Abstract
BackgroundAcute Respiratory Infections (ARI) are a leading cause of childhood mortality and morbidity. Malawi has high childhood mortality but limited data on the prevalence of disease in the community.MethodsA cross‐sectional study of children aged 0‐59 months. Health passports were examined for ARI diagnoses in the preceding 12 months. Children were physically examined for malnutrition or current ARI.Results828 children participated. The annual prevalence of ARI was 32.6% (95% CI 29.3‐36.0%). Having a sibling with ARI (OR 1.44, P = .01), increasing household density (OR 2.17, P = .02) and acute malnutrition (OR 1.69, P = .01) were predictors of infection in the last year. The point prevalence of ARI was 8.3% (95% CI 6.8‐10.4%). Risk factors for current ARI were acute‐on‐chronic malnutrition (OR 3.06, P = .02), increasing household density (OR1.19, P = .05) and having a sibling with ARI (OR 2.30, P = .02).ConclusionThis study provides novel data on the high prevalence of ARI in Malawi. This baseline data can be used in the monitoring and planning of future interventions in this population.
Highlights
Global reduction in childhood mortality by 66% is a millennium development goal.[1]
Acute Respiratory Infections (ARI) are the commonest cause of illness and mortality in under 5s resulting in over 900,000 deaths annually, most of which are due to pneumonia.[2]
The annual prevalence of ARI was the percentage of children with one or more episodes of ARI recorded in their health passport
Summary
Global reduction in childhood mortality by 66% is a millennium development goal.[1]. Acute respiratory infections (ARIs) encompass bacterial and viral infections of the upper respiratory tract (URT) or lower respiratory tract (LRI). Treatment for ARIs,[4] and they cause 6%-40% of childhood mortality.[5,6] Children living rurally are more likely to be affected,6.7 The prevalence of respiratory tract infections in the community has not been studied in rural areas of Malawi; the burden of disease to healthcare services is unknown. Malawi’s Expanded Programme of Immunization (EPI) includes tuberculosis, polio, tetanus, haemophilus influenzae B, measles and rotavirus.[15] Approximately 80% of Malawian children receive EPI immunizations with uptake being lower in rural communities.[16,17,18] Regional variations in vaccination uptake are associated with disparities in access to health care.[19]. This study considered risk factors for ARI including malnutrition, PCV vaccination, number of siblings, socio- economic status and access to health care to identify areas that preventative measures can target
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