Hospitalizations for diarrhea in children under 5 years of age: time and spatial series analysis, Arapiraca, 2010–2021Objective To analyze the temporal trend and spatial distribution of hospitalizations for diarrhea in children under 5 years of age in Arapiraca, Alagoas, between 2010 and 2021.
Methods This is a time and spatial series analysis of hospitalizations for diarrhea in children under 5 years of age in Arapiraca. The temporal trend in hospitalization rates was assessed using autoregressive linear regression from 2010 to 2019, estimating the average annual percent change (AAPC), the 95% confidence interval (95%CI), and the corresponding p-value. A density map was created to assess spatial distribution using the Kernel density estimator, identifying case clusters between 2017 and 2021.
Results A total of 4,013 hospitalizations were recorded; 59.9% occurred in children under 2 years of age, 57.1% remained hospitalized for 2 to 3 days, and there were 7 deaths. In 2021, hospitalization rates in children under 1 year of age were 4 times higher in the rural area (40.3/1,000 children/year; 95%CI 26.8; 64.7). The trend was increasing for hospitalizations in children under 5 years of age in rural (AAPC 0.56; 95%CI 0.29; 0.83; p-value 0.001) and urban areas (AAPC 0.06; 95%CI 0.02; 0.09; p-value 0.006), and in children aged 1 to 4 years, remaining stationary among those under 1 year of age. Spatial analysis identified clusters of cases in areas of accelerated urbanization.
Conclusion Diarrhea is one of the main causes of hospitalization in childhood, with increasing trends in vulnerable territories, reinforcing the need for health surveillance and planning.
Keywords
Diarrhea; Gastroenteritis; Epidemiology; Time Series Studies; Spatial Analysis
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