Ramani Vinod K, Pattankar Jayashree, Puttahonnappa Suresh Kuralayanapalya
Associate Professor, Department of Community Medicine, Sapthagiri Institute of Medical Sciences , Bangalore, India .
Professor, Department of Community Medicine, Khaja Banda Nawaz Institute of Medical Sciences , Bangalore, India .
J Clin Diagn Res. 2016 May;10(5):LC08-13. doi: 10.7860/JCDR/2016/15509.7779. Epub 2016 May 1.
Among all illness, Acute Respiratory Infections (ARI) account for 30-60% of paediatric outpatient attendance and 20-30% of hospital admissions.
To study the morbidity pattern of ARI among under-five-age group children and to assess the determinants.
A longitudinal cohort study was conducted for a one year period, comprising a cumulative sample of 400 children from 3 urban slums of Gulbarga city. History of nasal discharge, cough, fever, sore throat, breathing difficulty, any discharge from ear alone or in combination, was used in the recognition of an ARI episode. Respiratory rate >60/minute (<2 month infants), >50(2-11 months) and >40(1-5 years) in a child with cough, cold or fever singly or in combination was considered the criteria for recognition of pneumonia.
Out of the 400 surveyed, ARI was detected among 109 children giving an incidence of 27.25%. Among these, Upper Respiratory Tract Infection (URTI) was found among 19.25% and Lower Respiratory Tract Infection (LRTI) among 8%. ARI was observed among 38.04% of infants, 37.84% of 2-3-year-old children, 36.87% of boys, 40.43% of children born to illiterate father's, 35.77% of SES class IV & 40.79% of SES class V, and 41.89% of children with family history of respiratory illness. All these data were found to be statistically significant. High rates of ARI were also observed among 41.36% of children living in households with firewood fuel usage, 35.04% of children with pets in the household, 34.82% of children with delayed milestones, 53.85% of children with grade IV and 66.67% of children with grade V malnutrition. More episodes occurred during winter months of the year (Oct - Jan). During the follow-up phase of study done on a cohort of 112 children for a period of one year, an attack rate of 3.27 episodes/child/year was observed.
Community education programs should focus on addressing specific issues viz. identification of respiratory illness, simple case management, proper immunization practices, breast feeding of infants & nutrition of child and reduction of domestic air pollution.
在所有疾病中，急性呼吸道感染（ARI）占儿科门诊就诊人数的30%-60%，占住院人数的20%-30%。
研究五岁以下儿童急性呼吸道感染的发病模式并评估其决定因素。
进行了为期一年的纵向队列研究，样本包括来自古尔伯加市3个城市贫民窟的400名儿童。通过询问流鼻涕、咳嗽、发烧、喉咙痛、呼吸困难、单独或合并出现的耳部流脓等病史来识别急性呼吸道感染发作。对于单独或合并出现咳嗽、感冒或发烧的儿童，呼吸频率>60次/分钟（<2个月婴儿）、>50次/分钟（2-11个月）和>40次/分钟（1-5岁）被视为肺炎的识别标准。
在400名接受调查的儿童中，109名儿童被检测出患有急性呼吸道感染，发病率为27.25%。其中，上呼吸道感染（URTI）的发病率为19.25%，下呼吸道感染（LRTI）的发病率为8%。38.04%的婴儿、37.84%的2-3岁儿童、36.87%的男孩、40.43%父亲为文盲的儿童、35.77%的社会经济地位（SES）IV级儿童、40.79%的SES V级儿童以及41.89%有呼吸道疾病家族史的儿童患有急性呼吸道感染。所有这些数据在统计学上均具有显著意义。在使用木柴作为燃料的家庭中，41.36%的儿童、家中有宠物的家庭中35.04%的儿童、发育迟缓的儿童中34.82%、患有IV级营养不良的儿童中53.85%以及患有V级营养不良的儿童中66.67%的急性呼吸道感染发病率也很高。一年中的冬季月份（10月至1月）发病次数更多。在对112名儿童进行为期一年的随访研究阶段，观察到的发作率为3.27次/儿童/年。
社区教育项目应侧重于解决特定问题，即识别呼吸道疾病、简单病例管理、正确的免疫接种做法、婴儿母乳喂养及儿童营养以及减少家庭空气污染。
