Bayesian multilevel analysis of determinants of acute respiratory infection in children under the age of five years in Ethiopia

Abstract

Background Acute respiratory tract infection (ARI) is one of the leading causes of illness and mortality in children under the age of five worldwide. Pneumonia, which is caused by a respiratory tract infection, kills about 1.9 million children under the age of 5 years around the world. The majority of these deaths occur in underdeveloped countries. According to the 2016 Ethiopia Demographic and Health Survey (EDHS), the prevalence rate of ARI in Ethiopia was 7%. Prevalence is defined as the number of infectious diseases present at a given period in relation to the total number of children under the age of five who have been exposed to ARI. The goal of this study was to determine the risk factors for acute respiratory infection among children under the age of five in Ethiopia. Methods To provide representative samples of the population, a community-based cross-sectional sampling scheme was designed. Bayesian multilevel approach was employed to assess factors associated with the prevalence of ARI among children under age five in Ethiopia. The data was collected from 10,641 children under the age of 5 years out of which 9918 children were considered in this study. Results The ARI prevalence rate in children under the age of 5 years was assessed to be 8.4%, somewhat higher than the country’s anticipated prevalence rate. Children whose mothers did not have a high level of education had the highest prevalence of ARI. The key health, environmental, and nutritional factors influencing the proportion of children with ARI differed by area. Tigray (15.3%) and Oromia (14.4%) had the highest prevalence of ARI, while Benishangul Gumuz had the lowest prevalence (2.6%). The use of vitamin A was investigated, and the results revealed that roughly 43.1% of those who received vitamin A had the lowest prevalence of ARI (7.7%) as compared to those who did not receive vitamin A. Diarrhea affected 11.1% of children under the age of five, with the highest frequency of ARI (24.6%) and the highest prevalence of ARI reported in children whose drinking water source was unprotected/unimproved (9.4%). Conclusions The prevalence of ARI among children under the age of 5 years was found to be strongly affected by the child’s age, household wealth index, mother’s educational level, vitamin A supplement, history of diarrhea, maternal work, stunting, and drinking water source. The study also found that the incidence of ARI varies significantly between and within Ethiopian areas. When intending to improve the health status of Ethiopian children, those predictive variables should be taken into consideration.

Acute Lower Respiratory Infections among Children Under Five in Sub-Saharan Africa: A Scoping Review of Prevalence and Risk Factors

“…Among reviewed studies, 60.2% [18] and 1.9% [16] were the highest and lowest reported prevalence of ALRTIs, respectively. Furthermore, seven studies reported a prevalence between 1% and 10% [15][16][17][19][20][21][22]. The majority of the reviewed studies that provided the rates were between 11% and 20% [16, [23][24][25][26][27][28][29].…”

“…For instance, children under ve who are underweight [21,25] or stunted [25,41], and those anaemic [39] and not exclusively breastfed or poorly breastfed [1,15,21,37] are more likely to suffer ALRTIs. Unfortunately, unvaccinated children under ve [1] or children who did not complete their vaccination [13] or did not receive vitamin A supplements [19,20,39] are at higher risk of ALRTIs. Perhaps, children with existing health issues such as HIV [14] and a history of diarrhoea [19,20,23,25,28] become more vulnerable to ALRTIs (See Table 3 for details).…”

“…Unfortunately, unvaccinated children under ve [1] or children who did not complete their vaccination [13] or did not receive vitamin A supplements [19,20,39] are at higher risk of ALRTIs. Perhaps, children with existing health issues such as HIV [14] and a history of diarrhoea [19,20,23,25,28] become more vulnerable to ALRTIs (See Table 3 for details).…”

“…Malnutrition Malnutrition [15,22,29,35,38,42,43] Underweight [21,25] Stunting [25,41] Anaemia [39] Lack of breastfeeding/exclusive breastfeeding [1,15,21,37] Children who did not receive vitamin A supplement [19,20,39] Household facilities Poor ventilation/absence of windows [1,32,42,44] House without separate kitchen [1,16] Damp roof, mould growths on walls [49] Households with unclean water [49] Households with poor toilet facilities [49] Living in house with no chimney, eaves space, [26] Children in households with a low proportion of electricity [23] Lack of Immunisation Failure to receive the second dose of the pentavalent vaccine. [13] Unvaccinated children [1] Poor immunisation [15] Cooking Inhouse cooking, [24,26,27,29] Unclean fuel/stove or biomas [15,21,35,42] Frequency of cooking [26,27] Children who were held by their mothers while cooking [32,42] Solid fuel for cooking, …”

A Review on Human Metapneumovirus and Human Bocavirus Associated with Acute Respiratory Tract Infections

“…It risks young children, the elderly, and those with immune system disorders. Acute respiratory infections are thought to cause 2.6 million child deaths annually worldwide, according to the World Health Organization (WHO) [1]. Infections in children with human metapneumovirus (hMPV) and bocavirus (HBoV) are linked to a high prevalence of ARTIs.…”