Yach D, Strebel P M, Joubert G
Centre for Epidemiological Research in Southern Africa, South African Medical Research Council, Parowvallei.
S Afr Med J. 1989 Nov 4;76(9):472-5.
Diarrhoeal disease remains a major cause of morbidity and mortality in children in the RSA. In 1984, 8,984 deaths from diarrhoea of children under 5 years of age were registered, representing 27.7% of all registered deaths in this age group. Assuming a case/fatality ratio (deaths per 100 episodes of diarrhoea) of 0.6, it is estimated that 1.5 million cases of diarrhoea in children occurred during 1984 in the RSA. Analysis of diarrhoeal disease mortality rates revealed that the group at highest risk is black and coloured children under the age of 1 year. Over the period 1968-1985 there have been steady declines in diarrhoeal disease mortality rates for whites, coloureds and Asians. Uncertainty exists as to the true mortality rate in black children. A marked seasonal cycle is evident in diarrhoeal disease mortality rates for blacks and coloureds with peaks occurring in the period December-March. No seasonal effect on mortality is evident in the white and Asian groups. A nationally co-ordinated diarrhoea control programme is urgently needed in the RSA. This would involve a primary prevention component involving improved water supply, sanitation and sewerage, and a death prevention component emphasising the use of oral rehydration solutions. The seasonality in mortality suggests that the health education component of this programme should be aimed at the period just preceding the summer/autumn epidemic.
腹泻病仍然是南非儿童发病和死亡的主要原因。1984年，登记了8984例5岁以下儿童死于腹泻，占该年龄组所有登记死亡人数的27.7%。假设病例/死亡率（每100次腹泻发作的死亡人数）为0.6，据估计1984年南非发生了150万例儿童腹泻病例。腹泻病死亡率分析显示，风险最高的群体是1岁以下的黑人儿童和有色人种儿童。在1968年至1985年期间，白人、有色人种和亚洲人的腹泻病死亡率一直在稳步下降。黑人儿童的实际死亡率尚不确定。黑人和有色人种的腹泻病死亡率呈现明显的季节性周期，高峰期出现在12月至3月期间。白人和亚洲人群体中未发现死亡率有季节性影响。南非迫切需要一个全国性协调的腹泻控制项目。这将包括一个初级预防部分，涉及改善供水、卫生和污水处理，以及一个预防死亡部分，强调使用口服补液溶液。死亡率的季节性表明，该项目的健康教育部分应针对夏末/秋初疫情来临之前的时期。
