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Journal of Tropical Pediatrics 1994 40(5):279-284; doi:10.1093/tropej/40.5.279
© 1994 by Oxford University Press
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Acute Respiratory Infections in Nigerian Children: Prospective Cohort Study of Incidence and Case Management

D. Fagbule, MBBS, MRCP, FWACP*,, D. B. Parakoyi, MBBS, DPH, FWACP** and R. Spiegel, DVM, MPH***

*Departments of paediatrics, Faculty of Health Sciences, University of Ilorin Ilorin, Nigeria
**Departments of Community Medicine, Faculty of Health Sciences, University of Ilorin Ilorin, Nigeria
***Epidemiologist CCCD Project, Lagos, Nigeria and International Health Program Office, Centers for Disease Control Atlanta, Georgia 30333, USA

Correspondence: Dr D. Fagbule, Department of Paediatrics, Ogun State University, Sagamu, Nigeria

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.


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