Abstract
A review of medical records of health centres in Kangra districts, Himachal Pradesh during October 1984 to September 1985 revealed that of 3,72,000 attendances, 18% were for acute respiratory infections (ARI) and 12% for diarrheal diseases. The annual incidence of visits for ARI among children below five was higher than that of general population (8·2/1000 vs. 6·7/1000). ARI was more common during the post-monsoon period and among people living in mountainous areas. The case fatality rate in hospitalised ARI patients was 10·5%. Interview of health centre physicians regarding ARI management practices indicated that chest indrawing (considered by WHO as pathognomonic of severe ARI) was not recognised as an important sign by majority of physicians. Ninety-one per cent of physicians disagreed (69% in strong terms) with the idea of providing health workers with antimicrobials for management of ARI at the community level.
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