Epidemiology of acute respiratory infections in children - preliminary results of a cohort in a rural north Indian community

Anand Krishnan, Ritvik Amarchand, Vivek Gupta, Kathryn E. Lafond, Rizwan Abdulkader Suliankatchi, Siddhartha Saha, Sanjay Rai, Puneet Misra, Debjani Ram Purakayastha, Abhishek Wahi, Vishnubhatla Sreenivas, Arti Kapil, Fatimah Dawood, Chandrakant S. Pandav, Shobha Broor, Suresh K. Kapoor, Renu Lal, Marc-Alain Widdowson

Despite acute respiratory infections being a major cause of death among children in developing countries including India, there is a lack of community-based studies that document its burden and aetiology. A dynamic cohort of children aged 0-10 years was established in four villages in a north Indian state of Haryana from August 2012 onwards. Trained health workers conducted weekly home visits to screen children for acute respiratory infection (ARI) defined as one of the following: cough, sore throat, nasal congestion, earache/discharge, or breathing difficulty. Nurses clinically assessed these children to grade disease severity based on standard age-specific guidelines into acute upper or lower respiratory infection (AURI or ALRI) and collected nasal/throat swabs for pathogen testing. Our first year results show that ARI incidence in 0-10 years of age was 5.9 (5.8-6.0) per child-year with minimal gender difference, the ALRI incidence in the under-five age group was higher among boys (0.43; 0.39-0.49) as compared to girls (0.31; 0.26-0.35) per child year. Boys had 2.4 times higher ARI-related hospitalization rate as compared to girls. ARI impose a significant burden on the children of this cohort. This study platform aims to provide better evidence for prevention and control of pneumonia in developing countries.