Socioeconomic differentials of diarrhoea morbidity and mortality in selected villages of Bangladesh

Abstract

In an attempt to examine the possible effects of socioeconomic factors on diarrheal disease in terms of 1) number of household episodes, 2) hospitalizations, and 3) fatalities, data from the Matlab study area, Camilla District, Bangladesh, was examined and linked to patients' ages and education levels, occupational categories of the heads of households, and dwelling ownership and type. Data comes from 3 sources: 1) a year-long (1975) study, as part of a UNICEF Cholera Research Laboratory (CRL), based on weekly visits to each household in 11 of 12 selected villages to obtain specific 1st-hand information about diarrheal episodes; 2) records of diarrhea patients hospitalized at the Matlab field treatment center for 1975; and 3) data regarding 1975 diarrheal deaths reported in a longitudinal Demographic Surveillance System maintained by the CRL. Socioeconomic data for the study villages was collected in 1974 as part of a larger periodic census. Households having a higher socioeconomic status reported diarrhea better, suggesting that possible attitude differences among diverse socioeconomic groups should be recognized before designing studies to estimate disease prevalence and control. The diarrhea hospitalization rate increased with educational status, but was not explained by either higher occupational status or ownership of a better dwelling. The diarrhea mortality rate decreased consistently with higher educational and occupational status as well as with ownerhsip of better houses. Correlation of age with diarrhea episode and hospitalization rates was highest in the 0-4 age group, and decreased with increasing age; the highest mortality rate was found in the age group 45+, a lower rate in age group 0-4, with the lowest rates for mid-range ages. Children under age 5 were most affected by diarrhea episodes, followed by age groups 5-14 and 45+; least affected was age group 15-44.