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Determinants of morbidity and mortality due to acute respiratory infections: implications for intervention
T E Tupasi1, M A Velmonte, M E Sanvictores
1Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines.
Abstract:
Acute respiratory infections (ARI) were monitored every two weeks in an urban community in Metro Manila, Philippines, to determine the incidence and risk factors for ARI morbidity. Hospitalized children with acute lower-respiratory-tract infection (ALRI) were studied to determine case-fatality rates (CFR) and predictors for mortality. Incidence rates were highest in infants, 3.2-4.0 per person, followed by children one to four years of age, with corresponding rates of 3.0-3.4 per person. The risk factors for ARI morbidity were low socioeconomic status and age less than one year. A CFR of 5% in children with ALRI was observed. Malnutrition and a positive culture of blood were significant risk factors for mortality. These identified risk factors underscore the value of primary health care interventions, such as the standard ARI case management, immunization, health education, promotion of breast-feeding, and vitamin A supplementation, as strategies for reducing ARI mortality in developing countries.
Insights
Infants and young children in Metro Manila face high rates of acute respiratory infections (ARI). Low socioeconomic status and malnutrition are key risk factors for ARI morbidity and mortality, highlighting the need for primary health care interventions.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Acute respiratory infections (ARI) pose a significant health burden globally, particularly in developing countries.
- Understanding the incidence and risk factors for ARI is crucial for effective public health strategies.
Purpose of the Study:
- To determine the incidence and risk factors for acute respiratory infection (ARI) morbidity in an urban community in Metro Manila, Philippines.
- To assess case-fatality rates (CFR) and identify predictors of mortality among hospitalized children with acute lower-respiratory-tract infection (ALRI).
Main Methods:
- Two-weekly monitoring of ARI incidence in an urban community.
- Retrospective study of hospitalized children with ALRI to determine CFR and mortality predictors.
Main Results:
- Incidence rates of ARI were highest in infants (3.2-4.0 per person) and children aged 1-4 years (3.0-3.4 per person).
- Low socioeconomic status and younger age (<1 year) were identified as risk factors for ARI morbidity.
- A 5% CFR was observed in children with ALRI, with malnutrition and positive blood cultures being significant mortality predictors.
Conclusions:
- Primary health care interventions, including standard ARI case management, immunization, health education, and nutritional support (breast-feeding, vitamin A), are vital for reducing ARI mortality in developing nations.
- Targeting interventions towards high-risk groups, such as infants and children from low socioeconomic backgrounds, is essential.