Acute respiratory infections in Nigerian children: prospective cohort study of incidence and case management.
A community-based prospective surveillance and case management study of acute respiratory infection (ARI) in children aged 2-60 months of age was carried out over a 12-month period in Pakata, a semi-urban community in Ilorin, Kwara State, Nigeria. A cohort of 481 children was followed by trained community health assistants with thrice weekly home visits to record all symptoms and signs of ARI, and institute treatment based on WHO recommendations. There were three episodes of mild, moderate, or severe ARI per child per year, including 1.3 pneumonia episodes per child per year. The peak of infection corresponded to the rainy season (July-November), and a smaller peak to the dry season (February-April). Most of the health worker decisions were considered appropriate, although there was a tendency toward over-treatment with antibiotic drugs. An effective referral system was established from the community to a tertiary centre. There were no ARI-related deaths during the study period. These data indicate that a system of case management using trained community health workers can improve case management of ARI and may prevent severe ARI-related disease and deaths.
Fagbule
D
D
Department of Paediatrics, Faculty of Health Sciences, University of Ilorin, Nigeria.
Parakoyi
D B
DB
Spiegel
R
R
D000208:Acute Disease; D002675:Child, Preschool; D003023:Cloxacillin / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D003153:Community Health Services / Q000458:organization & administration / Q000592:standards; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006293:Health Promotion; D006699:Home Care Services; D006801:Humans; D007223:Infant; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D009549:Nigeria / Q000453:epidemiology; D010996:Pleural Effusion / Q000209:etiology / Q000382:microbiology; D011023:Pneumonia, Staphylococcal / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology*; D012720:Severity of Illness Index; D013211:Staphylococcus aureus / Q000302:isolation & purification; D011795:Surveys and Questionnaires; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use; D000078329:Workforce; D014944:World Health Organization
D005839:Gentamicins; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003023:Cloxacillin