Dynamics of acute diarrhea rates in Brazil: between vaccination advances and setbacks during the pandemic (2006–2020)

Abstract

Objective: To evaluate the temporal trend of vaccination coverage against human rotavirus and the rates of hospitalization and mortality due to acute diarrheal disease (ADD) in children under five years of age in Brazil, between 2006 and 2020, highlighting the pattern observed in 2020, the first year of the COVID-19 pandemic. Methods: An ecological time-series study using secondary data from Tabnet/DATASUS across the five Brazilian regions. Trends were analyzed using the Joinpoint regression model, considering APC, AAPC, and 95% confidence intervals (95% CI). Results: Vaccination coverage increased until 2015, followed by a decline and stabilization, reaching 77.29% in 2020, with higher values in the South, Southeast, and Central-West regions. Hospitalization and mortality rates due to ADD showed a consistent reduction nationwide and across all regions, with 2020 recording the lowest values in the historical series. Regional inequalities persisted, with worse indicators in the North and Northeast regions. Conclusion: Vaccination against human rotavirus showed a positive effect on reducing hospitalization and mortality due to ADD, despite periods of stabilization and declines in coverage, from its introduction through the year of the COVID-19 pandemic. The use of secondary data and the absence of records from the private healthcare sector represent limitations of the study.