Diagnosis and management of acute respiratory infections in lesotho

Document Type

Journal Article

Publication Date



Health Policy and Planning








Acute respiratory infections (ARI) accounted for 24% of deaths in hospitalized children under 5 years old in Lesotho in 1987, but little is known about how such infections are diagnosed and treated in this mountainous country of southern Africa. As a first step in developing a national programme to reduce infant and child mortality caused by respiratory infection, a survey of medical practitioners was conducted to determine whether current World Health Organization (WHO) recommendations on the management of ARI are being followed. Responses were analysed from 11 physicians, 12 nursas practising in hospitals, and 44 nurse-clinicians. WHO recommendations were followed by 94% of respondents for the management of a child with mild ARI and by 68% for the management of a child with severe acute lower respiratory tract infection (ALRI), but by only 17% for the management of moderate ALRI. For all categories of illness, physicians were more likely to prescribe an antimicrobial drug than nurse-clinicians. Eighty-four percent of respondents would have treated mildly ill febrile children with an antipyretic drug. Results of the survey show that focused training of health workers is needed to promote appropriate management of children with moderate ALRI, and that supportive therapy will probably cost more than antimicrobial therapy. The next steps in developing a national ARI programme will include refining the case-management strategy supported by WHO and developing appropriate tools to teach mothers to recognize serious respiratory illness. © 1990 Oxford University Press.