<p>Determinants of Acute Respiratory Infection Among Children in Ethiopia: A Multilevel Analysis from Ethiopian Demographic and Health Survey</p>

Abstract

Background: Acute respiratory infection (ARI) is one of the leading public health challenges among children in low-and middle-income countries. Child mortality due to ARI is disproportionately higher in African regions. In Ethiopia, an encouraging progress in the reduction of ARI was observed until 2010, however, since then the national prevalence is unchanged. There is limited information for the persistently higher prevalence of the infection. Therefore, the aim of this study was to determine regional variations and identify factors associated with the infection. Methods: This study used data from the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016. The analysis used information from 10,006 children. A twolevel logistic regression analysis was used to consider the cluster random effect. Results: Out of 10,006 children included, 15.9%, 8.9%, and 8.8% reported cough, short rapid breaths, and chest complaint respectively two weeks before the survey, making the overall prevalence of ARI 8.8%. Children aged six to 11 years (adjusted odds ratio (AOR)=1.466, 95% CI: 1.143-1.881), and 12 to 23 (AOR=1.390, 95%CI: 1.109-1.742), small birth size (AOR=1.387, 95%CI), and animal dung as cooking fuel (AOR=1.904, 95%CI: 1.152-3.146) are significantly associated with higher odds of ARI in the final multilevel modeling. The AOR (95%CI) for ARI for differing levels of altitude were: 1000 to 2000, 1.805 (1.403-2.483); 2000 to 3000, 1.882 (1.427-2.483); above 3000, 2.24 (1.023-4.907). Conclusion: ARI is still a significant public health problem in Ethiopia among children underfive, with a huge variation in the burden across the regional states. Age of children, birth size, household cooking fuel, and altitude above sea level were important variables. Therefore, regional governments, health-care workers and concerned organizations should give emphasis to minimize ARI and the consequences associated with the disease.

Factors associated with diarrhoea and acute respiratory infection in children under-5 years old in Ghana: an analysis of a national cross-sectional survey

“…Our study also found that children aged 6-11 months and 12-23 months had higher odds of diarrhoea and ARI compared to their peers aged 0-5 months. This finding is consistent with many previous studies [11,[33][34][35][36]. Children within the ages of 0-5 months in Ghana are usually exclusively breastfed [8], and therefore our observed finding may be a reflection of the important role exclusive breast feeding plays in reducing diarrhoea and respiratory infection in children who are exclusively breastfed [37,38].…”

Place of food cooking is associated with acute respiratory infection among under-five children in Ethiopia: multilevel analysis of 2005–2016 Ethiopian Demographic Health Survey data

“…Variables were selected based on prior findings that revealed their association with children's ARI [5,15,23,25,[32][33][34][35][36]]. These were the child's age, place of cooking food, maternal age, maternal education, paternal education, residency, nutrition status, household wealth quintile, frequency of watching television, frequency of listening to radio, maternal occupation, and paternal occupation, as indicated elsewhere.…”

“…In Ethiopia, there are 55 deaths per 1000 live births in children under-five due to acute respiratory infection, placing it among the world’s highest mortality rates [ 19 ]. Prior studies indicated that maternal age, residence, maternal hand hygiene information [ 20 ], maternal literacy, smoking, use of animal dung as a fuel source, nutritional status [ 21 ], absence of a separate kitchen, and lack of windows were significantly associated with acute respiratory infections [ 22 – 25 ].…”

Is There Any Association Between Undesired Children and Health Status of Under-five Children? Analysis of Nationally Representative Sample From Bangladesh

“…However, a good number of studies have been conducted to nd out the determinants and differentials of child mortality, morbidity, and nutritional status of children aged under-ve in developed and developing countries [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Most of the studies identi ed mother's age, the sex of children, birth order, household size, wealth status, education of parents, nutritional status of mothers, maternal care utilization, region, religion, residence as signi cant predictors of child health.…”