Trends in infectious disease incidence among children in Afghanistan at a time of public health services expansion

Abstract

This study reviewed trends in the incidence of common communicable diseases among children under five years in Afghanistan between 2005 and 2013, a period of expansion of public health services. New visits to outpatient clinics constituted the denominator for calculating proportions. In 2013, almost three-quarters of all new visits of children to public health services were for an infectious disease, with respiratory infections the most common. Because of inconsistent data collection for some infections early in the period, the trend for infectious diseases as a whole cannot be estimated. However, there was a statistically significant downward trend in the proportion of new visits that were diagnosed as one of the 11 leading communicable diseases from 74.5% in 2005 to 62.1% in 2013 (P < 0.001). There was no difference in communicable disease patterns between provinces, but a higher per capita consultation rate was associated with a higher proportion of the leading infections (P = 0.008). Recent improvements in maternal health, hygiene, and preventive services may have had an impact in reducing the burden of infections. ‫الصحية‬

Childhood pneumonia in humanitarian emergencies in low- and middle-income countries: A systematic scoping review

“…In four studies looking at pneumonia in outpatient settings , pneumonia represented 12%-34% of diagnoses for children U5 [ 17 , 19 - 21 ]. No studies included older children or adolescents.…”

“…Nationally representative data from conflict-affected Afghanistan showed that pneumonia cases decreased as a proportion of U5 admissions from 12.2% to 8.6% between 2005 and 2013 [ 19 ]. However, Bernasconi et al’s study of children attending primary care facilities in Kabul, Afghanistan, revealed significant under-recognition of pneumonia by health care workers finding that pneumonia represented 9.7% (39/404) of U5 presentation at baseline but 21.2% (141/665) of presentations after introduction of an electronic decision-making tool that encouraged adherence to IMCI guidelines [ 21 ].…”