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Simple approach to acute respiratory infection in rural under five children
D K Agarwal1, B D Bhatia, K N Agarwal
1Department of Pediatrics, Banaras Hindu University, Varanasi.
Insights
Implementing acute respiratory infection (ARI) control programs in rural preschool children significantly reduced ARI episodes and deaths. Strengthening immunization programs and involving local practitioners proved most effective for ARI control.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Acute Respiratory Infection (ARI) poses a significant health burden on rural preschool children.
- Effective control strategies are crucial for reducing ARI-related morbidity and mortality in this vulnerable population.
Purpose of the Study:
- To evaluate the feasibility and impact of an Acute Respiratory Infection (ARI) control program in rural preschool children.
- To assess the effectiveness of trained Primary Health Centre (PHC) staff and local practitioners in managing ARI.
Main Methods:
- A study involving 5,535 rural preschool children.
- Training PHC staff and local practitioners in ARI recognition, referral, drug administration, and community education.
- Utilizing a functional ARI classification system for program implementation.
Main Results:
- Significant reductions observed in moderate ARI (42%) and severe ARI (89%) episodes between 1985 and 1987.
- Reductions in both ARI (27.8%) and non-ARI (18.3%) related deaths.
- Unimmunized children constituted the majority of ARI deaths; immunized children showed significantly lower ARI morbidity and mortality.
Conclusions:
- National ARI control strategies including health education, case management, and immunization strengthening are beneficial.
- Proper implementation of immunization programs yields substantial dividends in reducing ARI.
- Involving and training local medical practitioners is essential for community trust and program acceptance.
Abstract:
The feasibility of acute respiratory infection (ARI) control in 5,535 rural preschool children was studied. The Primary Health Centre (PHC) staff and local practitioners (drug distribution centres) were identified and trained in recognition of moderate/severe ARI, referral, drug administration and in the education of the community. Functional ARI classification as envisaged in ARI control programme was followed. There was significant reduction in moderate (42% reduction) and severe (89% reduction) ARI episodes from year 1985 to 1987. Both ARI (27.8%) and non-ARI (18.3%) deaths showed reduction. Majority of children who died due to ARI were also unimmunized. The moderate and severe ARI related morbidity and mortality was significantly reduced in immunized children compared to unimmunized children. Although, strategies of National ARI control programme by health education, standard case management and strengthening of immunization is a good thought but it is clear that proper implementation of immunizations is going to pay more dividends. It is also evident that the local medical practitioners should be trained and involved in this control programme to have community faith as well as to avoid opposition.