Mothers' perceptions of signs and symptoms of acute respiratory infections in their children and their assessment of severity in an urban community of Ethiopia.

ABSTRACT

PIP: In Ethiopia, acute respiratory infections (ARI) account for 33% of infant mortality and 20% of mortality among children younger than age 5 years. The author interviewed 222 mothers who brought their children to Ethio-Swedish Children's Hospital in Addis Ababa with cough or difficulty breathing to assess their perception and interpretation of ARI signs and symptoms in relation to those of a physician. 230 control mothers were also studied. Most mothers did not recognize rapid breathing and chest indrawing as key signs of pneumonia. Good agreement was observed between two physicians on kappa values above 70% for most ARI signs, but there was little agreement between physicians and mothers or between mothers whose children came for ARI problems and mothers of hospital controls. The few mothers who recognized the signs did not interpret them as serious. The author recommends intensive health education and further ethnographic studies on community beliefs about ARI in children, with particular emphasis upon documentation of the terms, signs, and symptoms by which families recognize the illness.