Prevalence, determinants and health care-seeking behavior of childhood acute respiratory tract infections in Bangladesh

Abstract

BackgroundAcute respiratory infections (ARIs) are one of the leading causes of child mortality worldwide and contribute significant health burden for developing nations such as Bangladesh. Seeking care and prompt management is crucial to reduce disease severity and to prevent associated morbidity and mortality.ObjectiveThis study investigated the prevalence and care-seeking behaviors among under-five children in Bangladesh and identified factors associated with ARI prevalence and subsequent care-seeking behaviors.MethodThe present study analyzed cross-sectional data from the 2014 Bangladesh Demographic Health Survey. Bivariate analysis was performed to estimate the prevalence of ARIs and associated care-seeking. Logistic regression analysis was used to determine the influencing socio-economic and demographic predictors. A p-value of <0.05 was considered as the level of significance.ResultAmong 6,566 under-five children, 5.42% had experienced ARI symptoms, care being sought for 90% of affected children. Prevalence was significantly higher among children < 2 years old, and among males. Children from poorer and the poorest quintiles of households were 2.40 (95% CI = 1.12, 5.15) and 2.36 (95% CI = 1.06, 5.24) times more likely to suffer from ARIs compared to the wealthiest group. Seeking care was significantly higher among female children (AOR = 2.19, 95% CI = 0.94, 5.12). The likelihood of seeking care was less for children belonging to the poorest quintile compared to the richest (AOR = 0.03, 95% CI = 0.01, 0.55). Seeking care from untrained providers was 3.74 more likely among rural residents compared to urban (RRR = 3.74, 95% CI = 1.10, 12.77).ConclusionARIs continue to contribute high disease burden among under-five children in Bangladesh lacking of appropriate care-seeking behavior. Various factors, such as age and sex of the children, wealth index, the education of the mother, and household lifestyle factors were significantly associated with ARI prevalence and care-seeking behaviors. In addition to public-private actions to increase service accessibility for poorer households, equitable and efficient service distribution and interventions targeting households with low socio-economic status and lower education level, are recommended.

Inequalities in health care utilization for common illnesses among under five children in Bangladesh

“…Paternal educational attainment was significantly associated with inequalities in medical treatment use for children with fever, cough and diarrhea. This finding aligns with our expectation that educated parents are more likely to seek health care for their children and this result is consistent with findings from other studies [18,20,21] . The reasoning behind this might be the fact that educated fathers have better knowledge and understanding about childhood illnesses which motivates their spouses to seek health care for their children [20].…”

“…Children from the richest household had higher likelihood of receiving treatment compared to children from poorest households. This finding aligns with findings from other studies in different settings [14,16,[18][19][20][21]. This inequality, largely due to the wealth status of households, can be explained as wealth has a direct positive influence on the utilization of health care services and a lack of resources can create bottlenecks to accessing health care services for children [21].…”

“…They found some of the socioeconomic factors, especially, wealth index and number of children in the household as the most important predictors. Another study on prevalence and determinants of acute respiratory tract infections (ARI) of children in Bangladesh found sex of children and wealth status of household as significant determinants of health care seeking [18]. These studies focused on a single disease e.g.…”

Acute respiratory infection and its associated factors among children under-five years attending pediatrics ward at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: institution-based cross-sectional study

“…Children from rural setup were more prone to develop ARI in the current study which is in line with several earlier studies [12,39,[44][45][46]. The probable justification for the greater ARI symptoms proportion for rural children may be due to lack of access to medical care, low socio-economic standards in rural regions [47] and most risk factors for ARI prevail in rural setup [48].…”

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“…Child's weight was recoded into below 2.5kg (1) and 2.5kg and above (2). This weight was generated based on studies that have considered a child's weight less than 2.5kg as low birth weight and those 2.5kg and above as non-low birth weight [35][36][37][38]. Child's twin status was recoded into single birth (1) and multiple birth (2).…”