Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda

Abstract

Background Globally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda. Methods A cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years. Results In Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12–1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06–1.53), and farm workers (1.25; 95% CI: 1.11–1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48–59 months (OR: 0.69; 95% CI: 0.60–0.80), breastfed children (OR: 0.83; 95% CI: 0.76–0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69–0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61–0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda. Conclusion Policy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children’s healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education.

Trends and determinants of acute respiratory infection symptoms among under-five children in Cambodia: Analysis of 2000 to 2014 Cambodia demographic and health surveys

“…ARI symptoms in young children (0–35 months) were common in our study than in older children (36–59 months). These results are in line with other studied [ 6 , 13 , 30 ]. The increased risk for ARI in this age group might be explained by the children’s low immunity.…”

“…The immune system appeared to be stronger at a later stage in older children after vaccination. In particularly in countries in Southeast Asia and sub-Saharan African, where health facilities and maternal healthcare education need to be improved, the factors were low rates of immunization in young children, low maternal literacy, and young mothers engaged in farming activities that prevent the care of young children [ 30 , 31 ]. Additionally, compared to children living households with improved toilet facilities, children from households with unimproved toilet facilities were more likely to experience ARI symptoms.…”

Acute Lower Respiratory Infections among Children Under Five in Sub-Saharan Africa: A Scoping Review of Prevalence and Risk Factors

“…The reviewed studies showed that children above the age of two years are at higher risk of ALRTIs [6, 25,27,28,30,35,[39][40][41]. However, this evidence is inconclusive because under two years seem highly susceptible to ALRTIs compared to the rest of children under ve [30,39,40]. Moreover, children under ve of teenage mothers [21,30,40] and children from mothers above age 35 [42] are more susceptible to ALRTIs.…”

“…However, this evidence is inconclusive because under two years seem highly susceptible to ALRTIs compared to the rest of children under ve [30,39,40]. Moreover, children under ve of teenage mothers [21,30,40] and children from mothers above age 35 [42] are more susceptible to ALRTIs. Evidence strongly establishes that children of mothers with low education [14, 15, 19, 21, 23-25, 37, 38, 43] and lack of employment [20,42] are more vulnerable to developing ALRTIs.…”

Adoption of Artificial Intelligence in the Ugandan Health Sector: a review of Literature

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