Prevalence and risk factors of acute lower respiratory infection among children living in biomass fuel using households: A community-based cross-sectional study in Northwest Ethiopia

Abstract

income countries (LMICs) (1) across all ages and sexes (2). Lower respiratory infections caused 652, 572 deaths in children younger than 5 years worldwide in 2016 (3). Particularly, acute lower respiratory infection (ALRI) in the form of pneumonia is recognized as the single largest cause of childhood death globally accounting for 16% of the overall deaths in 2015 (4).In Ethiopia, lower respiratory infections were the leading cause of premature mortality across all ages in the year 2015 (5) and pneumonia, in particular, was the second most common causes of mortality in Northeast Ethiopia (6). In addition, the 2016 EDHS report confirmed a countrywide ARI prevalence of 7% among children under 5 years old (7), and a number of cross-sectional studies conducted in different parts of the country reported an even higher prevalence of childhood ARI in Ethiopia which ranges from 16% up to 33.5% (8-12).Concerning the risk factors, studies have shown that household air pollution (HAP) exposure is linked with childhood ALRI (13,14). However, the factors are not identical across different circumstances and further investigations should be extended to other locations, populations, and cultures to determine the relationships more precisely (15). There are, however, limited community-based studies in Ethiopia in general (16-18), and there is a robust lack of evidence in the current study region in particular as reported by a recent synthesis of situational analysis in Ethiopia (16). The availability of such evidence would drive commitments by governments, industries, non-governmental organizations, communities, and individual citizen to find suitable HAP prevention method in order to reduce the burden of preventable HAP related child ARI morbidity and mortality in Ethiopia and somewhere else in LMICs.Therefore, taking account of the critical need for more evidence in the area as recommended by previous studies (16)(17)(18), the present study was conducted to assess the prevalence and factors associated with community-acquired childhood ALRI using the definition of Integrated Management of Childhood Illnesses (IMCI) pneumonia algorithm developed by World Health Organization (WHO) (19, 20). The IMCI-pneumonia assessment protocol is a common diagnostic criterion for the classification and treatment of childhood pneumonia at health facilities in Ethiopia (21). The Ethiopian Demographic and Health Survey (EDHS) (7) and other similar studies conducted in different parts of the world also