A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria

Abstract

BackgroundNigeria has the second highest estimated number of deaths due to acute respiratory infection (ARI) among children under five in the world. A common hypothesis is that the inequitable distribution of socioeconomic resources shapes individual lifestyles and health behaviors, which leads to poorer health, including symptoms of ARI. This study examined whether lifestyle factors are associated with ARI risk among Nigerian children aged less than 5 years, taking individual-level and contextual-level risk factors into consideration.MethodsData were obtained from the nationally representative 2013 Nigeria Demographic and Health Survey. A total of 28,596 surviving children aged 5 years or younger living in 896 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between lifestyle factors and ARI symptoms.ResultsThe multivariate results from multilevel regressions indicated that the odds of having ARI symptoms were increased by a number of lifestyle factors such as in-house biomass cooking (OR = 2.30; p < 0.01) and no hand-washing (OR = 1.66; p < 0.001). An increased risk of ARI symptoms was also significantly associated with living in the North West region and the community with a high proportion of orphaned/vulnerable children (OR = 1.74; p < 0.001).ConclusionsOur findings underscore the importance of Nigerian children’s lifestyle within the neighborhoods where they reside above their individual characteristics. Program-based strategies that are aimed at reducing ARI symptoms should consider policies that embrace making available basic housing standards, providing improved cooking stoves and enhancing healthy behaviors.

Factors contributing to regional inequalities in acute respiratory infections symptoms among under-five children in Nigeria: a decomposition analysis

“…Those cut-off points were selected based on prior research that have identified a high occurrence of adverse events for intervals shorter than 24 months [ 47 ]. Region is a six-level variable (North west, North east, North central, South east, South south and South west) that was included to take into account between region heterogeneity [ 28 ].…”

“…Differential exposures of niche where a child is born and raised constitutes determinants of health outcomes [ 26 ]. Thus evidence of specific interventions effective in reducing ARI is necessary [ 27 ] for understanding the contributing factors to the inequity of ARI prevalence and examining why children from poor regions, with political problems and religious unrest in recent times leading to air pollutions, migration which may result into communities or households having higher risk of ARI [ 28 ].…”

“…Using the World health organization (WHO) child growth standards, and measured socio-economic inequality using concentration index, Van de Poel ecological study including 47 countries contended that child malnutrition (stunting and wasting/thinning) disproportionately affected the poor [ 36 ]. Adesanya and Chiao in their findings revealed children living in the North western/eastern Nigeria had higher odds of ARI symptoms indicating inequalities in outcomes [ 28 ]. Still, no study has included these sources to explain the unequal distribution of ARI by region and over time especially in the Nigerian context.…”

Efficacité des pratiques en matière d’hygiène des mains dans la prévention de l’infection par le virus de la grippe en milieu communautaire : examen systématique

“…Résumé des données relatives à l'efficacité des pratiques d'hygiène des mains dans la prévention de la grippe présumée ou confirmée en laboratoire en milieu communautaireHygiène des mains et grippeNeuf études ont évalué l'efficacité des interventions ou des pratiques d'hygiène des mains dans la prévention de la grippe présumée ou confirmée en laboratoire en milieu communautaire, dont deux ECR(13,15), une étude de cohortes(25), trois études cas témoins(19,21,26) et trois études transversales(18,20,23).Les résultats des études étaient variables; six études sur neuf ont conclu qu'une intervention ou pratique d'hygiène des mains réduisait le nombre de cas de grippe confirmée en laboratoire(21,26) ou présumée(15,18,20,23), tandis que trois études ont conclu qu'il n'y avait pas de lien statistiquement significatif entre l'hygiène des mains et une diminution des cas de grippe(13,19,25). Un des deux ECR a fait état d'un lien significatif entre le lavage des mains et une diminution du risque de syndrome grippal(15), tandis que l'autre ECR n'a relevé aucun effet d'une intervention de désinfection des mains sur le lieu de travail sur les cas de grippe cliniquement diagnostiquée auto-déclarée(13).…”

“…Un des deux ECR a fait état d'un lien significatif entre le lavage des mains et une diminution du risque de syndrome grippal(15), tandis que l'autre ECR n'a relevé aucun effet d'une intervention de désinfection des mains sur le lieu de travail sur les cas de grippe cliniquement diagnostiquée auto-déclarée(13). Quant aux études observationnelles, fondées sur les pratiques d'hygiène des mains auto-déclarées(20,21,23,25,26) ou observées(18,19), elles ont pour la plupart fait état d'une probabilité d'infection présumée significativement inférieure sur le plan statistique(18,20,21,23,26). Il n'a pas été possible de réaliser une analyse qualitative plus détaillée des résultats étant donné le nombre limité d'études hétérogènes.…”