Pandey M R, Sharma P R, Gubhaju B B, Shakya G M, Neupane R P, Gautam A, Shrestha I B
ARI Project, Mrigendra Medical Trust, Kathmandu, Nepal.
Ann Trop Paediatr. 1989 Dec;9(4):212-20. doi: 10.1080/02724936.1989.11748635.
A prospective study was conducted to determine the magnitude of morbidity and mortality caused by acute respiratory infections (ARI) among children under 5 years of age and to assess the feasibility of reducing mortality owing to ARI by the use of community health workers. Villages selected for this study were situated on the south-west edge of Kathmandu Valley, about 24 km from the city centre. The study group consisted of 1019 children under the age of 5 years at the beginning of the study and followed for 3 years. During the 1st year, baseline information was collected. During the 2nd and 3rd years, intervention measures (health education, immunization and antibiotics for children with signs suggesting pneumonia) were taken and their effect assessed. There was a 59% reduction in the ARI-specific death rate among study children between surveillance year and intervention year I and a further 25% reduction in the ARI-specific death rate between intervention years I and II. Despite a substantial reduction in ARI mortality with the interventions, there was still an unacceptably high mortality from chronic diarrhoea, malnutrition and other factors. This implies that the programme to control ARI, diarrhoea, malnutrition and immunizable diseases should be integrated into one, within the framework of a primary health care strategy.
开展了一项前瞻性研究，以确定5岁以下儿童急性呼吸道感染（ARI）所致发病和死亡的严重程度，并评估利用社区卫生工作者降低ARI死亡率的可行性。本研究选定的村庄位于加德满都谷地西南边缘，距市中心约24公里。研究组在研究开始时有1019名5岁以下儿童，并进行了3年的跟踪。在第1年收集基线信息。在第2年和第3年，采取了干预措施（健康教育、免疫接种以及对有肺炎迹象的儿童使用抗生素）并评估其效果。在监测年与干预年I之间，研究儿童中ARI特异性死亡率降低了59%，在干预年I与干预年II之间，ARI特异性死亡率又降低了25%。尽管通过干预措施ARI死亡率大幅降低，但慢性腹泻、营养不良和其他因素导致的死亡率仍然高得令人无法接受。这意味着应在初级卫生保健战略框架内，将控制ARI、腹泻、营养不良和可免疫疾病的方案整合为一个方案。
