Spatial distribution and determinants of acute respiratory infection among under-five children in Ethiopia: Ethiopian Demographic Health Survey 2016

Abstract

Background Childhood acute respiratory infection remains the commonest global cause of morbidity and mortality among under-five children. In Ethiopia, it remains the highest burden of the health care system. The problem varies in space and time, and exploring its spatial distribution has supreme importance for monitoring and designing effective intervention programs. Methods A two stage stratified cluster sampling technique was utilized along with the 2016 Ethiopian Demographic and Health Survey (EDHS) data. About 10,006 under-five children were included in this study. Bernoulli model was used to investigate the presence of purely spatial clusters of under-five acute respiratory infection using SaTScan.ArcGIS version 10.1 was used to visualize the distribution of pneumonia cases across the country. Mixed-effect logistic regression model was used to identify the determinants of acute respiratory infection. Result In this study, acute respiratory infection among under-five children had spatial variations across the country (Moran’s I: 0.34, p < 0.001). Acute respiratory infection among under-five children in Tigray (p < 0.001) and Oromia (p < 0.001) National Regional States clustered spatially. History of diarrhoea (Adjusted Odds Ratio (AOR) = 4.71, 95% CI: (3.89–5.71))), 45–59 months of age (AOR = 0.63, 95% CI: (0.45–0.89)), working mothers (AOR = 1.27, 95% CI: (1.06–1.52)), mothers’ secondary school education (AOR = 0.65; 95% CI: (0.43–0.99)), and stunting (AOR = 1.24, 95% CI: (1.00–1.54)) were predictors of under-five acute respiratory infection. Conclusion and recommendation In Ethiopia, acute respiratory infection had spatial variations across the country. Areas with excess acute respiratory infection need high priority in allocation of resources including: mobilizing resources, skilled human power, and improved access to health facilities.

Acute Respiratory Infection of under-five children associated with place of food cooking in Ethiopia: Multilevel Analysis of 2005-2016 Ethiopian Demographic Health Survey data

“…The nding complies with a prior study in urban areas of Oromia region, Ethiopia [36]; in Wondo-Genet district, southern Ethiopia [19] and in Afghanistan [37]. This could be because of the few time the older children spend with their mothers in the house [37], and the higher number in younger children could be associated with the underdeveloped epithelial linings of the lungs and weaker immune system of younger children compared with the older counterparts [37][38][39].…”

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

“…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]. However, in other studies [23,49], the residence was not significantly associated and Kumar et' al reported urban residence to be a risk factor for ARI [17].…”

“…Several factors predispose children under five years of age for ARIs. These factors may be attributed to child factors such as age [11][12][13][14][15] and female sex [16], maternal factors such as lower age [11,13], unemployment [11,13] and lower educational status [16,17] environmental-related factors such as urban residence [17], rural residence [18], wet season [19][20][21] and co-morbid diseases [14,22,23]. There is a paucity of studies regarding the prevalence and associated factors of ARI among hospitalized under-five years children in Ethiopia even though few community-based cross-sectional studies [24][25][26] have been undertaken in to assess the prevalence and associated factors of ARIs among under-five years children.…”

Associations between infant and young child feeding practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach

“…The potential confounders were selected based on previously published studies [10,13,15,26,34,35] and data availability. Potential confounding factors were broadly classified into socioeconomic, demographic and behavioural, health service and community-level factors.…”