The fight against diarrhoeal diseases: The case of Costa Rica

Abstract

Like most developing nations, Costa Rica exhibited a very high morbidity and mortality attributable to diarrhoeal diseases during the first half of this century. Relatively good data on total population and on diarrhoea deaths are available from 1925 onwards (Mata, 1981). San Jose, the capital city; had a population of about 25,000 at the turn of the century and an estimated mortality rate from all causes of 41 per 1000 population; the city was described as one of the filthiest in the world (Jiménez and Jiménez, 1901). The diarrhoea disease death rate for 1900 was 239 per 100,000, almost surely an underestimate, and clinical descriptions from the records of the San Juan de Dios Hospital indicate that most fatal cases were due to dysentery and cholera-like syndromes. The diarrhoeal disease mortality and infant mortality rates In Costa Rica progressively declined from very high rates during the first quarter of the century, to very low figures In the 1970s. Rates In the 1930s are comparable to those in ports of contemporary Asia and Africa, where poverty and malnutrition are still highly prevalent.