[Risk factors for behavioral and emotional problems in childhood: a community study in Uruguay]. / Factores de riesgo de trastornos conductuales y emocionales en la niñez: estudio comunitario en el Uruguay.

OBJECTIVES: To explore some of the demographic risk factors that are associated with the risk of behavioral or emotional problems in children, and to examine the possibility of an association between psychological stress in the parents and psychological problems in their children. METHODS: In this study, the presence of psychological stress in the parents and certain psychosocial characteristics that increase the risk of mental problems in childhood were examined in a sample of Uruguayan children from three communities, two urban and one rural. The study, which was carried out in Ciudad Vieja and Barrio Sur, in the city of Montevideo, and in Colonia de Sacramento, a rural town, comprised 115 children between the ages of 5 and 15. Mothers answered the Child Psychiatric Morbidity Questionnaire (QMPI), an instrument for the detection of behaviors pointing to the presence of emotional problems in children. Both parents also supplied the demographic information requested in the Psychiatric Epidemiology Research Interview Demoralization Scale; they answered the CAGE questionnaire, a screening tool for alcoholism; they responded to the Social Support Network Inventory; and they answered questions about their self-perceived mental health. RESULTS: Fifty-three percent of the children had scores greater than 6 on the QMPI, which indicates the possible presence of behavioral or emotional problems. Fathers' self-perception of emotional problems and mothers' feeling of being demoralized showed a statistically significant association with a greater risk of behavioral or emotional problems in their children. CONCLUSIONS: In light of our results, mental health in childhood is a social and public health problem that warrants further epidemiologic study in Uruguay.

Etiology and severity of community acquired pneumonia in children from Uruguay: a 4-year study.

The 4-year study (1987-1990) covered the major clinical-epidemiological characteristics of pneumonia in children as diagnosed at the emergency service of the Children's Hospital, as well as etiologies, and factors involved in the most severe cases. Etiology was determined in 47.7% of the 541 pneumonia cases, involving 283 pathogens of which 38.6% were viruses and 12.6% bacteria. Viral and mixed etiologies were more frequent in children under 12 months of age. Bacteria predominated in ages between 6 and 23 months. Among the viruses, respiratory syncytial virus predominated (66%). The bacterial pneumonias accounted for 12.2% of the recognized etiologies. The most important bacterial agents were S. pneumoniae (64%) and H. influenzae (19%). H. influenzae and mixed infections had a relevant participation during the 1988 season, pointing to annual variations in the relative participation of pathogens and its possible implication in severity of diseases. Correlation of severity and increased percentage of etiological diagnosis was assessed: patients with respiratory rates over 70 rpm, or pleural effusion and/or extensive pulmonary parenchyma compromise yielded higher positive laboratory results. Various individual and family risk factors were recognized when comparing pneumonia children with healthy controls.

Acute respiratory infections in children from a deprived urban population from Uruguay.

To obtain base line data on incidence, duration, clinical characteristics and etiology of acute respiratory infections (ARI), 276 children from deprived families living in Montevideo were followed during 32 months. The target population was divided into two groups for the analysis of the results: children aged less than 12 months and those older than this age. During the follow-up period 1.056 ARI episodes were recorded. ARI incidence was 5.2 per child/year. It was 87% higher in infants than in the older group, as was the duration of the episodes. Most of the diseases were mild. Tachypnea and retractions were seldom observed, but 12 children were referred to the hospital, and 2 infants died. Viral etiology was identified in 15.3% of the episodes. RSV was the predominant agent producing annual outbreaks. Moderate to heavy colonization of the upper respiratory tract by Streptococcus pneumoniae (32.3%) and Hemophilus sp. (18.9%) was recorded during ARI episodes. This community-based study furnish original data on ARI in Uruguay. It enabled to assess the impact of these infections on childhood.

A community-based study of acute respiratory tract infections in children in Uruguay.

Acute respiratory tract infection (ARI) was investigated in children less than 5 years old in a longitudinal community-based study of 166 families living in a socioeconomically depressed area in Montevideo, Uruguay. Pediatricians made home visits every 10 days from May 1985 to December 1987, and symptoms and signs of ARI were recorded. The incidence of ARI was 5.8 episodes per child-year during the first 12 months of life and decreased with increasing age of the index children; the rate was highest in children 1-5 months old. Children observed from birth were ill during 21% of the visits. According to the definitions of the study, the incidence of lower respiratory tract infection was 11.6% higher than the incidence of upper respiratory tract infections. The rates of ARI were higher during the colder months. Most risk factors for ARI were only marginally statistically significant.