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  • Title: Acute respiratory disease survey in Tripura in case of children below five years of age.
    Author: Deb SK.
    Journal: J Indian Med Assoc; 1998 Apr; 96(4):111-6. PubMed ID: 9844332.
    Abstract:
    This epidemiological study has been carried out in urban and rural areas of West Tripura district, to determine the incidence, causes, risk factors, morbidity and mortality associated with acute respiratory infection (ARI) and impact of simple case management in children under 5 years of age. The annual attack rate (episode) per child was more in urban area than in rural area. Monthly incidence of ARI was 23% in urban area, 17.65% in rural area. The overall incidence of ARI was 20%. The incidence of pneumonia was 16 per 1000 children in urban area and 5 per 1000 in rural area. The incidence of pneumonia was found to be the highest in infant group; 3% of ARI cases in rural area and 7% in urban area developed pneumonia. Malnourishment in urban area was 54% and in rural area 65%. Malnourished children have higher likelihood for developing respiratory infection. The relative risk (RR) of developing pneumonia was 2.3 in malnourished children. Most children (59%) had been immunised with measles and diphtheria, pertussis and tetanus (DPT) vaccine earlier. The immunisation had a protective role in pneumonia. The RR was 2.7 in non-immunised group. Air pollution of the urban area had stronger relation for bronchial asthma than pneumonia. Breastfeeding had protective role in pneumonia and severe disease. Bottlefeeding had greater risk of developing pneumonia. Lower socio-economic status had the greater risk of ARI episodes. ARI was decreased as the per capita income increased. An increase in magnitude of ARI was observed with the decrease of literacy rate. Administration of co-trimoxazole for pneumonia case by trained health worker using simple case management strategies can reduce deaths from pneumonia significantly. Health education can change health care seeking behaviours and attitude of parents and other family members to take care of the ARI child in the home itself for preventing pneumonia death. 800 children aged 0-5 years were involved in an epidemiological study conducted in urban and rural areas of West Tripura district, India, to determine the incidence, causes, risk factors, morbidity, and mortality associated with acute respiratory infection (ARI) and the impact of simple case management in children under age 5 years. The incidence of ARI was 23% in the urban area and 17.65% in the rural area, an overall mean incidence of 20.32%. The incidence of pneumonia was 16/1000 children and 5/1000 children in the urban and rural areas, respectively, with the incidence of pneumonia highest among infants. 54% of urban and 65% of rural children were malnourished; malnourished children had a relatively higher risk of acquiring respiratory infection (RR = 2.3). 59% of children had previously been immunized against measles, diphtheria, pertussis, and tetanus, and that immunization played a protective role against pneumonia. Urban pollution was more related to bronchial asthma than to pneumonia, breast-feeding played a protective role against pneumonia and severe disease, and bottle-feeding was linked to a greater risk of developing pneumonia. Children of lower socioeconomic status were at higher risk of ARI episodes, with ARI decreasing as per capita income increased. Co-trimoxazole treatment and health education can help reduce the level of ARI-related mortality.
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