Agarwal D K, Bhatia B D, Agarwal K N
Department of Pediatrics, Banaras Hindu University, Varanasi.
Indian Pediatr. 1993 May;30(5):629-35.
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.
对5535名农村学龄前儿童的急性呼吸道感染（ARI）控制可行性进行了研究。确定了初级卫生保健中心（PHC）工作人员和当地从业者（药品分发中心），并对他们进行了中度/重度ARI识别、转诊、药物管理及社区教育方面的培训。遵循ARI控制项目中设想的功能性ARI分类。从1985年到1987年，中度ARI发作（减少42%）和重度ARI发作（减少89%）显著减少。ARI死亡（27.8%）和非ARI死亡（18.3%）均有所减少。因ARI死亡的儿童多数也未接种疫苗。与未接种疫苗的儿童相比，接种疫苗儿童中与中度和重度ARI相关的发病率和死亡率显著降低。虽然通过健康教育、标准病例管理和加强免疫来实施国家ARI控制项目的策略是个好想法，但显然正确实施免疫接种将带来更多益处。同样明显的是，当地医生应接受培训并参与该控制项目，以赢得社区信任并避免遭到反对。
