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Title: The epidemiology of acute lower respiratory infections in young children in a rural area of The Gambia
Author: Campbell, Harry
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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For children growing up today in the developing world, acute respiratory infection (ARI) is the 'Captain of the men of death'. The World Health Organisation estimate that 4.3 million young children die every year from ARI making it the largest single cause of death. Given the magnitude of this problem, relatively little research has been carried out in developing countries. In keeping with this observation, ARI was known to be a major cause of childhood mortality and morbidity in The Gambia but little was known about their epidemiology or aetiology. Suitable methods for their treatment or prevention had not been investigated. A one year community based longitudinal study was undertaken in a rural area of The Gambia in which approximately 500 young children were monitored for signs of acute lower respiratory infection (ALRI). An attempt was made to determine the incidence of ALRI in this community, all identified episodes of ALRI were investigated in order to try to establish the cause of the infection; the association between a number of possible risk factors with ALRI incidence was explored; and two different regimens of antibiotic treatment were compared. A survey was made of the knowledge, attitudes and practices of mothers with respect to acute respiratory infections in their children. The study documented very high incidence rates of ALRI among children in the study villages. The use of simple clinical criteria for the diagnosis of ALRI, which could be taught to health workers, was investigated and the most valid criteria for this community identified. Preliminary evidence suggests that bacterial infections are important causes of community acquired ALRI. These infections responsed well to a 5 day course of an inexpensive, oral antibiotic (cotrimoxazole) which was well tolerated. An important clinical overlap between ALRI and malaria was suggested by the study data. Widespread recognition of fast breathing was found among rural mothers and valid traditional concepts of difficulty breathing discovered.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available