World Rural Health Conference
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 1704
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 9  |  Page : 2908-2911  

Parental knowledge and common practices regarding acute respiratory infections in children admitted in a hospital in rural setting


1 Department of Pediatrics, Pt BD Sharma PGIMS, Rohtak, Haryana, India
2 House Surgeon, Trauma Centre, Pt BD Sharma PGIMS, Rohtak, Haryana, India
3 Department of Microbiology, Pt BD Sharma PGIMS, Rohtak, Haryana, India
4 Department of Pharmacology, Pt BD Sharma PGIMS, Rohtak, Haryana, India

Date of Submission29-Jun-2019
Date of Decision22-Aug-2019
Date of Acceptance03-Sep-2019
Date of Web Publication30-Sep-2019

Correspondence Address:
Dr. Ashish Gupta
H. No. 624, Sector 17 A, Gurugram, Haryana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_510_19

Rights and Permissions
  Abstract 


Context: In developing countries, there is paucity of data regarding knowledge and practices of parents regarding acute respiratory infections (ARIs). Aims: The present study was undertaken to study the knowledge and practices of parents for ARIs. Settings and Design: This was a prospective, cross-sectional study conducted over period of 3 months in pediatric ward of a tertiary care teaching hospital. Subjects and Methods: All the children admitted in pediatrics ward with complaints of ARI were included in the study. Statistical Analysis Used: Statistical analysis was carried out by using Statistical Package for Social Sciences software version 20. Results: A total of 1,752 children were enrolled in the study out of which 885 (50.51%) were males and 867 (49.49%) were females. Only 42.6% of parents answered correct answers about the proper use of antibiotics for children with ARI. Most of the caregivers (58.4%) had poor knowledge about incomplete immunization as a risk factor for developing diseases like diphtheria and pertussis. Majority of caregivers (66.3%) practice home remedies by themselves. Conclusion: The knowledge of caregivers/parents regarding symptoms, risk factors, and complications of ARI was adequate. Better awareness is needed for safe use of antibiotics, and caregivers shall be encouraged to minimize indoor air pollution. More awareness is required for discouraging the practice of visiting quacks as it can lead to serious complications in the child.

Keywords: Child, infection, knowledge, pneumonia, pollution, respiratory


How to cite this article:
Bhalla K, Gupta A, Nanda S, Mehra S, Verma S. Parental knowledge and common practices regarding acute respiratory infections in children admitted in a hospital in rural setting. J Family Med Prim Care 2019;8:2908-11

How to cite this URL:
Bhalla K, Gupta A, Nanda S, Mehra S, Verma S. Parental knowledge and common practices regarding acute respiratory infections in children admitted in a hospital in rural setting. J Family Med Prim Care [serial online] 2019 [cited 2019 Oct 19];8:2908-11. Available from: http://www.jfmpc.com/text.asp?2019/8/9/2908/268039




  Introduction Top


Acute respiratory infection (ARI) is the infection of upper or lower respiratory tract, or of adjoining structures such as paranasal sinuses, middle ear, or lung pleura.[1],[2] It is considered as one of the leading causes of morbidity and mortality in children less than 5 years of age.[3],[4] Viral infections account for half of the cases among those hospitalized in India. Of these, respiratory syncytial virus, influenza A, and parainfluenza virus 3 are important viruses in rural settings.[5],[6] ARIs are categorized into upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The URIs comprises of rhinitis, sinusitis, tonsillitis, pharyngitis, laryngitis, epiglottitis, and ear infections. LRIs consist of pneumonia and bronchiolitis.[7] The various risk factors include illiteracy among parents, low socioeconomic status, overcrowding, malnutrition, lack of breast feeding, prelacteal feeds, partial immunization, indoor air pollution, early weaning, anemia, etc.[4],[8],[9],[10] All these are modifiable risk factors and can be prevented by simple interventions such as proper infant feeding practices, providing proper nutrition to the child, and proper education of parents and the caregivers. The irrational use of antibiotics by parents and excessive use of radiographic and laboratory investigations further helps in spread of ARIs.[11] In developing countries, there is paucity of data regarding knowledge and practices of parents regarding ARIs. Hence, the present study was undertaken to study the knowledge and practices of parents for ARIs.


  Subjects and Methods Top


The study was conducted in the Department of Pediatrics in a tertiary care hospital of North India over a period of 3 months. The ethical approval was obtained from Institutional Ethics Committee (19th of December, 2019). All the children admitted in pediatrics ward from rural areas with complaints of ARI were included in the study. The demographic details were taken from the patients such as age, gender, height, weight, immunization status, socioeconomic status, indoor air pollution, etc. The parents were given preformed self-administered questionnaire consisting of two sections. Section A comprised of questions assessing the knowledge of parents regarding ARIs, and section B comprised of questions assessing the practices of parents regarding the same. All the data were entered in Microsoft office excel 2016 analyzed using SPSSv20 software.


  Results Top


A total of 1,752 children were enrolled in the study out of which 885 (50.51%) were males and 867 (49.49%) were females. Mean age of presentation was 1.01 ± 1.98 years. Demographic details of subjects are shown in [Table 1]. A total of 1,196 (68.26%) children were malnourished out of which 1,040 (59.36%) were moderately malnourished and 156 (8.9%) were severely malnourished. 96% children were immunized as per National Immunization Schedule. 36.6% households were burning firewood as combustion fuel and 54.5% had a smoker in their family, thus contributing toward indoor air pollution. History of hospitalization in last 1 year was present in 18.83% of the children. [Table 2] demonstrates the awareness of caregivers toward ARI. About 98% of caregivers were correctly aware regarding presenting symptoms of ARI and only 2% showed inadequate knowledge with incorrect answers. Only 42.6% of parents answered correct answers about the proper use of antibiotics for children with ARI and most of parents (57.4%) had incorrect answers. 64.4% of caregivers had good knowledge regarding pneumonia being the most common complication of ARI. Majority of subjects (57.4%) had correct knowledge regarding consulting a physician if the child had ARI and 42.6% had poor knowledge. 66.3% of caregivers were aware of malnutrition as a risk factor for pneumonia, 70.3% were aware about indoor smoking as a risk factor for ARI. Most of the caregivers (58.4%) had poor knowledge about incomplete immunization as a risk factor for developing diseases like diphtheria and pertussis.
Table 1: Demographic details of the subjects

Click here to view
Table 2: Awareness of caregivers toward ARIs

Click here to view


[Table 3] demonstrates the practice pattern of caregivers toward ARI. Majority of the caregivers (56.4%) do not practice self-medication. On the other hand, most of the participated caregivers (89.1%) had positive attitude toward consulting a physician but 10.9% had poor practice. Majority of caregivers (66.3%) practice home remedies by themselves. Most of the caregivers (66.3%) had a practice of minimizing indoor air pollution as compared with 33.7% who do not do so.
Table 3: Practice pattern of caregivers toward ARIs

Click here to view



  Discussion Top


ARI in children contributes for about 3.9 million deaths worldwide annually. In developing countries like India, pneumonia incidence is high due to high prevalence of malnutrition, low birth weight, and presence of indoor air pollution.[12],[13] Malnutrition, indoor air pollution, low socioeconomic status, and low immunization are key risk factors for ARI.[12],[14] In this study, 68.26% children were malnourished, and children belonging to low socioeconomic status were more malnourished than higher socioeconomic status. These findings were similar to a study by Stalin et al.[15] 36.6% households were burning firewood as combustion fuel and 54.5% had a smoker in their family, thus contributing toward indoor air pollution. Many studies have suggested indoor air pollution as a major risk factor for ARI,[12],[16],[17] therefore we assessed the knowledge of parents regarding indoor air pollution as a risk factor, and to our surprise 70.3% parents had the knowledge regarding the same. These findings are concordance with a study by Saldanha et al.[18] Biomass fuels and other fuels like kerosene oil are major contributing factors to indoor air pollution. The mechanism is the injury caused to local defenses of respiratory tract because of toxic pollutants arising from incomplete combustion of these fuels.[12] Therefore, use of cleaner fuels like LPG shall be promoted for which mother's education is very important.

In this study, 57.4% of the caregivers believed that antibiotics can be self-administered for treatment of ARI. In studies by Chan et al.[19] and Bhanwra et al.,[20] misuse of antibiotics has been reported. The knowledge of caregivers regarding consultation for physician was adequate (57.4%). This was in contrast with findings by other researchers.[11],[21] Knowledge of symptoms of ARI was very good among caregivers (98%), which was higher than other studies.[22] Use of self-medication was found (43.6%) in this study which is similar to other studies.[23],[24] Home remedies were practiced by 66.3% of the parents in our study. This was slightly higher than other studies.[11],[24],[25],[26] 66.3% of parents showed a healthy practice of minimizing indoor air pollution. 89.1% parents agreed that they visit a physician whenever child presents with symptoms such as cough, fever, etc. On further interviewing it was noted that most of the parents visit an unregistered medical practitioner (quacks) which is a dangerous practice. Therefore, parents' education and socioeconomic status play a very important role toward consulting a registered medical practitioner. Also, government and all other stakeholders shall take necessary steps for strengthening the primary healthcare system so as to discourage the practice of visiting quacks and thereby controlling serious complications and misuse of antibiotics.


  Conclusion Top


The knowledge of caregivers/parents regarding symptoms, risk factors, and complications of ARI was adequate. The parents in the study had good practice of consulting a physician whenever child develops symptoms of ARI. Better awareness is needed for safe use of antibiotics, and caregivers shall be encouraged to minimize indoor air pollution. More awareness is required for discouraging the practice of visiting quacks as it can lead to serious complications in the child.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Choube A, Kumar B, Mahmood SE, Srivastava A. Potential risk factors contributing to acute respiratory infections in under five age group children. Int J Med Sci Public Health 2014;3:1385-8.  Back to cited text no. 1
    
2.
WHO Programme for the Control of Acute Respiratory Infections. Acute Respiratory Infections in Children: Case Management in Small Hospitals in Developing Countries: A Manual for Doctors and Other Senior Health Workers (WHO/ARI/90.5). Geneva: WHO; 1990.  Back to cited text no. 2
    
3.
Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C. Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis2002;2:25-32.  Back to cited text no. 3
    
4.
Smith KR, Samet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax 2000;55:518-32.  Back to cited text no. 4
    
5.
Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM. A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in Rural India. PLoS One 2007;2:e491.  Back to cited text no. 5
    
6.
Swamy MA, Malhotra B, Janardhan Reddy PV, Tiwari J. Profile of respiratory pathogens causing acute respiratory infections in hospitalised children at Rajasthan a 4 year's study. Indian J Med Microbiol 2018;36:163-71.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Simoes EAF, Cherian T, Chow J, Shahid-Salles SA, Laxminarayan R, John TJ. Acute respiratory infections in children. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al., editors. Disease Control Priorities in Developing Countries. 2nd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2006. Chapter 25. Available from: https://www.ncbi.nlm.nih.gov/books/NBK11786/Co-published by Oxford University Press, New York. [Last accessed on 2019 Apr 26].  Back to cited text no. 7
    
8.
Savitha MR, Nandeeshwara SB, Pradeep Kumar MJ, ul-Haque F, Raju CK. Modifiable risk factors for acute lower respiratory tract infections. Indian J Pediatr 2007;74:477-82.  Back to cited text no. 8
    
9.
Bates MN, Pokhrel AK, Chandyo RK, Valentiner-Branth P, Mathisen M, Basnet S, et al. Kitchen PM2.5 concentrations and child acute lower respiratory infection in Bhaktapur, Nepal: The importance of fuel type. Environ Sci 2018;161:546-53.  Back to cited text no. 9
    
10.
Perez-Padilla R. Household air pollution: Consider lifelong exposure. Am J Respir Crit Care Med 2019;199:553-4.  Back to cited text no. 10
    
11.
Alluqmani MF, Aloufi AA, Abdulwahab AAA, Alsharif AIK, AlShathri AAA, AlShehri MS, et al. Knowledge, attitude and practice of mothers on acute respiratory infection in children under five years in Saudi Arabia, 2017. Egypt J Hosp Med 2017;69:1959-63.  Back to cited text no. 11
    
12.
Taksande AM, Yeole M. Risk factors of Acute respiratory infection (ARI) in under-fives in a rural hospital of Central India. J Pediatric Neonatal Individ Med 2016;5:e050105.  Back to cited text no. 12
    
13.
WHO, regional office of SEAR. Health Situation in the South East Asia Region monograph, 1994-1997. New Delhi: WHO; 1999.  Back to cited text no. 13
    
14.
Wardlaw T, Salama P, Johansson EW, Mason E. Pneumonia: The leading killer of children. Lancet 2006;368:1048-50.  Back to cited text no. 14
    
15.
Stalin P, Bazroy J, Dimri D, Singh Z, Senthilvel V, Sathyanarayanan S. Prevalence of underweight and its risk factors among under five children in a rural area of Kancheepuram District in Tamil Nadu, India. J Dent Med Sci 2013;3:71-4.  Back to cited text no. 15
    
16.
Bhalla K, Nehra D, Nanda S, Verma R, Gupta A, Mehra S. Prevalence of bronchial asthma and its associated risk factors in school-going adolescents in Tier-III North Indian City. J Family Med Prim Care 2018;7:1452-7.  Back to cited text no. 16
[PUBMED]  [Full text]  
17.
Smith KR. National burden of disease in India from indoor air pollution. PNAS2000;97:13286-93.  Back to cited text no. 17
    
18.
Saldanha SJ, Fernandes PJ, Antony EM, Manar B, Jai J, Johns E, et al. Knowledge of Mothers on the effect of Passive Smoking in Children in a selected Hospital at Mangalore. Asian J Nurs Edu Res 2017;7:43-7.  Back to cited text no. 18
    
19.
Chan G, Tang S. Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore Med J 2006;47:266-70.  Back to cited text no. 19
    
20.
Bhanwra S. A study of non-prescription usage of antibiotics in the upper respiratory tract infections in the urban population. J Pharmacol Pharmaco Ther 2013;4:62-4.  Back to cited text no. 20
    
21.
Alsaleem S, SBFM Aabdullah AS. Parental knowledge regarding acute respiratory infections among their children. J Pediatr 2013;81:189-95.  Back to cited text no. 21
    
22.
Aung T, Tun KM, Thinn K, Thein AA. Knowledge, attitudes and practices of mothers on childhood Acute respiratory infections (ARI). Southeast Asian J Trop Med Public Health 1994;25:590-3.  Back to cited text no. 22
    
23.
Bham SQ, Saeed F, Shah MA. Knowledge, attitude and practice of mothers on acute respiratory infection in children under five years. Pak J Med Sci 2016;32:1557-61.  Back to cited text no. 23
    
24.
AllahYar M, Iqbal I. Knowledge and practices of mothers regarding acute respiratory infection in children under 5 years of age in Urban Slums of Multan. Med Fourm Monthly 2012;23:45-9.  Back to cited text no. 24
    
25.
Choudhry AJ, Mujib SA, Mubashar M. Maternal practices regarding acute respiratory tract infections in an urban slum of Lahore. Mother Child 1999;35:84-90.  Back to cited text no. 25
    
26.
Kumar H, Mishra S, Sharma D. Can health workers be trained in case detection of pneumonia? Indian Pediatr 1993;29:499-501.  Back to cited text no. 26
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

Top
   
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
   Abstract
  Introduction
  Subjects and Methods
  Results
  Discussion
  Conclusion
   References
   Article Tables

 Article Access Statistics
    Viewed33    
    Printed0    
    Emailed0    
    PDF Downloaded9    
    Comments [Add]    

Recommend this journal