2691

ACUTE RESPIRATORY ILLNESS INCIDENCE AND DEATH AMONG CHILDREN UNDER TWO YEARS OF AGE ON LOMBOK ISLAND, INDONESIA

Bradford D, Gessner, Agustinus Sutanto, IGG Djelantik, Mark Steinhoff, Helen Murphy, Carib Nelson, Anton Widjaya, Soemarjati Arjoso

Disease Prevention and Health Promotion Division, West Nusa Tenggara Provincial Health office, Lombok, Indonesia;

Association Pour l' Aide a la Medicine Preventive Institute Pasteur, Paris, France;

Program for Appropriate Technology in Health Seattle, WA and Lombok Indonesia;

Departments of International Health, Pediatrics and Schools of Medicine and Public Health, Johns Hopkins University, Balrimore, MD;

Center for Infectious Disease Research and Development, Ministry of Health, Jakarta, Indonesia

Background: No childhood pneumonia incidence data for Indonesia and few for Asia as a whole exist.

Objective: To determine the incidence of acute respiratory illness(ARI) and ARI mortality among children less than 24 months of age on Lombok, Island, Indonesia.

Methods: During February 1, 1998 to January 31, 1999 we conducted childhood ARI and mortality surveillance among 50 mainly rural villages on Lombok Island ARI mortality was ascertained with a verbal autopsy.

Results: The total number of child-years at risk during the study period was 17,015. The incidences of simple, severe, hospitalized, and radiologically confirmed alveolar pneumonia were 21,8.3,5.3, and 1.8 per 100 child-years of observation, respectively. For all outcomes, the incidence was higher among younger and rural children. Overall and ARI-specific infant mortality rates were 84 and 33 per 1,000 live births, respectively. Over 65% of ARI deaths occurred outside of a hospital setting.

Conclusions: The incidence of pneumonia is high in lombok. Interventions should include introduction of vaccines to prevent infections leading to pneumonia and increasing the access of critically ill infants to the health care system.