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This paper shows the results of a study of acute diarrhoea (AD) in 137 rural communities in Mexico. We studied 51 communities with 1000 inhabitants or less, 45 communities with 1001 to 5000 inhabitants and, 41 with 5001 to 15000 inhabitants. All in all we observed 4,796.9 persons year during a period comprised from March 1982 to February 1983. In communities with more than 5000 inhabitants there occurred 0.85 episodes of AD per person-year, whereas in the smaller ones the incidence was only 0.58 episodes per person-year p less than 0.01). In small communities the frequency was higher in families with poor water supply and inadequate excreta disposal, whereas in large communities the frequency was not affected by such services. In 95.6 percent of the cases the episodes were self-limited within the first 14 days. There were seven deaths, five occurring in children under one year of age, six in children living in small communities and, five associated with dehydration. These results suggest that the size of the community constitutes a risk factor for AD in rural areas, which deserves to be explored in further studies. The lethality observed in small communities stresses the need of programs for better treatment of this frequent disease.

This study describes the epidemiology of acute respiratory infections (ARI) in a sample of rural population of México. The study includes 137 communities from all over the country: 51 with 5001 to 15000. In each community ten families with one child under one year of age were followed. Each family was child under one year of age were followed. Each family was visited weekly by one physician from the local IMSS-COPLAMAR clinic in order to register frequency and characteristics of ARI in each family member. We followed 1359 families and observed 4796.9 persons-year. Eight thousand and two episodes of ARI were observed. The relative risk of getting ARI in children below two years of age was 2.8 and in severe malnourished was 1.8. The frequency of ARI was higher in large communities than in small ones. Eight six point eight percent of the episodes were upper respiratory infections, 95.3 percent of the cases cured, 4.6 became chronic and there were four deaths. Mortality rate was 0.8 per 1000 persons-year. Sixty nine point eight percent of the cases received antithermics, 49.3 percent antihistaminics and, 48.6 percent antibiotics.