MATERNAL REPORTING OF ACUTE RESPIRATORY-INFECTION IN EGYPT

Background. Acute respiratory infection (ARI) is a major cause of chil dhood morbidity and mortality in developing countries. Community surve ys are used to determine the proportion of children with ARI for whom care is sought by questioning mothers about the signs and symptoms of illness episodes. The validity of this approach has been studied infre quently. Methods. We evaluated matemal reporting of signs and symptoms 2 and 4 weeks after diagnosis among 271 Egyptian children < 5 years o ld. Children with ARI were evaluated by physical examination, chest ra diography, and pulse oximetry, and were alternately assigned for a mat ernal interview about the episode 14 or 28 days later. Results. For ra diographically-defined acute lower respiratory infection (ALRI), the s ensitivity of several symptoms for combined open- and close-ended ques tions was relatively high: nahagan (deep or rapid breathing) (80%), na fas sarie (fast breathing) (66%), and kharfasha (coarse breath sounds) (63%). The specificity of these terms was 50-68%. The specificity was inversely related to the follow-up time. No term provided both a sens itivity and specificity of > 50% at day 28 across the radiographically , clinically- and pulse oximetry-based definitions of ALRI, Spontaneou sly mentioned karshet nafas (difficult or rapid breathing) at 14 days had a specificity and sensitivity for radiographic ALRI of 87% and 41% , respectively, suggesting that this term is a good choice for communi ty surveys, Conclusions. Maternal reporting of ARI symptoms is non-spe cific 2 and 4 weeks after diagnosis but may be useful for monitoring t rends in the proportion of children with pneumonia who receive medical care, To maximize specificity, ARI programmes should generally use a recall period of 2 weeks.