ABSTRACT
THE MAGNITUDE OF THE PROBLEM Acute respiratory infections (ARI) are one of the chief causes of mortality and morbidity among infants and children under five in developing countries (Berman and McIntosh 1985, Shann 1985a, WHO 1981, 1983).1 In much of the developing world, approximately half of all deaths are in children under five years of age. Depending on the region, ARI accounts for between one fifth and one third of these deaths (Leowski 1986, Pio, Leowski, and Dam 1985, Rohde 1983). While surpassed by diarrheal diseases as a cause of death in some developing countries, ARI has been reported as the chief cause of mortality in several other areas (Denny and Loda 1986, Grant 1984), including regions of Africa (Bulla and Hitze 1978, Greenwood et al. 1987), China and Indonesia (Parker 1987, Edmundson and Harris 1989), India (Edmundson and Harris 1989), Guatemala (Mata 1978), Papua
New Guinea (Riley and Carrad 1983), Nepal (Adhikari 1985, Pandey, Sharma, and Nuepane 1985), Burma (Aung 1985) and the Philippines (PDH 1986). In the case of Papua New Guinea, 42% of deaths in children under age one and 25% of deaths between ages one and five have been attributed to ARI. In regions of India where rigorous data collection on ARI has been initiated, up to 36% of infant deaths have been associated with ARI (Kumar 1987, Steinhoff and John 1983). Between 500,000 and 750,000 children are estimated to die of ARI in India each year.
