Abstract
SummaryThe aim of this study was to assess spatial co‐occurrence of acute respiratory infections (ARI), diarrhoea and stunting among children of the age between 6 and 59 months in Somalia. Data were obtained from routine biannual nutrition surveys conducted by the Food and Agriculture Organization 2007–2010. A Bayesian hierarchical geostatistical shared component model was fitted to the residual spatial components of the three health conditions. Risk maps of the common spatial effects at 1×1 km resolution were derived. The empirical correlations of the enumeration area proportion were 0.37, 0.63 and 0.66 for ARI and stunting, diarrhoea and stunting and ARI and diarrhoea, respectively. Spatially, the posterior residual effects ranged 0.03–20.98, 0.16–6.37 and 0.08–9.66 for shared component between ARI and stunting, diarrhoea and stunting and ARI and diarrhoea, respectively. The analysis showed clearly that the spatial shared component between ARI, diarrhoea and stunting was higher in the southern part of the country. Interventions aimed at controlling and mitigating the adverse effects of these three childhood health conditions should focus on their common putative risk factors, particularly in the South in Somalia.
Highlights
Illness in children living in developing countries is commonly characterised by more than one health condition (Fenn, Morris, & Black, 2005)
We model the comorbidity of acute respiratory infections (ARIs), diarrhoea and stunting among children of the age of 6–59 months in Somalia in order to identify areas where comorbidity is most prevalent
A biological link between diarrhoeal diseases and ARI is plausible where persistent diarrhoeal diseases may lead to acute malnutrition, which in turn increases the risk of ARI (Schmidt, Cairncross, Barreto, Clasen, & Genser, 2009)
Summary
Illness in children living in developing countries is commonly characterised by more than one health condition (Fenn, Morris, & Black, 2005). Diarrhoea and respiratory infections, which both impair growth, remain the leading cause of death and often co-occur in children under the age of 5 years (Black, Morris, & Bryce, 2003; Torres et al, 2000). The comorbidity of the two health conditions may be as a result of shared risk factors at child level, or as a result of shared extrinsic factors. Diarrhoea and respiratory infection may both share age as a child-dependent risk factor or poor sanitation and crowding as the environmental risk factors (Kosek, Bern, & Guerrant, 2003; Williams, Gouws, Boschi-Pinto, Bryce, & Dye, 2002). Persistent or frequent diarrhoeal diseases in children can lead to permanent growth retardation (Lutter et al, 1989; Rowland, Rowland, & Cole, 1988; Victora, Barros, Kirkwood, & Vaughan, 1990). Malnutrition or linear growth retardation are known risk factors of respiratory tract infections (Caulfield, de Onis, Blossner, & Black, 2004; Savitha, Nandeeshwara, Pradeep Kumar, ul-Haque, & Raju, 2007)
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