizados en comparación con sus características sociales y culturales. Conclusiones: en Bucaramanga, madres y cuidadores de menores de cinco años, continúan la tradición familiar en lo referente a identificación de signos de deshidratación y costumbres en el manejo de la diarrea; la mayoría acude a consulta médica para su tratamiento; sin embargo, se encuentra un alto porcentaje que también recurre al tegua­sobandero. Para el manejo de la diarrea, las madres o cuidadores suministran caldos a los menores, aumentan la cantidad de líquidos, les administran sales de rehidratación oral y jugo de guayaba. Se encuentran diferencias acerca de las costumbres y tradiciones entre estratos socioeconómicos y niveles de escolaridad.

Goal: to determine the beliefs of mothers and caregivers about the management of acute diarrhea in children under 5 years old in Bucaramanga city in the year 2015. Materials and Methods: the research is part of the quantitative paradigm by development of cross-sectional descriptive study; 200 mothers or caregivers of children under five were surveyed in Bucaramanga city,they were selected through stratified random sampling with proportional allocation, reliability and 95% margin of error of 7%. For data collection, a survey was conducted by the author with statistical validation and experts. Results: information on knowledge and traditions about the management of diarrhea and identify signs of dehydration by caregivers, which are analyzed in comparison with their social and cultural characteristics were obtained. Conclusions: in Bucaramanga city , mothers and caregivers of children under five years, continue the family tradition when it comes to checking for signs of dehydration and the old fashioned method in the management of diarrhea; most of them go to see their doctor for treatment; however, there is a high percentage that also relies `Tegua-sobandero`. For the management of diarrhea, mothers or caregivers provide wines to children, increase the amount of fluids administered them ORS and guava juice.There were some differences concerning to the customs and traditions between socioeconomic and educational levels.

Objetivo: para determinar as crenças de mães e cuidadores sobre a gestão da diarreia aguda em crianças menores de 5 anos na cidade de Bucaramanga em 2015. Materiais e Métodos: a pesquisa é parte do paradigma quantitativo por desenvolvimento de estudo descritivo transversal; 200 mães ou cuidadores de crianças menores de cinco anos foram pesquisados na cidade de Bucaramanga, selecionadas por amostragem aleatória estratificada com alocação proporcional, confiabilidade e margem de 95% de erro de 7%. Para pesquisa de coleta de dados realizada pelo autor com validação estatística e os peritos que ele estava acostumado. Resultados: informações sobre o conhecimento e tradições sobre a gestão de diarreia e identificar sinais de desidratação por cuidadores, que são analisadas em comparação com as suas características sociais e culturais é obtido. Conclusões: em Bucaramanga, mães e cuidadores de crianças menores de cinco anos, continuar a tradição da família quando se trata de verificar se há sinais de desidratação e alfândegas na gestão da diarreia; mais ir ver o seu médico para tratamento; no entanto, há uma alta porcentagem que também se baseia Tegua-sobandero. Para a gestão de diarreia, mães ou cuidadores fornecem vinhos a menores, aumentar a quantidade de fluidos administrados los ORS e suco de goiaba. diferenças sobre os costumes e tradições entre os níveis socioeconômicos e educacionais são.

Tendência temporal da mortalidade geral e morbidade hospitalar por doença diarreica em crianças brasileiras menores de cinco anos no período de 2000 a 2010 / Temporal trends of overall mortality and hospital morbidity due to diarrheal disease in Brazilian children younger than 5 years from 2000 to 2010

OBJETIVO: Conhecer as tendências temporais dos indicadores de mortalidade geral e morbidade hospitalar por doença diarreica em crianças menores de um ano e de um a quatro anos, conforme as regiões brasileiras, entre 2000 e 2010. MÉTODO: Estudo ecológico de séries temporais. Os dados sobre Autorização de Internação Hospitalar, média de permanência e valor médio dessa autorização foram obtidos do Sistema de Informações Hospitalares; o número de óbitos infantis foi adquirido no Sistema de Informações sobre Mortalidade; as informações sobre os nascidos vivos e a população geral foram obtidas do Sistema de Informações sobre Nascidos Vivos e dos Censos Demográficos, respectivamente. Dados disponíveis no endereço eletrônico do Departamento de Informática do Sistema Único de Saúde/Ministério da Saúde. RESULTADOS: A mortalidade por diarreia no Brasil evidenciou tendência de decréscimo desacelerado em ambas as faixas etárias. Quanto à hospitalização, houve tendência decrescente discreta nos menores de um ano e ascendência insignificante entre 1-4 anos, entretanto, com menor permanência e valor médio de internamento, independentemente da idade e da região. Registraram-se no Norte e Nordeste os maiores coeficientes de mortalidade e maior porcentagem de internação nos menores de um ano. O Centro-Oeste apresentou maior redução média anual do tempo de permanência hospitalar. CONCLUSÃO: Atualmente, os indicadores de mortalidade geral e morbidade hospitalar por diarreia em crianças brasileiras encontram-se, de forma geral, mais baixos, porém lentamente decrescentes.

OBJECTIVE: To verify the temporal trends of the indicators of overall mortality and hospital morbidity due to diarrheal disease in children younger than 1 year and between 1 and 4 years, according to the region of Brazil, between 2000 and 2010. METHOD: This was an ecological study of temporal series. Data on hospital admission authorization, mean length of stay, and mean value of the authorization were obtained from the Hospital Information System. The number of infant deaths was obtained from the Mortality Information System; information on live births and the general population were obtained from the Information System on Live Births and Demographic Censuses, respectively. These data were available at the website of the informatics department of the Brazilian Unified Health System/Ministry of Health. RESULTS:Mortality due to diarrheal disease in Brazil showed a downwards trend in both age groups. Regarding hospitalization, there was a slight downwards trend in children younger than 1 year and a non-significant upwards trend between 1-4 years, with a shorter hospital stay and lower mean value of hospital stay, regardless of age and region. The North and Northeast had the highest mortality rates and the highest percentage of hospitalizations in children younger than 1 year. The Midwest had the highest mean annual reduction in hospital stay. CONCLUSION: Currently, the indicators of overall mortality and hospital morbidity due to diarrhea in Brazilian children are generally lower, but decreasing slowly.

Ações iniciais de mães diante do filho com diarreia / First actions of mothers before the child with diarrhea

Objetivou-se identificar as ações realizadas pelas mães diante do filho com diarreia. Estudo descritivo, transversal, com 47 mães de uma Unidade Básica de Saúde de Caucaia-CE, Brasil, realizado de maio a julho/2010 por meio de formulário. As ações referidas pelas mães foram: condução dos filhos à UBS (25) e oferta de soro de reidratação oral (22). As mães diante da criança com episódio de diarreia procuraram a UBS para atendimento clínico, importante ação, pois minimiza as possíveis complicações relacionadas à diarréia. O trabalho educativo realizado pelos profissionais tem melhorado a conduta inicial das mães.

Phenotypic and Genotypic Characteristics of Enteropathogenic E. coli Isolated from Children with Diarrhea in Gwangju City

BACKGROUND: Enteropathgenic Escherichia coli (EPEC) commonly causes infantile diarrhea in the developing countries. This study aims to find out the phenotypic and genotypic characteristics of EPEC in children with diarrhea in Gwangju city. METHODS: We isolated 35 strains from the stool obtained from diarrheal patients and investigated the presence of various virulence genes, adherence patterns, hemolysis, and antibiotic resistance patterns. RESULTS: All isolates were negative for the EPEC adherence factor (EAF) plasmid, and 14 isolates were bfpA-positive by PCR. The eae, tir, espA, and espB genes were analyzed by multiplex PCR. When the results of the four multiplex PCRs were analysed, we observed that the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was highest. The incidence of enteroaggregative E. coli heat-stable enterotoxin (east) was 17.1%. Analysis of Hep-2 cell adherence showed three adherence patterns:the localized adherence pattern, the diffuse adherence pattern, the localized adherence-like pattern. In hemolysin assay, four isolates produced enterohemolysin. The resistance rate of isolates against tetracycline, streptomycin, ampicillin, and rifampin was 56%, 39%, 34%, and 34%, respectively. All isolates were susceptible to ciprofloxacin and colistin. CONCLUSION: In our study, the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was the highest. Analysis of Hep-2 cell adherence showed various adherence patterns. Seventy-five percent of isolates were resistant to at least one antibiotic and 28% were resistant to four or more antibiotics.

Phenotypic and Genotypic Characteristics of Enteropathogenic E. coli Isolated from Children with Diarrhea in Gwangju City

BACKGROUND: Enteropathgenic Escherichia coli (EPEC) commonly causes infantile diarrhea in the developing countries. This study aims to find out the phenotypic and genotypic characteristics of EPEC in children with diarrhea in Gwangju city. METHODS: We isolated 35 strains from the stool obtained from diarrheal patients and investigated the presence of various virulence genes, adherence patterns, hemolysis, and antibiotic resistance patterns. RESULTS: All isolates were negative for the EPEC adherence factor (EAF) plasmid, and 14 isolates were bfpA-positive by PCR. The eae, tir, espA, and espB genes were analyzed by multiplex PCR. When the results of the four multiplex PCRs were analysed, we observed that the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was highest. The incidence of enteroaggregative E. coli heat-stable enterotoxin (east) was 17.1%. Analysis of Hep-2 cell adherence showed three adherence patterns:the localized adherence pattern, the diffuse adherence pattern, the localized adherence-like pattern. In hemolysin assay, four isolates produced enterohemolysin. The resistance rate of isolates against tetracycline, streptomycin, ampicillin, and rifampin was 56%, 39%, 34%, and 34%, respectively. All isolates were susceptible to ciprofloxacin and colistin. CONCLUSION: In our study, the rate of the presence of eaegamma-tiralpha-espAalpha-espBalpha was the highest. Analysis of Hep-2 cell adherence showed various adherence patterns. Seventy-five percent of isolates were resistant to at least one antibiotic and 28% were resistant to four or more antibiotics.