Acute lower respiratory infections: a major cause of death in children in Bangladesh

The importance of acute lower respiratory infections (ALRI) as a cause of death in children was estimated using systematically collected demographic data on the population of the Teknaf area of southern Bangladesh. Of 1349 children aged 1-59 months who died between 1 January 1982 and 31 December 1985, ALRI was diagnosed by verbal autopsy in 390 (29%) and was the leading cause of death. ALRI mortality rates were highest in the youngest age groups (136/1000 for those less than or equal to 5 months) and decreased in older children (16/1000 for those 3-4 years old). Half of all fatal ALRI cases occurred in children less than 6 months old. In older children, ALRI-associated deaths tended to occur during the months October to January, while deaths in infants tended to follow the seasonal birth pattern. Significant predisposing factors for fatal ALRI were malnutrition and measles, detected, respectively, in 18% and 8% of children who died from ALRI. This study emphasizes the importance of ALRI as a major cause of death in developing countries and suggests that interventions to reduce childhood mortality are needed and should be targeted to specific age groups at risk.