ISPUB.COM The Internet Journal of Pediatrics and Neonatology Volume 4 Number 1 1 of 7 Clinical Course Of Diarrhea In Pediatric Primary Health Care D Joveleviths, J Prolla, E Fernandes, J Corrêa, D Coelho Citation D Joveleviths, J Prolla, E Fernandes, J Corrêa, D Coelho. Clinical Course Of Diarrhea In Pediatric Primary Health Care. The Internet Journal of Pediatrics and Neonatology. 2003 Volume 4 Number 1. Abstract The main purpose of this study was to observe the evolution of diarrheic disease, detect the incidence of chronic diarrhea, and identify some of the factors related to the protection against or worsening of the disease. For this purpose the methodology of the uncontrolled study of a cohort was employed. All cases of diarrhea which came to the out patient clinic for primary care in a low-income area, on the outskirts of Porto Alegre during the period of one year (from January, 2000 to January, 2001) were followed for two months. The data collection instrument was made up of six protocols including data which would help grasp the natural history of the disease and some factors which may be related such as: age, birth, weight, breast-feeding, degree of nutrition, family income, level of education of the persons responsible for the child, and length of stay with the mother. It was concluded that the population studied presented a high rate of chronicity (43%) and there was no association with the above prognostic factors INTRODUCTION The decision to study diarrhea in childhood is due to the magnitude of this problem in Third World countries such as Brazil. The discovery and use of the rehydration solution, during the last decade, has reduced morbidity and mortality in most cases. Despite this, diarrheic disease is still the major cause of death in childhood. In 24 studies performed in Africa, Asia and Latin America, excluding China, the population of children under the age of five, a total of 338 millions, had a mean morbidity rate between 2.2 and 3 episodes of diarrhea/child/year. A mortality/case rate equal to 0.6 deaths/100 episodes was observed in children below the age of 5 ( 1 , 2 ). In the Brazilian Northeast, diarrhea accounts for 22% to the total number of deaths and 53% to the total number of deaths, in the under 5 age group( 3 , 4 ). This work proposes to study some epidemiological aspects of pediatric diarrhea in a low-income area a large city including demographic, socioeconomic and clinical factors. In the latter, an attempt was made to observe the evolution of the disease, chronification rate, and some likely prognostic factors. METHODS The study was performed in a low-income area of the city of Porto Alegre, Rio Grande do Sul, with approximately 6000 inhabitants. The sample included all children (see inclusion criteria below) who came to the local Sanitary Unit, between January 19, and January 20. The inclusion criteria were all children living in this area up to 5 years old with diarrhea (increased proportion of liquid contents in stools) who came to the Sanitary Unit for treatment of diarrhea during the period of study. Children who were new-born infants with liquid stools when exclusively breast-fed or whose mother did not understand what diarrhea is were excluded. When the study began, 6 case follow-up protocols were applied. The first was applied at the first interview with person responsible for the child. This was done at any time during diarrheic disease, i.e.; it might be on the first day or during the extended period. Prevalent cases (defined as chronic if there was a diarrheic condition which lasts more than fifteen days or when three episodes of diarrhea occur in less than two months) were excluded from the analysis of results. The protocol consisted of identification data (personal information) on the child, diarrhea (characteristics of the stools, duration, associated symptoms, medication used, triggering factors), weight at birth, nutrition, previous medical history of the child, socioeconomic data on the