MOTHERS PERCEPTIONS OF SIGNS AND SYMPTOMS OF ACUTE RESPIRATORY-INFECTIONS IN THEIR CHILDREN AND THEIR ASSESSMENT OF SEVERITY IN AN URBAN-COMMUNITY OF ETHIOPIA

Standard case management strategy has been recommended to reduce the h igh mortality rate in children with acute respiratory infections (ARI) . Appropriate case management has been shown to prevent such deaths, b ut only if families recognize signs of possible pneumonia and seek car e promptly from a trained health worker. The purpose of the present st udy was to assess mothers' perception and interpretation of ARI signs and symptoms in relation to that of a physician in an urban community in Addis Ababa. Two hundred and twenty-two mothers who brought their c hildren to hospital with cough or difficulty in breathing and an equal number of control mothers were studied. Most mothers did not recogniz e these signs, including the key signs of pneumonia-rapid breathing an d chest indrawing. While it was shown that between two physicians ther e was good agreement on kappa values above 70% for most ARI signs, the re was little agreement between physicians and mothers or between moth ers whose children came for ARI problems and mothers of hospital contr ols. The few mothers who recognized these signs did not interpret them as serious. The study concludes by recommending intensive health educ ation and further ethnographic studies on community beliefs about ARI in children, with particular emphasis on documentation of the terms, s igns and symptoms by which families recognize the illness.