Determinants of morbidity and mortality due to acute respiratory infections: Implications for intervention

Acute respiratory infections (ARI) were monitored every two weeks in an urban commu-nity in Metro Manila, Philippines, to determine the incidence and risk factors for ARI morbidity. Hospitalized children with acute lower-respiratory-tract infection (ALRI) were studied to determine case-fatality rates (CFR) and predictors for mortality. Incidence rates were highest in infants, 3.2-4.0 per person, followed by children one to four years of age, with corresponding rates of 3.0-3.4 per person. The risk factors for ARI morbidity were low socioeconomic status and age less than one year. A CFR of 50/0 in children with ALRI was observed. Malnutrition and a positive culture of blood were significant risk factors for mortality. These identified risk factors underscore the value of primary health care interventions, such as the standard ARI case management, immunization, health educa-tion, promotion of breast-feeding,and vitamin A supplementation, as strategiesfor reducing ARI mortality in developing countries. Acute respiratory infections (ARIs) are the leading cause of morbidity and mortality in many develop-ing countries [1]. ARI mortality rate was 10.23 per 1000persons in infants and 3.0 per 1000 persons in children one to four years of age as of 1983 in the Philippines. These rates are rv12and 50 times higher than the corresponding rates from the United States and Canada (0.85 and 0.06 per 1000persons in in-fants and children one to four years of age, respec-tively) [1]. In September 1979, a national ARI steering com-mittee was organized by the Philippine Ministry of Health for the purpose of formulating a national program of control of this important health prob-This address was presented at the 25th annual meeting of th