Epidemiology of acute respiratory infections in children - preliminary results of a cohort in a rural north Indian community.

Anand Krishnan,Vivek Gupta,Siddhartha Saha,Suresh K Kapoor,Ritvik Amarchand,Renu Lal,Puneet Misra,Shobha Broor,Vishnubhatla Sreenivas,Arti Kapil,Fatimah Dawood,Sanjay Rai,Rizwan Abdulkader Suliankatchi,Debjani Ram Purakayastha,Chandrakant S Pandav,Abhishek Wahi,Marc-Alain Widdowson,Kathryn E Lafond

doi:10.1186/s12879-015-1188-1

Abstract

BackgroundDespite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology.MethodsA dynamic cohort of children aged 0–10 years was established in four villages in a north Indian state of Haryana from August 2012 onwards. Trained health workers conducted weekly home visits to screen children for acute respiratory infection (ARI) defined as one of the following: cough, sore throat, nasal congestion, earache/discharge, or breathing difficulty. Nurses clinically assessed these children to grade disease severity based on standard age-specific guidelines into acute upper or lower respiratory infection (AURI or ALRI) and collected nasal/throat swabs for pathogen testing.ResultsOur first year results show that ARI incidence in 0–10 years of age was 5.9 (5.8–6.0) per child-year with minimal gender difference, the ALRI incidence in the under-five age group was higher among boys (0.43; 0.39–0.49) as compared to girls (0.31; 0.26–0.35) per child year. Boys had 2.4 times higher ARI-related hospitalization rate as compared to girls.ConclusionARI impose a significant burden on the children of this cohort. This study platform aims to provide better evidence for prevention and control of pneumonia in developing countries.

Highlights

Despite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology
The first year results of the open cohort of 2859 children aged 0–10 years with weekly house visits showed a high burden of acute respiratory infection in children. * Correspondence: anand.drk@gmail.com 1Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India Full list of author information is available at the end of the article
There was a significant gender difference skewed towards males in the burden and health seeking

Summary

Introduction

Despite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology. Acute respiratory infections (ARI) are a major burden to child health in developing countries like India [1, 2]. ARI, mainly of lower respiratory tract, are the leading cause of death among children under five years of age in such countries [3,4,5], resulting in nearly 1.9 million childhood deaths per year, of which 20 % are estimated to occur in India [6, 7]. We recently estimated that among children aged < 5 years, the median direct cost of ARI was US$135 in private and US$54 in public institutions [12]

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