Acute Respiratory Infections among Under-Five Age Group Children at Urban Slums of Gulbarga City: A Longitudinal Study.

Abstract

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.