Environmental Risks Associated with Symptoms of Acute Respiratory Infection among Preschool Children in North-Western and South-Southern Nigeria Communities

Abstract

The exposure-disease-stress model places young children in their physical and social contexts and considers the extent and intensity of associational links to symptoms of acute respiratory infection (ARI), taking in to account a range of biological, social, and environment components. This study uses the 2013 Nigeria Demographic and Health Survey to assess the individual and environmental risks present in the North-Western and South-Southern Nigerian communities and examines their associations with ARI symptoms. The descriptive findings show that the prevalence of ARI symptoms is significantly higher among preschool children in the North-Western province (5.7%) than in the South-Southern province (1.4%) (p < 0.001). In addition to regional differences, multilevel logistic models further indicate that the increased likelihood of a child suffering from ARI symptoms is significantly associated with the dry season (aOR 1.42; 95% CI: 1.02–1.97) and household poverty (aOR 1.42; 95% CI: 1.01–1.99), even after adjusting for the cooking fuel used and various other characteristics of the children, households, and communities. These findings underscore the importance of taking into account environmental risks when addressing specific regional variations in ARI symptoms, because these determinants differ between communities in Nigeria. As it is imperative to achieve minimum levels of child health, in order to improve economic development across regions, future health policies aiming to promote child health will benefit from taking a region-specific perspective into consideration.

Prevalence and determinants of Acute Lower Respiratory Infections among children under-five years in sub–Saharan Africa: Evidence from demographic and health surveys

“…The outcome variable was derived by categorising children under-five as having ALRI or otherwise based only on the occurrence of signs and symptoms of ALRI as reported by the mothers of the children without any medical validation (Adesanya & Chiao, 2017; Akinyemi & Morakinyo, 2018). Since participants were asked about events which occured in the past, potential effects of recall bias on the side of the mothers, on our results can, therefore, not be overlooked (Adesanya & Chiao, 2017). In addition, due to the cross-sectional nature of the data, it is impossible to draw a cause-effect relationship in this study (Adesanya & Chiao, 2017; Harerimana et al, 2016).…”

“…Since participants were asked about events which occured in the past, potential effects of recall bias on the side of the mothers, on our results can, therefore, not be overlooked (Adesanya & Chiao, 2017). In addition, due to the cross-sectional nature of the data, it is impossible to draw a cause-effect relationship in this study (Adesanya & Chiao, 2017; Harerimana et al, 2016). Also, some of the differences in the occurrence of ALRIs maybe very well explained by country specific conditions.…”

“…Others have observed that parental factors such as age (Cardoso, Coimbra, & Werneck, 2013; Gebertsadik, Worku, & Berhane, 2015), employment status (Cardoso, Coimbra & Werneck, 2013; Gebertsadik et al, 2015) and educational levels (Al-Sharbatti & AlJumaa, 2012; Prajapati, Talsania, & Sonaliya, 2011) are found to be associated with ALRIs among children under-five. Evidence exists to show that factors including wealth status (Adesanya & Chiao, 2017; Akinyemi & Morakinyo, 2018; Cardoso et al, 2013), place of residence and household size (Adesanya & Chiao, 2017; Akinyemi & Morakinyo, 2018; Al-Sharbatti & AlJumaa, 2012), type of toilet facility and type of cooking fuel (Akinyemi & Morakinyo, 2018; Alemayehu, Alemu, Sharma, Gizaw, & Shibru, 2014) can also predict the risk of ALRIs.…”

“…In relation to ALRIs, some studies have been conducted in sub-Saharan African countries such as Nigeria (Adesanya & Chiao, 2017; Akinyemi & Morakinyo, 2018), Rwanda (Harerimana et al, 2016), Ethiopia (Alemayehu et al, 2014; Gebertsadik et al, 2015), Cameroun (Tazinya et al, 2018) and Ghana (Jones et al, 2016; Sumaila & Tabong, 2018). Some of these studies conducted in sub-Saharan and other settings on ALRIs have been at the micro level using smaller samples (see Chen et al, 2014; Ramani, Pattankar, & PuttAhonnAPPA, 2016, Cardoso, Coimbra & Werneck, 2013, Fekadu, Terefe, & Alemie, 2014; Alemayehu et al, 2014; Arun, Gupta, Sachan, & Srivsatava, 2014; Mirji, Shashank, & Shrikant, 2016; Prajapati, Talsania, Lala & Sonalia, 2012).…”

Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh

“…Although many studies have been conducted to identify the factors associated with ARI and diarrhea in lower-income countries, most have included all children under 5 years of age, and have not focused on the first 2 years of life. Factors associated with both ARI and diarrhea among children under five include lower household Xsocio-economic status [5, 11, 13, 15, 19–21], poor sanitation [12, 15, 17, 20, 22], larger family size [6, 9, 12, 13, 17], living in a rural area [11, 14, 17, 23], younger mother [7, 11], low maternal education [11, 12, 15, 21, 22, 24], male child [10, 13, 15, 23], younger child [5–17], higher birth order of the child [9, 12, 22], suboptimal breastfeeding practices [9, 11, 24, 25], inadequate complementary feeding practices [20, 23, 24] and poor anthropometric status of the child [9, 11, 15, 20, 24]. Other factors associated with ARI include use of biomass fuel for cooking [5, 8, 24], low paternal education [24], and prematurity [24], and other factors associated with diarrhea include improper waste disposal [12, 17, 21, 22], improper drainage system [22, 26], unsafe drinking water [15, 26], maternal depression [27], improper hand washing [11, 15, 21–23] and lower birth order of the child [11].…”