Spatial epidemiology of acute respiratory infections in children under 5 years and associated risk factors in India: District-level analysis of health, household, and environmental datasets
Abstract:BackgroundIn India, acute respiratory infections (ARIs) are a leading cause of mortality in children under 5 years. Mapping the hotspots of ARIs and the associated risk factors can help understand their association at the district level across India.MethodsData on ARIs in children under 5 years and household variables (unclean fuel, improved sanitation, mean maternal BMI, mean household size, mean number of children, median months of breastfeeding the children, percentage of poor households, diarrhea in childr… Show more
“…The influenza virus is classified within the Orthomyxoviridae family ( Fig. 2 ) and exhibits genetic similarities with the influenza A virus responsible for the 2009 swine flu outbreak [ 69 ]. As of March 9, 2023, 3038 cases of H3N2 and 955 cases of H1N1 were reported in India according to the latest data available on IDSP-IHIP ( Fig.…”
Section: Emerging Disease and Its Vaccinementioning
“…The influenza virus is classified within the Orthomyxoviridae family ( Fig. 2 ) and exhibits genetic similarities with the influenza A virus responsible for the 2009 swine flu outbreak [ 69 ]. As of March 9, 2023, 3038 cases of H3N2 and 955 cases of H1N1 were reported in India according to the latest data available on IDSP-IHIP ( Fig.…”
Section: Emerging Disease and Its Vaccinementioning
“…Limited studies have focused on the risk factors of the infection using nationally representative data. [ 3 , 18 , 31 , 32 ]. However, these studies have ignored the asthmatic history of mothers as a possible predictor of ARI.…”
Background
Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five.
Study design
Cross-sectional study.
Methods
The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed.
Results
Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79–0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69–0.99) are less likely to seek treatment.
Conclusion
The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.
“…Respiratory tract infections (RTIs) present a significant challenge to the health system, particularly in developing countries, and are the leading cause of mortality and morbidity among children under five years [ 1 ]. The National Family Health Survey (NFHS-5) conducted during 2019-2021 reported a 2.8% prevalence of acute respiratory infection (ARI) among children under the age of five years in India [ 2 ].…”
Background: Probiotics are co-prescribed with co-amoxiclav to prevent antibiotic-associated diarrhea (AAD). The study assesses the co-prescription pattern of probiotics with co-amoxiclav in pediatric patients with respiratory tract infections (RTIs).Methods: This was a mixed methods research study with a retrospective study and a prospective survey. The retrospective part included a multicenter, observational, real-world study utilizing patients' electronic medical records for three years (2018-2020) from seven outpatient pediatric clinics and hospitals. The qualitative evaluation was performed with a predefined questionnaire.Results: The patients having RTIs (N=984) were prescribed Clamp ® (46.7%), CAA (23.8%), and CAM (29.5%). The mean age of the patients was 4.05 years, with 59.25% males and most patients having upper RTIs. Coamoxiclav was prescribed twice daily for one to 15 days. A significantly lesser number of probiotic coprescriptions were observed with Clamp ® (19.57%) than with CAA (38.46%) and CAM (29.31%) at baseline (p<0.001). Similar findings were observed for follow-up visits one and two. Saccharomyces boulardii, Bacillus clausii, and lactic acid bacillus were the most commonly co-prescribed probiotics. The qualitative evaluation indicated that most clinicians were aware of the co-amoxiclav-related gastrointestinal side effects and the benefits of probiotics in preventing them.
Conclusion:The frequency of co-prescriptions of probiotics with Clamp ® among pediatric patients with RTIs was significantly less, potentially indicating better gastrointestinal tolerability.
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