Symptoms of Acute Respiratory Infection (ARI) and careseeking

Percentage of children under age 5 with symptoms of ARI, and among children under age 5 with symptoms of ARI, the percentage for whom advice or treatment was sought and for whom advice or treatment was sought the same or next day

Definition

1)      Percentage of children under age 5 with symptoms of ARI at any time in the 2 weeks preceding the survey.

2)      Percentage of children under age 5 with symptoms of ARI at any time in the 2 weeks preceding the survey for whom advice or treatment was sought.

3)      Percentage of children under age 5 with symptoms of ARI at any time in the 2 weeks preceding the survey for whom advice or treatment was sought the same or next day.

Coverage:

Population base: Living children under age 5 years (KR file)

Time period: 2 weeks preceding the survey

Numerators:

1)      Number of living children under age 5 with symptoms of ARI (short, rapid breathing which was chest-related and/or difficult breathing which was chest-related) in the 2 weeks preceding the survey (b5=1 & b19 < 60 & h31b = 1 & h31c in 1,3)

2)      Number of living children under age 5 with symptoms of ARI in the 2 weeks preceding the survey for whom treatment was sought (b5=1 & b19 < 60 & h31c = 1 & h31c in 1,3 & any of h32a – x = 1 excluding advice or treatment from a traditional practitioner (usually h32t))

3)      Number of living children under age 5 with symptoms of ARI in the 2 weeks preceding the survey for whom treatment was sought the same or next day (b5=1 & b19 < 60 & h31b = 1 & h31c in 1,3 & any of h32a – x = 1 excluding advice or treatment from a traditional practitioner (usually h32t) & h46b in 0,1)

Denominators:

a)       Number of living children under age 5 (b5=1 & b19 < 60)

b)      Number of children under age 5 with symptoms of ARI at in the 2 weeks preceding the survey (b5=1 and b19 < 60 and h31b = 1 & h31c in 1,3)

c)       Same as denominator 2

Variables: KR file.

Calculation

Numerator divided by the denominator, multiplied by 100.

Handling of Missing Values

Missing data or “don’t know” responses on the questions on short, rapid breathing and/or difficult breathing and whether it was chest-related are excluded from numerator 1, and from numerators and denominators 2 & 3, assuming no illness.

Missing data or “don’t know” responses for whether sought advice or treatment and who from are excluded from numerators 2 & 3, assuming no treatment sought from a health facility or provider.

Notes and Considerations

Indicators 2 & 3 include advice or treatment from the public sector, private medical sector, NGO medical sector, shops, market, and itinerant drug sellers, but excludes advice or treatment from a traditional practitioner.

Changes over Time

For DHS-7, symptoms of ARI is defined as short, rapid breathing which was chest-related and/or difficult breathing which was chest-related. In prior surveys, the definition of symptoms of ARI included cough. Specifically, in DHS-VI and later DHS-V surveys, symptoms of ARI was defined as a cough accompanied by short, rapid breathing which was chest-related and/or by difficult breathing which was chest-related (h31b = 1 & h31c in 1,3). In earlier DHS-V and DHS-IV surveys, the wording of the question about breathing only defined the symptoms of ARI as cough accompanied by short, rapid breathing. In prior surveys symptoms of ARI was defined as cough accompanied by rapid breaths alone (h31b = 1) as the question on whether the illness was chest-related (h13c) was not included.

For surveys prior to DHS-7, care seeking was defined differently. The indicator measured care seeking from a medical source or provider, and excluded pharmacy, shop, market, itinerant drug seller and traditional practitioner.

In DHS-8, NGO medical sector was added as a separate source category. Previously, it was lumped in with private medical sector.

References

Assaf, S., L. Horton, M. Bornstein, and T. Pullum. 2017. Levels and Trends of Maternal and Child Health Indicators in 11 Middle East and North African Countries. DHS Comparative Report No. 46. Rockville, Maryland, USA: ICF. https://www.dhsprogram.com/publications/publication-CR46-Comparative-Reports.cfm

Rutstein, S.O., S. Staveteig, R. Winter, and J. Yourkavitch. 2016. Urban child poverty, health, and survival in low- and middle-income countries. DHS Comparative Reports No. 40. Rockville, Maryland, USA: ICF International. https://www.dhsprogram.com/publications/publication-CR40-Comparative-Reports.cfm

WHO and UNICEF. 2013. Ending preventable child deaths from Pneumonia and Diarrhoea by 2025: The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD). Geneva: WHO https://apps.who.int/iris/bitstream/handle/10665/79207/WHO_FWC_MCA_13_01_eng.pdf

World Health Organization. 2018. Global reference list of 100 core health indicators. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/259951

UNICEF. 2012. Pneumonia and diarrhea: Tackling the deadliest diseases for the world’s poorest children. New York, New York, USA:UNICEF https://data.unicef.org/resources/pneumonia-and-diarrhoea-tackling-the-deadliest-diseases-for-the-worlds-poorest-children/

Resources

DHS-8 Tabulation plan: Table 10.6

API Indicator IDs:

CH_ARIS_C_ARI

(API link, STATcompiler link)

WHO 100 Core Health Indicators: Care-seeking for symptoms of pneumonia

MICS6 Indicator TC.19: Care-seeking for children with acute respiratory infection (ARI) symptoms

Percentage of children under age 5 with symptoms of ARI for whom advice or treatment was sought from specific sources, and among those for whom advice or treatment was sought, percentage for whom advice or treatment was sought from specific sources

Definition

1)      Percentage of children under age 5 with symptoms of ARI for whom advice or treatment was sought from specific sources.

2)      Among children under age 5 with symptoms of ARI for whom advice or treatment was sought, the percentage for whom advice or treatment was sought from specific sources.

Coverage:

Population base: Living children under age 5 with symptoms of ARI (KR file)

Time period: 2 weeks preceding the survey

Numerator:

1)      Number of living children under age 5 with symptoms of ARI (short, rapid breathing which was chest-related and/or by difficult breathing which was chest-related) in the 2 weeks preceding the survey for whom care was sought from each specific source (b5=1 & b19 < 60 & h31b = 1 & h31c in 1,3 & h32a – x)

2)      Same as numerator 1

Denominators:

a)       Number of living children under age 5 with symptoms of ARI in the 2 weeks preceding the survey (b5=1 & b19 < 60 & h31b = 1 & h31c in 1,3)

b)      Number of living children under age 5 with symptoms of ARI in the 2 weeks preceding the survey for whom treatment was sought from any source (b5=1 & b19 < 60 & h31b = 1 & h31c in 1,3 & h32a – x)

Variables: KR file.

Calculation

Numerator divided by the denominator, multiplied by 100.

Handling of Missing Values

Missing data or “don’t know” responses on the questions on short, rapid breathing and/or difficult breathing and whether it was chest-related are excluded from numerators and denominators, assuming no illness.

Missing data or “don’t know” responses for whether sought advice or treatment and who from are excluded from numerators, assuming no treatment sought from a specific health facility or provider.

Notes and Considerations

In contrast to the indicator Percentage of children under age 5 with symptoms of ARI, and among children under age 5 with symptoms of ARI, the percentage for whom advice or treatment was sought and for whom advice or treatment was sought the same or next day, these indicators include advice or treatment from a traditional practitioner.

Changes over Time

For DHS-7, symptoms or ARI is defined as short, rapid breathing which was chest-related and/or difficult breathing which was chest-related. In prior surveys, the definition of symptoms of ARI included cough. Specifically, in DHS-VI and later DHS-V surveys, symptoms of ARI was defined as a cough accompanied by short, rapid breathing which was chest-related and/or by difficult breathing which was chest-related (h31b = 1 & h31c in 1,3). In earlier DHS-V and DHS-IV surveys, the wording of the question about breathing only defined the symptoms of ARI as cough accompanied by short, rapid breathing. In prior surveys symptoms of ARI was defined as cough accompanied by rapid breaths alone (h31b = 1) as the question on whether the illness was chest-related (h13c) was not included.

In DHS-8, NGO medical sector was added as a separate source category. Previously, it was lumped in with private medical sector.

Resources

DHS-8 Tabulation plan: Table 10.7

API Indicator IDs:

Among children with symptoms of ARI:

CH_ARSS_C_PUB, CH_ARSS_C_GHS, CH_ARSS_C_GHC, CH_ARSS_C_GHP, CH_ARSS_C_GMB, CH_ARSS_C_GFW, CH_ARSS_C_GOT, CH_ARSS_C_PRV, CH_ARSS_C_PHS, CH_ARSS_C_PPH, CH_ARSS_C_PDR, CH_ARSS_C_PMB, CH_ARSS_C_PFW, CH_ARSS_C_POT

(API link, STATcompiler link)

CH_ARSS_C_OSR, CH_ARSS_C_SHP, CH_ARSS_C_TRP, CH_ARSS_C_MKT, CH_ARSS_C_OTH

(API link, STATcompiler link)

Among children with symptoms of ARI for whom treatment was sought:

CH_ARSA_C_PUB, CH_ARSA_C_GHS, CH_ARSA_C_GHC, CH_ARSA_C_GFP, CH_ARSA_C_GMB, CH_ARSA_C_GFW, CH_ARSA_C_GOT, CH_ARSA_C_PRV, CH_ARSA_C_PHS, CH_ARSA_C_PPH, CH_ARSA_C_PDR, CH_ARSA_C_PMB, CH_ARSA_C_PFW, CH_ARSA_C_POT,

(API link, STATcompiler link)

CH_ARSA_C_OSR, CH_ARSA_C_SHP, CH_ARSA_C_TRP, CH_ARSA_C_MKT, CH_ARSA_C_OTH

(API link, STATcompiler link)