Mtango F D, Neuvians D
Trans R Soc Trop Med Hyg. 1986;80(6):851-8. doi: 10.1016/0035-9203(86)90241-5.
Control of acute respiratory infections (ARI) in children under five years of age has been implemented as an integrated part of Primary Health Care in rural Bagamoyo District in Tanzania. Community supported Village Health Workers visited each family at their homes every six to eight weeks, giving health education on recognition and prevention of ARI, treating children with pneumonia on the spot with oral Cotrimoxazole or referring them to the next higher level of care. Within a two-year period the total under five mortality has been reduced by 27.2% from 40.1 to 29.2/1000 children aged under five per year. The disease-specific mortality rate for pneumonia has been reduced by 30.1% from 14.3 to 10.0/1000 under-five per year, contributing 40% to the overall mortality reduction. It is concluded that an active health service outreach programme, within Primary Health Care, can efficiently reduce high child mortality rates from ARI and other diseases. A similar approach will be used to tackle other problems such as diarrhoeal diseases, malnutrition, malaria and child spacing.
坦桑尼亚巴加莫约区农村将五岁以下儿童急性呼吸道感染（ARI）的防控作为初级卫生保健的一个综合组成部分。社区支持的乡村卫生工作者每六至八周家访每户家庭，就ARI的识别与预防开展健康教育，用口服复方新诺明就地治疗患肺炎的儿童，或将他们转诊至更高一级的医疗机构。在两年时间里，五岁以下儿童的总死亡率从每年每千名五岁以下儿童40.1例降至29.2例，降幅为27.2%。肺炎的疾病特异性死亡率从每年每千名五岁以下儿童14.3例降至10.0例，降幅为30.1%，占总体死亡率降幅的40%。得出的结论是，初级卫生保健范围内积极的卫生服务外展项目能够有效降低ARI及其他疾病导致的高儿童死亡率。将采用类似方法解决腹泻病、营养不良、疟疾和生育间隔等其他问题。
