Public health importance of acute respiratory infections among infants and pre-school children

The goals of this research are to define the link between the incidence of acute respiratory infection (ARI) and their treatment with antibiotics and the child’s age, to decide upon the percentage of ARI in morbidity rate of children between 0 to 6 years of age, as well as to assess the incidence of ARI treatment at primary, secondary and tertiary health care level. Retrospective annual research in primary health care (PHC) paediatrics offices included 1003 children aged between 0 to 6 of which 5130 were examined for the first time due to some illnesses and 3408 due to ARI. ARI most frequently occurs between the ages of 2 and 4. ARI caused 56.8% of morbidity rate, of which 91.8% were infections of the upper, and 8.2% of lower respiratory tract. Children had 5.1 ą 2.8 examinations for the first time and 3.8 ą 2.3 had ARI once in a year. 66% of the examined persons with ARI were treated with antibiotics. Exclusively based upon the clinical examination, ARI was diagnosed among 41.8% cases in PHC pediatrics offices. Haemophilus influenzae was isolated in 27.2% cases by microbiological analysis of throat and nose swabs, Streptococcus pyogenes in14.4%, and Streptococcus pneuomniae in 10.6% cases of positive cultures. PHC provided care for 96.6% of patients with ARI, 2.8% were cared for at secondary and 0.6% at tertiary level. The acute respiratory infections play the largest role in morbidity among children in primary health care, and their incidence and anti-microbial treatment increase significantly with the child’s age (p<0.001). The importance of acute respiratory infection in public health results from necessity for rational diagnostic procedures and from the interpretation of clinical and laboratory findings in everyday practice, in order to reduce too frequent and uncritical anti-microbial treatment.