An evaluation of Diarrheal Diseases and Acute respiratory infections control programmes in a Delhi slum
- 265 Downloads
Effective early management at home level and health seeking behavior in case of appearance of danger signs are key strategies in Acute respiratory Infections (ARI) and Acute Diarrheal Diseases (ADD) where majority of episodes are self-limiting and viral in origin. Integrated Management of Childhood illnesses (IMNCI) also envisages that family and community health practices especially health care seeking behaviors are to be improved to reduce childhood morbidity, mortality and cost of admissions to hospitals. Thus, a study was undertaken at an urban slum area —‘Gokul Puri’ in Delhi, among under-5 children with the aim to assess the magnitudes of ARI and ADD.
A Cross-sectional survey was conducted in this urban slum of Trans-Yamuna, covering 1307 under-5 children for five days starting from 9th of August, 2004. Survey team consisted of 14 FETP Participants (WHO Fellows) from India, Nepal, Myanmar, Bhutan and Sri Lanka. A pre-tested, house-hold tally marking form was used to interview the caretakers/mothers. History of episodes of ARI and/or ADD in the last two weeks was asked. Health care practices including use of ORS & home available fluids in diarrhea, continued feeding during diarrhea, awareness of danger signs of ARI & ADD and medical advice sought were asked of those mothers whose children had such an episode.
191 (14.6 %) of 1307 children surveyed, had an attack of ARI in the preceding two wk. The common symptoms of ARI cases were mild running nose (78%), cough (76.4%) and/or fever (45.5%). Only 8 (4%) had fast breathing. One or more danger signs were known to 80% (152/191) of mothers and an equal number (80%) of mothers had sought treatment. ARIs are mostly mild or self limiting but only 16% of caretakers perceived so and doctors also prescribed medicines. The attack rate of Acute Diarrheal Diseases was 7.73% in the study and ADD’s annual adjusted morbidity rate was 1.69 episodes per child per year. Though nearly three-fourth of mothers (71.3%) had reported to be seeking medical advice (which is not needed in mild episodes of diarrhea) the ORS use was 38.6%, use of Home available fluids (HAF) was 42% and continued feeding was 50% during the ADD episode and awareness of at least two danger signs was present in 34%.
Though aware of danger signs of ARI, care takers were still seeking medical advice for mild cases of ARI and doctors were prescribing drugs. Correct home based management e.g. use of ORS, continued feeding etc. was deficient in the community. Knowledge of danger symptoms was low and medical advice was being sought and drugs were being prescribed for ADD, too.
Key wordsEvaluation ARI ADD Health seeking behavior Morbidity rate Incidence
Unable to display preview. Download preview PDF.
- 1.Management of childhood illness in developing countries: Rationale for an integrated strategy. IMCI Information. WHO, & UNICEF. WHO/CHS/CAH/98.1A: Rev. 1; 1999:1.Google Scholar
- 2.Major causes of death among children under 5 uears of age and neonates in the world, 2000–2003 (Available from: http://www.who.int/child-adolescent health/integr.htm).
- 4.Health situation in South-East Asia Region. (Available from: http://w3.whosea.org/health_situt_98-00/c4b.htm.).
- 5.National Family Health Survey (1998–99). International Institute of Population Sciences. Oct, 2000:216, 218, 220.Google Scholar
- 6.Chhabra P, Garg S, Mittal SK, Chhabra SK. Risk factors for acute respiratory infection in underfives in a rural community. Indian J Matern and Child Health 1997;8(1): 13–17.Google Scholar
- 9.Anand K, Sundaram KR, Lobo J, Kapoor SK. Are diarheal incidence and malnutrition related in under five children? A longitudinal study in an area of poor sanitary conditions. Indian Pediatr 1994;31(8): 942–948.Google Scholar
- 15.Park K. Acute diarrhoeal diseases. In Park’s Textbook of Preventive and Social Medicine. Fifteenth Edition. M/S Banarsi Das Bhanot Publishers, Jabalpur (India); 1997:171.Google Scholar
- 16.Abhaya Indrayan Sanjeev B. Sarmukaddam. Gausian Conditions. In Marcel Dekker, ed. Medical Statistics. Inc. Publishers. New York (U.S.A.); 2001: 277.Google Scholar