Individual and climate factors associated with acute respiratory infection in Colombian children.

Luz Mery Cárdenas-Cárdenas,Carlos Andrés Castañeda-Orjuela,Fernando De La Hoz-Restrepo,Pablo Chaparro-Narváez

doi:10.1590/0102-311x00028216

Luz Mery Cárdenas-Cárdenas, Carlos Andrés Castañeda-Orjuela + Show 2 more

Open Access

https://doi.org/10.1590/0102-311x00028216

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Abstract

The objective of this study was to examine the association between acute respiratory infection recall (ARI-recall) and individual and environmental factors such as climate, precipitation, and altitude above sea level in Colombian children. A secondary analysis of 11,483 Colombian children, whose mothers were interviewed in the 2010 National Demographic and Health Survey, was carried out. The outcome variable was the mother's or caregiver's ARI-recall. The independent variables were expressed at individual, cluster, and municipal levels. At the individual level, we considered health and individual characteristics of the children; at cluster level, we incorporated the altitude above sea level; and at the municipal level, we included precipitation and annual average climate. The association between ARI-recall and independent variables was assessed using a multilevel logistic regression model. ARI-recall was significantly associated with age (OR = 0.61; 95%CI: 0.48-0.79), belonging to an indigenous group (OR = 1.51; 95%CI: 1.16-1.96), and a medium or very poor wealth index (OR = 2.03; 95%CI: 1.25-3.30 and OR = 1.75; 95%CI: 1.08-2.84, respectively). We found interaction between acute child malnutrition and average annual precipitation. Children with acute malnutrition and from municipalities with high annual precipitation had significantly 3.6-fold increased risk of ARI-recall (OR = 3.6; 95%CI: 1.3-10.1). Individual conditions and precipitation are risk factors for ARI-recall in Colombian children. These results could be useful to understand ARI occurrence in children living in tropical countries with similar characteristics.

Highlights

Acute respiratory infection (ARI) is a main cause of death in the population aged five years or less, especially in developing countries 1
The association between wealth index and ARI-recall does not show a dose-response pattern, the results found among children from very poor households or with medium wealth index in terms of ARI compared to rich ones reveal differences in health between rich and poor children, and suggest the possibility of a socioeconomic disparity that has been described in the literature as the underlying condition of worse behaviors and health outcomes 19
We showed that individual and climate conditions, as age, belonging to an indigenous group, wealth index, child malnutrition and average annual precipitation, were associated with ARIrecall in Colombian children

Summary

Introduction

Acute respiratory infection (ARI) is a main cause of death in the population aged five years or less, especially in developing countries 1. Children aged under five years were the age group with higher number of ARI hospitalized cases in 2013, especially related with influenza A and respiratory syncytial virus 3. The literature mentions factors like environmental pollution inside and outside their home and climatic factors such as the rainy season, humidity, and temperature. The latter aspects and the role of the altitude above sea level remain poorly documented and understood in tropical countries like Colombia [8,9]

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