A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital
acute respiratory infection ari, children, epidemiological factors, under-five
S Chatterjee. A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital. The Internet Journal of Pulmonary Medicine. 2006 Volume 7 Number 2.
Infection of the respiratory tract are among the most common of human ailments. They are a substantial cause of increased morbidity and mortality rates in young children in less developed countries like India.
The WHO World Health Report 1999(Making a Difference-Report of Director General, WHO) indicates that incidence rate of Acute Respiratory Infection (ARI) in developing countries like those in the Indian subcontinent is comparable to developed countries. But cause specific mortality due to ARI is 10-50 times higher in developing countries than developed countries. Every year ARI in young children is responsible for an estimated 4.1 million deaths worldwide. In India ARI constitute a major public health problem and is the most important contributory to mortality and morbidity in under 5 accounting for (15-34)% of all childhood deaths(according to the WHO bulletin, Health Situation in South East Asia Region 1994-1997, Regional office for SEAR, New Delhi, 1999). India accounted for 28% of the mortality and 30% of Disability Adjusted Life Years (DALYs) lost due to ARIs as stated in the WHO World Health Report, 1995, Bridging The Gaps.
In relative values, ARI mortality is highest in the postneonatal period. ARI, mainly pneumonia, accounts for about 18% of underlying causes of death in developing countries. Pneumonia and other ARI are frequent complications of measles and pertussis. ARI is also commonly found after other infections and in association with severe malnutrition. Virtually no data are available in developing countries to provide final estimates of the role of ARI in mortality of children aged under 5 years. However, the WHO figure of 1 out of 3 deaths due to--or associated with--ARI may be close to the real range of the ARI-proportional mortality in children of developing countries.
Incidence of pneumonia in developing countries like India range between (20-30)%. This is due to high prevalence of malnutrition, low birth weight, and indoor air pollution in developing countries.
ARI is an important cause of morbidity and mortality in children under 5 years of age who suffer about 5 episodes of ARI per year, thus averaging 238 million attacks consequently.
Thus I conducted my study with the objective of -
a) estimating the attack rate of ARI among under 5 children attending the
Immunisation Clinic of Calcutta National Medical College and Hospital.
b) To find out socio-economic, environmental and cultural factors related to
Children suffering from ARI.
Interpretation: From Table I it is evident that within the study population, age specific attack rate of ARI decreased with increasing age of the child in both sexes and the worst sufferers were in the age group 6-11 months in both sexes, but considering all the age groups, sex specific attack rates were more in males than in females.
Interpretation: From Table II it was seen that attack rate of ARI was maximum among Muslim children, followed by Hindus and much lower attack rate among Christian children.
A cross-sectional observational study was undertaken among the under-5 children attending the immunization clinic at Calcutta National Medical College and Hospital with the objective of estimating the attack rates of ARI in those children. The study also attempted to seek out the relation of different socio-economic, environmental and cultural factors on occurrence of ARI . Data was collected from 264 children and analyzed as
1) Age specific attack rates of ARI decreased with increasing age of the children. Among all age groups, sex specific attack rates were more in males.
2) Crowding with increasing number of family members tended to predispose to ARI.
3) Increased educational status of the mother appeared protective.
4) Lower socioeconomic status appeared conducive to ARI.
5) Increased smoke from cooking or smoking made attacks of ARI more common.
6) Child rearing factors like exclusive breast feeding and complete immunization apparently protected from ARI attacks.
7) Among followers of different religious practices, Muslims had highest no. of attack rates among their children.
What this paper adds: Apparent associations of ARI in the Under 5 children in an Urban setting of India, and introduces a line of thought as regards how to circumvent them.
Health policy implications: Existing health policy shortcomings and ways to improve the shortcomings.