Spatial heterogeneities in acute lower respiratory infections prevalence and determinants across Ethiopian administrative zones

Abstract

BackgroundAcute lower respiratory infections (ALRI) are a major cause of mortality among children under five. This study aimed to investigate the spatiotemporal pattern of ALRI in Ethiopian administrative zones.MethodsIn this study, a total of 29,599 under-five children from 2299 geographical units in 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHSs) were involved. The generalized multilevel mixed model to analyze the effect of child-household level characteristics on ALRI was adopted.ResultsOverall prevalence of ALRI among Ethiopian under-five children is found to be 15%, with 2000, recording the highest prevalence of 24.44% while 2016 had the lowest prevalence of 11.07%. Being in the higher age group of children and having no experience of undernutrition status showed significantly lower ALRI prevalence than their counterparts. Among the household characteristics children from uneducated parents, unimproved household sanitation, lower wealth index, and rural residents were more likely to have ALRI than their counterparts. Based on the best linear unbiased prediction (BLUP) for the zonal-level random effect, the performance of Zones was ranked.ConclusionsBetween and within the Ethiopian administrative Zones disparities in ALRI were observed. The ranking of the performance of the Zones may help to target the worst performing Zones for immediate intervention strategy and the best performing Zones as a role model to adopt their best practice in the Ethiopian strategy to achieve the Sustainable Development Goal by the year 2030.