La enfermedad diarreica aguda en los países en vías de desarrollo : I. Base epidemiológica de su control

Abstract

In most populations, a continuum of clinical severity from inapparent infection to fatal disease characterizes the acute diarrheas, independently of whether or not a recognized microbial pathogen is involved. In lesser developed regions of the world, average severity is greater and the clinical course longer and more irregular than in more favored areas. Generally, the same kinds of infectious agents are recognized in the two situations, although they differ in relative and absolute frequency. The observed differences in clinical effect, especially among children, appear related primarily to nutritional state of the host and to an unsanitated environment with resultant larger doses of infecting agent. In any single situation, endemic or epidemic, clinical entities cannot be distinguished with certainty, although etiologically distinct diseases can be demonstrated. A mixture of diseases is usual and mutiple infections of an individual relatively frequent. Clinical differences do not provide a basis for community control

Specific enteric agents, including Shigella, Salmonella, enteropathogenic Esch. coli, or Entamoeba histolytica, ordinarily can be domonstrated in about 20 percent of diarrheas of lesser developed countries, Shigella being commonest. A total of 40 percent is occasional and 60 percent exceptional. Many cases apparently are related to enteric microorganisms ordinarily not ... (AU)

Difunciones por gastritis y enteritis por 100.000 habitantes