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Acute respiratory infections in children: a community-based longitudinal study in rural Bangladesh
1International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Insights
Acute respiratory infections (ARI) are a major cause of illness in rural Bangladeshi children, with upper respiratory infections (URI) being most common. Lower respiratory infections (ALRI) also pose a significant risk, particularly in infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Acute Respiratory Infections (ARI) are a leading cause of childhood morbidity and mortality globally, particularly in low-resource settings.
- Understanding the incidence, prevalence, and risk factors of ARI is crucial for developing effective public health interventions.
Purpose of the Study:
- To investigate the incidence and characteristics of acute respiratory infections (ARI) in children under five years of age in rural Bangladesh.
- To identify patterns of upper respiratory infections (URI) and acute lower respiratory infections (ALRI) and their duration.
Main Methods:
- A community-based longitudinal study was conducted in Matlab, Bangladesh, following 696 children under five for one year.
- Trained field workers conducted regular home visits, collecting data on ARI symptoms and performing physical examinations.
- Data included daily observations and recall of symptoms such as fever, cough, and nasal discharge.
Main Results:
- The overall incidence of ARI was 5.5 episodes per child-year, with 96% being URI.
- The incidence of URI was highest in 18-23-month-olds, while ALRI incidence was highest in 0-5-month-old infants.
- Longer illness durations were common, with 46% of URI and 65% of ALRI episodes lasting 15 days or more.
Conclusions:
- ARI represents a significant burden of disease among young children in rural Bangladesh.
- Specific age groups are more vulnerable to URI and ALRI, highlighting the need for targeted prevention and treatment strategies.
- Sociodemographic factors did not influence ARI incidence, suggesting environmental or biological factors may play a larger role.
Abstract:
A community-based logitudinal study conducted in Matlab, a rural area in Bangladesh, investigated acute respiratory infections (ARI) among children. A cohort of 696 children under 5 years of age was followed for 1 year yielding 183,865 child-days of observation. Trained field workers visited the study children every fourth day. Data on symptoms suggesting ARI, such as fever, cough, and nasal discharge, were collected for the preceding 3 days by recall. To determine the type and severity of ARI, the field workers conducted physical examinations (temperature, rate of respiration, and chest indrawing) of children reporting cough and/or fever. The overall incidence of ARI was 5.5 episodes per child-year observed; the prevalence was 35.4 per hundred days observed. Most of the episodes (96 per cent) were upper respiratory infections (URI). The incidence of acute lower respiratory infections (ALRI) was 0.23 per child per year. The incidence of URI was highest in 18-23-month-old children, followed by infants 6-11 months old. The highest incidence of ALRI was observed in 0-5-month-old infants followed by 12-17-month-old children. Among 559 children who were followed for 6 months or longer, about 9 per cent did not suffer any URI episode and about 16 per cent suffered one or more ALRI episodes. About 46 per cent of URI and 65 per cent of ALRI episodes lasted 15 days or more. The incidence rates of URI were higher during the monsoon and pre-winter periods, and that of ALRI at the end of the monsoon and during the pre-winter periods. Sociodemographic variables were not associated with the incidence of URI or ALRI. The study documents ARI to be a major cause of morbidity among rural Bangladeshi children.