[Environmental sanitation and mortality associated with waterborne diseases in children under 5 years of age in Brazil].
OBJECTIVE
Determine and evaluate the relationship between the variables for water conditions, environmental sanitation, and mortality in children under 5 years of age associated with a group of waterborne diseases.


METHODS
An exploratory ecological study was conducted based on data obtained from the 2000 national demographic census and the Unified Health System for the 558 microregions of Brazil. The model used multiple linear regression analysis. Mortality associated with waterborne diseases in children under 5 years of age was considered to be the response variable. Water conditions, sanitation, and level of education were considered to be explanatory variables.


RESULTS
A direct relationship was observed between inadequate sanitation in the dwelling (e.g., sewage disposal via rudimentary gutters and pits, the disposal of waste in uncultivated land or public areas) and mortality in children under 5 years of age associated with waterborne diseases. An inverse relationship was found between level of education and mortality associated with waterborne diseases in these children.


CONCLUSIONS
The greatest health hazards related to poor sanitation were found in the microregions with a high concentration of low-income population with limited education. The general sanitation conditions and other factors related to dwelling quality and infrastructure are major determinants of mortality. Coverage of the water services, which reach 90% of households in Brazil, was not in itself found to be an important factor in the reduction of the mortality studied.
Departamento de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Manguinhos, Brazil. jbellido@icict.fiocruz.br
Jaime Gregorio
JG
Bellido
Christovam
C
Barcellos
Flavia dos Santos
Fdos S
Barbosa
Francisco Inacio
FI
Bastos
D001938:Brazil / Q000453:epidemiology; D046688:Child Mortality; D002675:Child, Preschool; D004197:Disease Reservoirs; D004522:Educational Status; D005260:Female; D006798:Housing; D006801:Humans; D006920:Hygiene; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D011203:Poverty; D012498:Sanitary Engineering / Q000379:methods / Q000706:statistics & numerical data; D012499:Sanitation / Q000706:statistics & numerical data*; D014871:Water Microbiology; D014876:Water Pollution; D014881:Water Supply / Q000592:standards / Q000706:statistics & numerical data