Prevalence Of Acute Respiratory Infections Research Articles

Factors of acute respiratory infection among under-five children across sub-Saharan African countries using machine learning approaches

Symptoms of Acute Respiratory infections (ARIs) among under-five children are a global health challenge. We aimed to train and evaluate ten machine learning (ML) classification approaches in predicting symptoms of ARIs reported by mothers among children younger than 5 years in sub-Saharan African (sSA) countries. We used the most recent (2012–2022) nationally representative Demographic and Health Surveys data of 33 sSA countries. The air pollution covariates such as global annual surface particulate matter (PM 2.5) and the nitrogen dioxide available in the form of raster images were obtained from the National Aeronautics and Space Administration (NASA). The MLA was used for predicting the symptoms of ARIs among under-five children. We randomly split the dataset into two, 80% was used to train the model, and the remaining 20% was used to test the trained model. Model performance was evaluated using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve. A total of 327,507 under-five children were included in the study. About 7.10, 4.19, 20.61, and 21.02% of children reported symptoms of ARI, Severe ARI, cough, and fever in the 2 weeks preceding the survey years respectively. The prevalence of ARI was highest in Mozambique (15.3%), Uganda (15.05%), Togo (14.27%), and Namibia (13.65%,), whereas Uganda (40.10%), Burundi (38.18%), Zimbabwe (36.95%), and Namibia (31.2%) had the highest prevalence of cough. The results of the random forest plot revealed that spatial locations (longitude, latitude), particulate matter, land surface temperature, nitrogen dioxide, and the number of cattle in the houses are the most important features in predicting the diagnosis of symptoms of ARIs among under-five children in sSA. The RF algorithm was selected as the best ML model (AUC = 0.77, Accuracy = 0.72) to predict the symptoms of ARIs among children under five. The MLA performed well in predicting the symptoms of ARIs and associated predictors among under-five children across the sSA countries. Random forest MLA was identified as the best classifier to be employed for the prediction of the symptoms of ARI among under-five children.

Factors of acute respiratory infection among under-five children across sub-Saharan African countries using machine learning approaches

Symptoms of Acute Respiratory infections (ARIs) among under-five children are a global health challenge. We aimed to train and evaluate ten machine learning (ML) classification approaches in predicting symptoms of ARIs reported by mothers among children younger than 5 years in sub-Saharan African (sSA) countries. We used the most recent (2012–2022) nationally representative Demographic and Health Surveys data of 33 sSA countries. The air pollution covariates such as global annual surface particulate matter (PM 2.5) and the nitrogen dioxide available in the form of raster images were obtained from the National Aeronautics and Space Administration (NASA). The MLA was used for predicting the symptoms of ARIs among under-five children. We randomly split the dataset into two, 80% was used to train the model, and the remaining 20% was used to test the trained model. Model performance was evaluated using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve. A total of 327,507 under-five children were included in the study. About 7.10, 4.19, 20.61, and 21.02% of children reported symptoms of ARI, Severe ARI, cough, and fever in the 2 weeks preceding the survey years respectively. The prevalence of ARI was highest in Mozambique (15.3%), Uganda (15.05%), Togo (14.27%), and Namibia (13.65%,), whereas Uganda (40.10%), Burundi (38.18%), Zimbabwe (36.95%), and Namibia (31.2%) had the highest prevalence of cough. The results of the random forest plot revealed that spatial locations (longitude, latitude), particulate matter, land surface temperature, nitrogen dioxide, and the number of cattle in the houses are the most important features in predicting the diagnosis of symptoms of ARIs among under-five children in sSA. The RF algorithm was selected as the best ML model (AUC = 0.77, Accuracy = 0.72) to predict the symptoms of ARIs among children under five. The MLA performed well in predicting the symptoms of ARIs and associated predictors among under-five children across the sSA countries. Random forest MLA was identified as the best classifier to be employed for the prediction of the symptoms of ARI among under-five children.

Factors associated with acute respiratory infection and healthcare-seeking behaviour among primary caregivers in Bangladesh: a study based on MICS 2019

IntroductionMore than 80% of deaths due to preventable and treatable causes among under 5 (U5) children occur in the sub-Saharan Africa and the South-Asia, pneumonia remains one of the most...

The association between anti-smoking legislation and prevalence of acute respiratory illnesses in Indian children

ObjectiveExposure to tobacco smoke causes numerous health problems in children, and create burden on the population in terms of economy, morbidity and mortality. In order to protect the child from exposure to tobacco smoke in the outdoor environment, sufficient legislative enactments are available in Indian legislation. The objective of the present study is to investigate the fact that in absence of any specific laws stating about protection of children from exposure to tobacco smoke in indoor environment, whether outdoor related legislations are sufficient to protect children from exposureand to explore the scope for enforcement of both state and central laws in improving health of children in India. Study designThe study considered cross-sectional survey data of Demographic and Health Survey Data on India, National Family and Health Survey fourth round (NFHS-4) for the year 2015-16 on Indian children (below age of four). MethodsBoth bivariate and multivariate logistic regression models were used to assess the impact of anti-smoking laws on the prevalence of acute respiratory infection (ARI) based on the place of residence, indoor tobacco smoke exposure and age of the child. ResultsThe results have shown an inclination of ARI among children in association with states having single law, rural area resident, exposure to indoor tobacco smoke and age of the child, both as independent or in combination are quite conspicuous, and are found to be underestimated. The logistic regression also revealed the influence of these factors both as independent and even in interaction with other. ConclusionsLegislative intervention through both at central (or national)and state levels through anti-smoking laws will decrease the indoor tobacco smoke exposure as a result ARI prevalence will also decrease among children in India.

Retrospective analysis of the prevalence of acute respiratory infections in children of the Ivano-Frankivsk region

Background. The article presents modern data about the prevalence and peculiarities of the course of acute respiratory viral infections in a childhood based on retrospective analysis of medical records. The purpose of this article was to analyze the epidemiology and features of acute respiratory viral infections in children based on the retrospective analysis of medical records, and reports of the Public Health Center. Materials and methods. Extracts from the medical charts of inpatients with acute respiratory pathology and statistical reports of the work of the ENT department of Ivano-Frankivsk Regional Children’s Clinical Hospital for 2017–2022, which included 1,177 patients, were carefully studied. Results. The clinical features of acute respiratory infections in children hospitalized to the ENT department were as follows: age over 3 years (89 %), frequent admissions to the hospital (> 4 times a year) at the age of 4–5 years, nasal congestion (87.0 %), headache (72.0 %), body temperature above 37.9 °С (37 %), purulent nasal discharge (20 %), cough (15.6 %), general weakness (12.3 %). The average duration of the disease before hospitalization was 8.0 ± 0.2 days, and after hospitalization, it was 7.0 ± 0.1 days. It was found that those hospitalized had mostly ENT pathology, which initially was more likely to be viral (75.0 %); moreover, predominantly girls were affected (45 %), χ2 = 15.7, p < 0.05. At the same time, the proportion of combined forms of ENT diseases with a complicated course was 25 %, and boys were more likely to be affected (60 %), χ2 = 18.9, p < 0.05. Pansinusitis, on the other hand, occurred more often against the background of secondary chronic pathology (70.0 and 30.0 %, p < 0.05), χ2 = 32, p < 0.05. During all years of observation, the age group of 3 years and older prevailed among hospitalized children with acute respiratory infections. Most patients were admitted to the hospital in a condition of moderate severity. In all children hospitalized during the reporting period, we have found signs of respiratory syndrome such as nasal congestion and anosmia, sore throat, cough, purulent nasal discharge, as well as symptoms of intoxication: general weakness, headache, fever. ­Conclusions. The obtained data require further study and observation in the dynamics in order to stratify risk factors for the development of IgA-vasculitis in a childhood.

RISK FACTORS OF ACUTE RESPIRATORY INFECTION AMONG UNDER FIVE CHILDREN IN RURAL COMMUNITY OF NORTH DELHI

Introduction: Children are mankinds seeds for the future and God given gift or hope. They deserve the almost care from us. Children are as a clay material. Acute respiratory infection (ARI) is a serious public health issue especially in developing nations like India where the majority of people are impoverished, live in slums and exposed to deadly diseases. Children under the age of five are particularly vulnerable to infection at an early stage. So, for the maintenance of best healthy status of children and identification of risk factors of acute respiratory infection among under five children is essential. Aim:To explore risk factors of acute respiratory infection among under five children in rural community of NorthDelhi region Methodology:An exploratory research design was adopted for this study. A total 430 one to five years age of children were selected with the help of consecutive sampling technique in randomly selected villages of North Delhi region. Semi structured interview schedulewas used for data collection. Results: The prevalence of acute respiratory infection was 35% (150 out of 430 children). It was identified that preterm delivery, Low birth weight, birth order of children, overcrowding in the house, indoor smoking, smoky fuel used for cooking, house location near by dusty main road, open drainage system, Family history of respiratory infection leading to cause of occurrence of ARI among children. Conclusion: Multivariate factors are responsible for acute respiratory infection among children which can be modified to prevent morbidity and mortality rate of under five children due to acute respiratory infection.

Prevalence and predictors of acute respiratory infection among children under-five years in Tigray regional state, northern Ethiopia: a cross sectional study

BackgroundAcute respiratory infection is still one of the leading causes of child morbidity and mortality worldwide. Developing countries, especially in Sub-Saharan Africa including Ethiopia continue to share an overburden of this infection. Studies showed that different predictor factors were associated with the occurrence of childhood acute respiratory infection. Therefore, the main aim of this study was to assess the prevalence and associated predictor factors of acute respiratory infection among children under-five years in the Tigray Regional State, northern Ethiopia.MethodsA retrospective cross-sectional study design was done from January 18, 2016, to June 27, 2016. A total of 986 children under-five years were selected for this study. The logistic regression model analysis was employed to examine the predictor factors of childhood acute respiratory infection. Both bi-variable and multivariable data analysis was performed using STATA version 14.0.ResultsOverall, the study showed that the two weeks prevalence of acute respiratory infection among children under-five years was 16.10% [95%CI: 13.80–18.40]. According to the multivariable logistic regression model analysis, children aged (24–60) months (AOR: 0.59, 95%CI: 0.352–0.98), rich wealth index of households (AOR: 0.60, 95%CI: 0.378–0.959), diarrhea status of children (AOR: 3, 95%CI: 1.97–4.73), and mothers smoking cigarettes (AOR: 4, 95%CI: 1.15–16.50), were significant predictors of acute respiratory infection.ConclusionThe prevalence of ARI displays that Tigray regional state was experiencing a higher ARI rate than the national level. The current study identified the low wealth index of households, children aged (24–60 months), mothers smoking cigarettes, and diarrhea status of the children as crucial predictor factors for ARI. Interventions should be improved to these modifiable major predictor factors that significantly decrease the ARI problem among under-five children.

The relevancy-analysis of air quality index to Acute Respiratory Infection (ARI) in A landfill site of Medan

The existence of open dumping in Medan City’s final waste processing since 1993 has certainly had a negative impact in the form of a decrease in air quality which has a further impact on public health problems. This study aims to analyse and maps the distribution of PM10 and PM2.5 concentrations in the Terjun Landfill and to examine the relationship between the air quality index and the prevalence of acute respiratory infection (ARI) in the nearby landfill site. The sampling method for this research uses the manual active and is mapped using the GIS application. The results of ambient air concentrations were converted into an air quality index which subsequently was tested in a statistical correlative method to investigate the prevalence of ARI. The results demonstrated the PM2.5 concentrations ranged from 38.94 – 163.1 µ/m3, the PM10 was between 46.84 – 184.2 µ/m3; indicating an excessive level of national ambient threshold. The distribution of the highest PM2.5 and PM10 is in the active zone of the landfill. The prevalence of ARI in the nearby landfill site showed a strong relationship; 0.86 for PM2.5 and 0.62 for PM10. These findings illustrate a poor-quality air would increase the number of inhabitants with ARI.

Prevalence and determinants of diarrhoea and acute respiratory infections among children aged under five years in West Africa: evidence from demographic and health surveys.

Diarrhoea and pneumonia are the leading causes of morbidity and mortality in children aged <5 y (under five) globally. This study sought to investigate the prevalence and determinants of diarrhoea and acute respiratory infections (ARIs) among children under five in West Africa. The most recent demographic and health survey (DHS) standard for 13 West African countries was used in the study. We calculated the prevalence of diarrhoea and ARIs (2 wk prior to the survey) and performed multivariable complex logistic regression analysis to identify possible predictors of diarrhoea and ARIs. The weighted prevalence of diarrhoea and ARI was 13.7% and 15.9%, respectively. The prevalence of comorbid diarrhoea and ARI was 4.4%. Children aged <2 y (p<0.001), mothers aged <30 y (p<0.003), mothers without formal education (p<0.001), poor households (p<0.001) and poor nutritional status, wasting (p=0.005) and underweight (p<0.001), were the independent predictors of diarrhoea. The independent predictors of ARIs were children with no childhood vaccinations (p=0.002), use of solid fuel in the household (p=0.007), being underweight (p=0.05) and diarrhoea (p<0.001). The findings imply the need for holistic public health interventions such as increased vaccination coverage, population-based nutritional programmes and campaigns on the use of cleaner cooking fuel targeted at high-risk subgroups in the population to reduce the burden and adverse effects of diarrhoea and ARIs in the West African region.

Copula based trivariate spatial modeling of childhood illnesses in Western African countries

Acute respiratory infections (ARI), diarrhea, and fever are three common childhood illnesses, especially in sub-Saharan Africa. This study investigates the marginal and pairwise correlated effects of these diseases across Western African countries in a single analytical framework. Using data from nationally representative cross-sectional Demographic and Health Surveys, the study analyzed specific and correlated effects of each pair of childhood morbidity from ARI, diarrhea, and fever using copula regression models in fourteen contiguous Western African countries. Data concerning childhood demographic and socio-economic conditions were used as covariates. In this cross-sectional analysis of 152,125 children aged 0–59 months, the prevalence of ARI was 6.9%, diarrhea, 13.8%, and fever 19.6%. The results showed a positive correlation and geographical variation in the prevalence of the three illnesses across the study region. The estimated correlation and 95% confidence interval between diarrhea and fever is 0.431(0.300,0.539); diarrhea and ARI is 0.270(0.096,0.422); and fever and ARI is 0.502(0.350,0.614). The marginal and correlated spatial random effects reveal within-country spatial dependence. Source of water and access to electricity was significantly associated with any of the three illnesses, while television, birth order, and gender were associated with diarrhea or fever. The place of residence and access to newspapers were associated with fever or ARI. There was an increased likelihood of childhood ARI, diarrhea, and fever, which peaked at about ten months but decreased substantially thereafter. Mother’s age was associated with a reduced likelihood of the three illnesses. The maps generated could be resourceful for area-specific policy-making to speed up mitigation processes.

The relationship Between The Smoking Habits Of Family Members And The Incidence Of Respiratory Infections Of Children Under 5 Years In Indonesia: A Literature Review

 Background : Reducing under five mortality is one of the SDGS aims for ensuring a healthy life and supporting wellbeing for all ages. When it comes to causes of death in babies and young children, acute respiratory infections always come in first. Cigarette smoke is one of the air pollutants that increases the occurrence of respiratory system disorders. The goal is to examine the connection between family members' smoking behaviors and the prevalence of ARI in young children. Methods: This literature review is sourced from various research articles, and official websites published in 2018-2022. Search articles using keywords, inclusion and exclusion criteria. Article assessment use CASP and article processing uses the Mendeley application Results: Determined 6 sources of articles that are feasible and relevant to be used after passing the critical appraisal stage. Conclusion: There is a connection between family members' smoking behaviors and the prevalence of acute respiratory infections..

Spatial patterns and spatially-varying factors associated with childhood acute respiratory infection: data from Ethiopian demographic and health surveys (2005, 2011, and 2016)

BackgroundIn Ethiopia, acute respiratory infections (ARIs) are a leading cause of morbidity and mortality among children under five years. Geographically linked data analysis using nationally representative data is crucial to map spatial patterns of ARIs and identify spatially-varying factors of ARI. Therefore, this study aimed to investigate spatial patterns and spatially-varying factors of ARI in Ethiopia.MethodsSecondary data from the Ethiopian Demographic Health Survey (EDHS) of 2005, 2011, and 2016 were used. Kuldorff’s spatial scan statistic using the Bernoulli model was used to identify spatial clusters with high or low ARI. Hot spot analysis was conducted using Getis-OrdGi statistics. Eigenvector spatial filtering regression model was carried out to identify spatial predictors of ARI.ResultsAcute respiratory infection spatially clustered in 2011 and 2016 surveys year (Moran’s I:-0.011621–0.334486). The magnitude of ARI decreased from 12.6% (95%, CI: 0.113–0.138) in 2005 to 6.6% (95% CI: 0.055–0.077) in 2016. Across the three surveys, clusters with a high prevalence of ARI were observed in the North part of Ethiopia. The spatial regression analysis revealed that the spatial patterns of ARI was significantly associated with using biomass fuel for cooking and children not initiating breastfeeding within 1-hour of birth. This correlation is strong in the Northern and some areas in the Western part of the country.ConclusionOverall there has been a considerable decrease in ARI, but this decline in ARI varied in some regions and districts between surveys. Biomass fuel and early initiation of breastfeeding were independent predictors of ARI. There is a need to prioritize children living in regions and districts with high ARI.

Trends and determinants of acute respiratory infection symptoms among under-five children in Cambodia: Analysis of 2000 to 2014 Cambodia demographic and health surveys.

Acute Respiratory Infections (ARIs) are the leading cause of mortality and morbidity among children under 5 years old and about 1.3 million annually worldwide. Account for 33% of deaths among children under 5 years that occurred in developing countries. In Cambodia, ARIs prevalence in children under 5 years old was 20% in 2000, and 6% in 2014. Hence, the aimed to describe the trends of ARI symptoms among children aged 0-59 months over time using the 2000, 2005, 2010, and 2014 Cambodia Demographic and Health Survey (CDHS) and determined the relationships between socio-demographic, behavioral, and environmental factors with ARI symptoms. We analyzed existing children's data from 2000, 2005, 2010 and 2014 of Cambodia Demographic and Health Survey (CDHS) that used a two-stage stratified cluster sampling design. We limited our analysis to children born in the last five years prior to the surveys, alive and living in households during interview time. Data were pooled across the four survey years for 29,171 children aged 0-59 months. All statistics were carried out using STATA V16, and survey weights were taken into account for the survey design of the CDHS. We used multiple logistic regression to determine the main predictors of ARI symptoms among children under 5 years. ARI symptoms in the previous two weeks in children aged 0-59 months in Cambodia were 19.9% in 2000 to 8.6% in 2005 to 6.4% in 2010, and 5.5% in 2014. Factors independently associated with increased odds of ARI symptoms were children ages 6-11 months with adjusted odds ratio [AOR = 1.91; 95% CI: 1.53-2.38], 12-23 months [AOR = 1.79; 95% CI: 1.46-2.20], and 24-35 months [AOR = 1.41; 95% CI: 1.13-1.76], smoking mother [AOR = 1.61; 95% CI: 1.27-2.05], and using non-improved toilets in households [AOR = 1.20; 95% CI: 0.99-1.46]. However, the following factors were found to be associated with decreased odds of having ARI symptoms: Mothers with higher education [AOR = 0.45; 95% CI: 0.21-0.94], breastfeeding children [AOR = 0.87; 95% CI: 0.77-0.98], and children born into richest wealth quantile [AOR = 0.73; 95% CI: 0.56-0.95], respectively. Survey 2005 [AOR = 0.36; 95% CI: 0.31-0.42], 2010 [AOR = 0.27; 95% CI: 0.22-0.33], 2014 [AOR = 0.24; 95% CI: 0.19-0.30]. The trends of ARI symptoms among children under five in Cambodia significantly decreased from 2000-2014. Smoking mothers, young children ages (0-35 months), and using non-improved toilet in household are factors that independently increased the likelihood that children would develop ARI symptoms. Inversely, factors were found to be associated with decreased odds of having ARI symptoms: Mothers with higher education, breastfeeding children, and children born into the richest wealth quantile and Survey years. Therefore, government and child family programs must promote maternal education, particularly infant breastfeeding. The government ought to support maternal education and infant breastfeeding in the interest of early childhood care.

Association between extreme rainfall and acute respiratory infection among children under-5 years in sub-Saharan Africa: an analysis of Demographic and Health Survey data, 2006–2020

ObjectiveDespite an increase in the number of studies examining the association between extreme weather events and infectious diseases, evidence on respiratory infection remains scarce. This study examined the association between...

EVALUATION OF A MOTHER'S KNOWLEDGE AND PRACTICE INTERVENTION PROGRAM FOR ACUTE RESPIRATORY INFECTIONS IN INDIAN CHILDREN

Acute respiratory Infection (ARI) causes approximately 3.9 million deaths yearly in children under ve years of age. In developing countries, where malnutrition is prevalent, and indoor air pollution is high, pneumonia is the leading cause of death. A structured questionnaire is used to collect data from 205 mothers. In addition, their practice regarding identifying, managing, and treating ARI is suboptimal due to inadequate knowledge about the signs and symptoms, prevalence, causes, diagnosis, and treatment of ARI. A signicant correlation is found between education and age, whereas a signicant correlation is found between joint family status and knowledge. The study highlights the importance of health education for mothers and suggests that nursing personnel can be crucial in counseling mothers in hospital and community settings

ВЛИЯНИЕ СТЕПЕНИ ЗАГРЯЗНЕНИЯ АТМОСФЕРНОГО ВОЗДУХА НА ЗДОРОВЬЕ НАСЕЛЕНИЯ КУЙБЫШЕВСКОГО РАЙОНА ГОРОДА САМАРА

The population living in the area of industrial facilities is exposed to adverse effects. Chemicals released into the atmospheric air are a risk factor for public health. More than 50 million residents of Russia live in conditions of air pollution caused by emissions from motor vehicles and industrial enterprises. Among the pollutants, such as benz(a)pyrene, formaldehyde, hexavalent chromium, hydrogen sulfide, nitrogen dioxide and dust should be distinguished. Exceeding the standards of concentrations of toxicants in the environment lead to an increase in the prevalence of acute respiratory infections, chronic nonspecific respiratory diseases, allergic diseases, coronary heart disease, diseases of the digestive and endocrine systems, hypertension, oncological pathology and congenital malformations

Differentials in the Prevalence of Acute Respiratory Infections Among Under-Five Children: An Analysis of 37 Sub-Saharan Countries

We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries. Data from Demographic and Health Survey (DHS) of 37 African countries was examined in this analysis. Data from children under the age of 5 years old were examined. Forest plot was used to identify disparities in the occurrence of ARIs across SSA countries. We observed a higher prevalence of ARI among children under 5 in Uganda, Kenya, Sao Tome and Principe (9% each), Gabon, Chad, Eswatini (8% each), Burundi, Ethiopia, Congo Democratic Republic (7.0% each). The prevalence of ARI among under-five children who sought medical advice/treatment from health facility was higher in South Africa (88%), Sierra Leone (86%), Tanzanian (85%), Guinea (83%) and Uganda (80%). The prevalence rate of ARI among under-five children who received antibiotics was higher in Tanzania (61%), Sao Tome and Principe (60%), Rwanda and Congo (58% each), Angola (56.0%), Mozambique (54.0%), Kenya (53.0%), Namibia (52.0%) and Gabon (50.0%). This study found that the household wealth index, maternal education, and urban residence were significantly associated with ARI (p <0.001). A higher prevalence of ARI was observed among urban residents, low income families, and those with mothers with lower education. ARI prevalence could be reduced by improving household socioeconomic status, child nutrition and community awareness of indoor and outdoor pollution. Interventions and programs focused on early diagnosis, treatment and prevention of ARIs are crucial in reducing ARIs particularly in developing countries.

A cross-sectional study on factors associated with health care seeking for acute respiratory infection and fever in children under-five in Zambia.

mortality in under-five children remains a significant challenge in developing countries, including Zambia, where pneumonia and malaria account for twenty percent of under-five deaths. Poor health care seeking is one of the contributors to the high mortality rates. This study examined the predictors of health care seeking for acute respiratory infection (ARI) and fever among under-five children in Zambia. the study used a population based cross-sectional survey program evaluation dataset with sample size of 12,507 households from 28 districts. Binary logistic regression was used to examine the determinants of appropriate care seeking for ARI or fever, ARI, and fever. the prevalence of fever or ARI in children under five was 22.9%, ARI 12.9%, and fever 13.4%. Educational status and non-participation in positive deviance hearth (PDH) were significant predictors in those with fever or ARI. Children whose household head had secondary education or higher were 4.5 times more likely to seek care than those whose household head did not have any education. Among those with ARI, educational status, women empowerment in decision-making and growth monitoring and promotion (GMP) were significant predictors while for fever only GMP was a significant predictor. over two thirds of caregivers sought care appropriately for fever or ARI. Only educational status and GMP were associated with more than one appropriate care seeking outcome. Through GMP services, policymakers can improve healthcare seeking behavior in children under five.

Influence of community-level sanitation coverage and population density on environmental fecal contamination and child health in a longitudinal cohort in rural Bangladesh.

BackgroundHousehold-level sanitation interventions have had limited effects on child health or environmental contamination, potentially due to low community coverage. Higher community-level coverage with safely managed sanitation can reduce opportunities for disease transmission.MethodsWe estimated associations between community sanitation coverage, environmental fecal contamination, and child health among 360 compounds in the control arm of the WASH Benefits trial in rural Bangladesh (NCT01590095). In each compound, we enumerated E. coli in environmental samples and recorded the 7-day prevalence of caregiver-reported diarrheal disease and acute respiratory infections (ARI) in children under five. We observed indicators of latrine access and quality among all neighboring compounds within 100 m of study compounds. We defined community coverage as the proportion of neighboring compounds with (1) at least one latrine, and (2) exclusively hygienic latrines (improved facility observed to safely contain feces), within both 50 m and 100 m of study compounds. We assessed effect modification by population density and season.ResultsAdjusted for confounders, study compounds surrounded by 100% coverage of at least one latrine per compound within 50 m had slightly lower log10E. coli counts in stored water (Δlog = −0.13, 95% CI -0.26, −0.01), child hand rinses (Δlog = −0.13, 95% CI -0.24, −0.02), and caregiver hand rinses (Δlog = −0.16, 95% CI -0.29, −0.03) and marginally lower prevalence of diarrheal disease (prevalence ratio [PR] = 0.82, 95% CI 0.64, 1.04) and ARI (PR = 0.84, 95% CI 0.69, 1.03) compared to compounds surrounded by <100% coverage. Effects were similar but less pronounced at 100 m. At higher population densities, community latrine coverage was associated with larger reductions in E. coli on child and caregiver hands and prevalence of diarrheal disease. Coverage with exclusively hygienic latrines was not associated with any outcome.ConclusionHigher community sanitation coverage was associated with reduced fecal contamination and improved child health, with stronger effects at highly local scales (50m) and at high population densities. Our findings indicate that the relationship between community sanitation coverage, environmental contamination, and child health varies by definition of coverage, distance, and population density. This work highlights significant uncertainty around how to best measure sanitation coverage and the expected health effects of increasing sanitation coverage using a specific metric. Better understanding of community-level sanitation access is needed to inform policy for implementing sanitation systems that effectively protect community health.

Association between Environmental Factors and the Incidence of Acute Respiratory Infection in Children under Five in East Nusa Tenggara, Indonesia

Introduction: ARI (Acute Respiratory Infection) is one of the main causes of death among children under five in many countries worldwide. In Indonesia, 10% of ARI cases occur in East Nusa Tenggara, which is the highest prevalence of ARI in this country, with 90% of them leading to under-five mortality. There are various factors that cause the prevalence of ARI. In East Nusa Tenggara itself, environmental factors are suspected to be the risk factors for this disease. This study aims to analyse the association between environmental factors and the incidence of ARI among children under five years old in East Nusa Tenggara. Methods: A cross-sectional study was conducted by analysing secondary data sets obtained from DHS, with a total of 337 subjects examined in this study. Multivariate logistic regression was applied to investigate the association between ARI and various environmental factors. Results: This study found that the prevalence of ARI among children under five years old in East Nusa Tenggara was 9.04% of all subjects. ARI was significantly associated with the types of residence (OR 2.2, 95%CI 1.1-4.3) and passive smoking status (OR 4.7, 95%CI 1.8-12.4) as its risk factors. In addition, there was strong association between ARI and the types of roof (OR 3.3, 95%CI 1.3-8.9) as its protective factor. Conclusion: Based on the findings of this study, it can be concluded that the incidence of ARI in children under five years old was closely associated with residential area, smoke exposure, and roof materials.