Assessment of a strategy for the control of respiratory diseases in children
A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
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| Series: | Revista de Saúde Pública |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89101992000600007&lng=en&tlng=en |
| _version_ | 1819106037824749568 |
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| author | Julio Cesar Rodrigues Pereira Luís Antonio Stuginsky Theotonio Victor de Miranda Ribeiro |
| author_facet | Julio Cesar Rodrigues Pereira Luís Antonio Stuginsky Theotonio Victor de Miranda Ribeiro |
| author_sort | Julio Cesar Rodrigues Pereira |
| collection | DOAJ |
| description | A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases. |
| first_indexed | 2024-12-22T02:31:47Z |
| format | Article |
| id | doaj.art-21abc9b7a001414d97ab3728ca5a3468 |
| institution | Directory Open Access Journal |
| issn | 0034-8910 1518-8787 |
| language | English |
| last_indexed | 2024-12-22T02:31:47Z |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-21abc9b7a001414d97ab3728ca5a34682022-12-21T18:41:51ZengUniversidade de São PauloRevista de Saúde Pública0034-89101518-8787266414423S0034-89101992000600007Assessment of a strategy for the control of respiratory diseases in childrenJulio Cesar Rodrigues Pereira0Luís Antonio Stuginsky1Theotonio Victor de Miranda Ribeiro2Secretaria de Saúde do Estado de São PauloSecretaria de Saúde do Estado de São PauloSecretaria de Saúde do Estado de São PauloA programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89101992000600007&lng=en&tlng=enrespiratory tract diseasesprogramme evaluationasthma |
| spellingShingle | Julio Cesar Rodrigues Pereira Luís Antonio Stuginsky Theotonio Victor de Miranda Ribeiro Assessment of a strategy for the control of respiratory diseases in children Revista de Saúde Pública respiratory tract diseases programme evaluation asthma |
| title | Assessment of a strategy for the control of respiratory diseases in children |
| title_full | Assessment of a strategy for the control of respiratory diseases in children |
| title_fullStr | Assessment of a strategy for the control of respiratory diseases in children |
| title_full_unstemmed | Assessment of a strategy for the control of respiratory diseases in children |
| title_short | Assessment of a strategy for the control of respiratory diseases in children |
| title_sort | assessment of a strategy for the control of respiratory diseases in children |
| topic | respiratory tract diseases programme evaluation asthma |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89101992000600007&lng=en&tlng=en |
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