1 According to the National Survey on Demography and Health/2006, Brazil used the “homemade hydration solution” more frequently than other forms of ORS (government-provided solution and commercially available solutions) to revert cases of morbid diarrhea.18 Lower numbers of deaths from diarrhea have been recorded, but without a proportional decrease in morbidity attributable to this

disease,6 and 18 which imposes a heavy burden on the public health system.19 The present study showed a slow annual reduction in rates of hospitalization for diarrhea in children younger than 1 year and a slight increase in children between 1 and 4 years, demonstrating that hospitalizations KRX-0401 in vivo remained generally stable, despite a modest increase in some regions of the country (North/Northeast). National literature mentions a reduction of approximately 40% to 60% in the rate of hospitalization

in children younger than 1 year,3 and 20 with different evolutions between the Brazilian regions and stabilization between the ages of 1 and 4 years,20 but at different time periods. In the U.S., diarrhea was considered a major cause of hospitalization of children younger than 5 years in 2000, with an expected reduction after rotavirus vaccination measures.21 This fact was recorded in Brazil,15 mainly in children younger than 1 year, although in the present study a small reduction in hospitalization rates was observed, perhaps explained Selleck Epacadostat by the low and variable rotavirus vaccine coverage achieved since 2006 in Brazil.8 Even though the Brazilian Ministry of Health established a goal of coverage

of 90%,22 the maximum coverage achieved was 84.4% in 2009, and the mean was only 58.7% in the country between 2006 and 2010. In spite of the mentioned reduction, gastroenteritis and its complications are the leading cause of hospitalization of children younger than 5 years Casein kinase 1 due to conditions treated in primary care between 1999 and 2006, with higher rates of hospitalization in the North, Northeast, and Midwest.20 The trend in this series was similar: the North and Northeast accounted for the greatest number of hospitalizations, especially in children younger than 1 year, throughout the study period. This is possibly due to socioeconomic and cultural differences historically found in these regions, in addition to the increased demand for public hospitals in these regions.18 The recommendation of hospitalization during an episode of diarrhea is restricted to complicated cases with severe dehydration due to hypovolemic shock and high risk of death, in addition to small infants, malnourished patients, those with elevated fecal loss, and those whose caregiver is unable to successfully manage the disease at home.23 Furthermore, the low level of education in certain regions of Brazil account for most of the hospitalizations.