Family education for early detection of acute respiratory infections in children
When do you decide to go to the doctor? For how long are you sick and what are the symptoms that convince you to go?
For those lucky enough, seeking medical attention is a simple and cost-effective process in which you receive immediate attention and a prescription to be filled at your local pharmacy. But for those less fortunate, seeking medical attention is much more difficult. For some, the only way to know whether or not a clinic is open is by going on foot. Caregivers may not speak the same language as you and the medication you need may be in short supply or unavailable. For these reasons, some people rarely seek medical attention and many times the severity of an illness is underestimated, leading to fatal consequences that could have been avoided.
What’s the issue? Pneumonia, a fatal but preventable child illness
Pneumonia is an infection of lungs that is most commonly caused by viruses or bacteria. These infections are generally spread by direct contact with infected people. Pneumonia is the primary cause of death for young children in Latin America, accounting for a third of pediatric services. Proper case management depends on early recognition of pneumonia and treatment with antibiotics avoiding about 85% of these deaths. However, many people do not know which symptoms indicate the need to seek medical attention.
Research to Practice: The necessity of family education for early detection of ARIs
How can the many cases of preventable pneumonia related deaths be averted? In a research initiative1 in the Kaqchiquel community of rural Guatemala, mothers have been asked how they identify the primary signs of pneumonia and acute respiratory infections (ARIs) in their children. These symptoms are potentially lethal if not treated immediately with antibiotics. By conducting interviews with 32 mothers in the Kaqchiquel community, researchers were able to understand the way the women identify the primary signs of the disease.
Although mothers were able to observe rapid breathing, high fevers, fatigue, and coughing (all symptomatic of a lung infection), they were less able to detect tachypnea, which is the presence of rapid shallow breaths. This was attributed to their inability to notice the children’s indrawn chest because the children are bundled up to keep warm. The women were then shown how to detect tachypnea by watching the children’s collarbones, which are not always covered with clothing and blankets. Tachypnea is an important indicator of the need to seek medical attention. This research initiative shows that training to recognize pneumonia must be directed not only to medical and nursing personnel and community health workers, but also to families, so that they will quickly seek medical attention for the child. Prompt treatment with antibiotics is crucial in cases of bacterial pneumonia.
What’s next: Improving access to medical clinics
More than 57% of women interviewed said that they treated their children at home before consulting a medical clinic. However, these home treatments were limited to anti-flu medicine and aspirin. To get the more effective antibiotics, the women most often sought out health centers, followed next by private doctors. Most stated that they preferred to go straight to the pharmacies where there was less waiting time and a greater likelihood of receiving medication.
Some of the main grievances these women had with the health clinics were the inconsistent schedules, the long waits, the difficulties in communication between Spanish speaking nurses and Kaqchiquel speaking mothers, and the scarcity of drugs. These inefficacies sway more mothers to treat illnesses solely at home. But given their lack of knowledge on medical topics, there remain a large proportion of childhood mortalities due to ARIs. Through this research initiative, researchers were also able to understand the ways in which clinics could be made more accessible to people within this community. Many of these problems can be solved by increasing education on health topics and renovating medical clinics. By teaching caregivers a general background in the treatment of prevalent illnesses in their area, more people will know when to seek medical attention. This accompanied with more adaptable health services can go a long way towards saving children’s lives.
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- SAENZ DE TEJADA, Sandra. Management of acute respiratory infections (ARI) in a Kaqchiquel community in Guatemala. Rev Panam Salud Publica [online]. 1997, vol.1, n.4, pp. 259-265.