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The effects of social variables on symptom recognition and medical care seeking behaviour for acute respiratory infections in infants in urban Mongolia
  1. N Gombojav1,
  2. S Manaseki-Holland2,
  3. J Pollock3,
  4. A J Henderson4
  1. 1
    Department of General Practice, Health Sciences University, Ulaanbaatar, Mongolia
  2. 2
    Aga Khan Health Services, Kabul, Afghanistan
  3. 3
    Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
  4. 4
    Department of Community-based Medicine, University of Bristol, UK
  1. Correspondence to Dr A J Henderson, ALSPAC, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; a.j.henderson{at}


Objective: To investigate potentially modifiable factors associated with carers’ recognition of symptoms and timely presentation of infants with acute respiratory infections (ARI) in urban Mongolia.

Methods: A prospective cohort study nested in a randomised controlled trial of infant swaddling. Data were collected on social, educational and childcare variables and all doctor contacts for ARI in primary and secondary care by regular questionnaires to carers of infants during the first 6 months of life.

Findings: Analyses were based on 9024 ARI related doctor contacts for 4554 illness episodes in 1218 infants. Delay in medical care seeking (>3 days from acute lower respiratory infection (ALRI) symptom onset) was associated with younger maternal age (OR (95% CI) 3.8 (1.2 to 11.6)), single child families (3.8 (1.2 to 11.61)), absent father (4.1 (1.2 to 14.4)) and residence more than 1 km from a clinic (3.5 (1.2 to 10.2)).

Conclusion: There is a continuing need to educate carers of infants in the management of ARI, particularly those of younger age and those with limited family support.

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  • Funding This project was supported by a Wellcome Trust Research Training Fellowship to Dr S Manaseki-Holland and a postgraduate student bursary from The University of the West of England, Bristol to Dr G Narangerel.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval The study was approved by the ethics committees of the Ministry of Health, Mongolia, and the London School of Tropical Medicine and Hygiene.