1
|
Yirdaw BE, Debusho LK, Samuel A. Application of longitudinal multilevel zero inflated Poisson regression in modeling of infectious diseases among infants in Ethiopia. BMC Infect Dis 2024; 24:927. [PMID: 39244566 PMCID: PMC11380412 DOI: 10.1186/s12879-024-09820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND In sub-Saharan African countries, preventable and manageable diseases such as diarrhea and acute respiratory infections still claim the lives of children. Hence, this study aims to estimate the rate of change in the log expected number of days a child suffers from Diarrhea (NOD) and flu/common cold (NOF) among children aged 6 to 11 months at the baseline of the study. METHODOLOGY This study used secondary data which exhibit a longitudinal and multilevel structure. Based on the results of exploratory analysis, a multilevel zero-inflated Poisson regression model with a rate of change in the log expected NOD and NOF described by a quadratic trend was proposed to efficiently analyze both outcomes accounting for correlation between observations and individuals through random effects. Furthermore, residual plots were used to assess the goodness of fit of the model. RESULTS Considering subject and cluster-specific random effects, the results revealed a quadratic trend in the rate of change of the log expected NOD. Initially, low dose iron Micronutrient Powder (MNP) users exhibited a higher rate of change compared to non-users, but this trend reversed over time. Similarly, the log expected NOF decreased for children who used MNP and exclusively breastfed for six months, in comparison to their counterparts. In addition, the odds of not having flu decreased with each two-week increment for MNP users, as compared to non-MNP users. Furthermore, an increase in NOD resulted in an increase in the log expected NOF. Region and exclusive breastfeeding also have a significant relationships with both NOD and NOF. CONCLUSION The findings of this study underscore the importance of commencing analysis of data generated from a study with exploratory analysis. The study highlights the critical role of promoting EBF for the first six months and supporting children with additional food after six months to reduce the burden of infectious diseases.
Collapse
Affiliation(s)
- Bezalem Eshetu Yirdaw
- Department of Statistics, University of South Africa, c/o Christiaan de Wet Road & Pioneer Avenue, Johannesburg, 1709, Florida, South Africa.
| | - Legesse Kassa Debusho
- Department of Statistics, University of South Africa, c/o Christiaan de Wet Road & Pioneer Avenue, Johannesburg, 1709, Florida, South Africa
| | - Aregash Samuel
- Ethiopian Public Health Institute, Gulele Sub City, Addis Ababa, Ethiopia
| |
Collapse
|
2
|
Azanaw J, Weldegebriel F, Malede A. Investigating neighbourhood environmental risk factors associated with childhood acute respiratory infection symptoms in Ethiopia mixed effect and multilevel logistic regression analysis based on EDHS 2016. Front Public Health 2024; 12:1391682. [PMID: 39157531 PMCID: PMC11328150 DOI: 10.3389/fpubh.2024.1391682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Background Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age. Method This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors. Results Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material. Conclusion Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.
Collapse
Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | |
Collapse
|
3
|
Yehuala TZ, Agimas MC, Derseh NM, Wubante SM, Fente BM, Yismaw GA, Tesfie TK. Machine learning algorithms to predict healthcare-seeking behaviors of mothers for acute respiratory infections and their determinants among children under five in sub-Saharan Africa. Front Public Health 2024; 12:1362392. [PMID: 38962762 PMCID: PMC11220189 DOI: 10.3389/fpubh.2024.1362392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
Background Acute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models. Methods The sub-Saharan African countries' demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models. Result In this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers' healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers' age group of 35-49 years, and distance to health facilities were significant predictors for the absence of mothers' healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children. Conclusion The RF model provides greater predictive power for estimating mothers' healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.
Collapse
Affiliation(s)
- Tirualem Zeleke Yehuala
- Department Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Awoke Yismaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
4
|
Cheng X, Li D, Yang C, Chen B, Xu P, Zhang L. Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age. Cochrane Database Syst Rev 2024; 5:CD015306. [PMID: 38738639 PMCID: PMC11089595 DOI: 10.1002/14651858.cd015306.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND According to global prevalence analysis studies, acute upper respiratory tract infections (URTIs) are the most common acute infectious disease in children, especially in preschool children. Acute URTIs lead to an economic burden on families and society. Vitamin A refers to the fat-soluble compound all-trans-retinol and also represents retinol and its active metabolites. Vitamin A interacts with both the innate immune system and the adaptive immune system and improves the host's defences against infections. Correlation studies show that serum retinol deficiency was associated with a higher risk of respiratory tract infections. Therefore, vitamin A supplementation may be important in preventing acute URTIs. OBJECTIVES To assess the effectiveness and safety of vitamin A supplements for preventing acute upper respiratory tract infections in children up to seven years of age. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, the Chinese Biomedical Literature Database, and two trial registration platforms to 8 June 2023. We also checked the reference lists of all primary studies and reviewed relevant systematic reviews and trials for additional references. We imposed no language or publication restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs), which evaluated the role of vitamin A supplementation in the prevention of acute URTIs in children up to seven years of age. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. MAIN RESULTS We included six studies (27,351 participants). Four studies were RCTs and two were cluster-RCTs. The included studies were all conducted in lower-middle-income countries (two in India, two in South Africa, one in Ecuador, and one in Haiti). Three studies included healthy children who had no vitamin A deficiency, one study included children born to HIV-infected women, one study included low-birthweight neonates, and one study included children in areas with a high local prevalence of malnutrition and xerophthalmia. In two studies, vitamin E was a co-treatment administered in addition to vitamin A. We judged the included studies to be at either a high or unclear risk of bias for random sequence generation, incomplete outcome data, and blinding. Primary outcomes Six studies reported the incidence of acute URTIs during the study period. Five studies reported the number of acute URTIs over a period of time, but there was population heterogeneity and the results were presented in different forms, therefore only three studies were meta-analysed. We are uncertain of the effect of vitamin A supplementation on the number of acute URTIs over two weeks (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.92 to 1.09; I2 = 44%; 3 studies, 22,668 participants; low-certainty evidence). Two studies reported the proportion of participants with an acute URTI. We are uncertain of the effect of vitamin A supplementation on the proportion of participants with an acute URTI (2 studies, 15,535 participants; low-certainty evidence). Only one study (116 participants) reported adverse events. No infant in either the placebo or vitamin A group was found to have feeding difficulties (failure to feed or vomiting), a bulging fontanelle, or neurological signs before or after vitamin A administration (very low-certainty evidence). Secondary outcomes Two studies (296 participants) reported the severity of subjective symptoms, presented by the mean duration of acute URTI. Vitamin A may have little to no effect on the mean duration of acute URTI (very low-certainty evidence). AUTHORS' CONCLUSIONS The evidence for the use of vitamin A supplementation to prevent acute URTI is uncertain, because population, dose and duration of interventions, and outcomes vary between studies. From generally very low- to low-certainty evidence, we found that there may be no benefit in the use of vitamin A supplementation to prevent acute URTI in children up to seven years of age. More RCTs are needed to strengthen the current evidence. Future research should report over longer time frames using validated tools and consistent reporting, and ensure adequate power calculations, to allow for easier synthesis of data. Finally, it is important to assess vitamin A supplementation for preschool children with vitamin A deficiency.
Collapse
Affiliation(s)
- Xiao Cheng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, NMPA, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China
| | - Dan Li
- Department of Pharmacy, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pharmacy, Chongqing Health Center for Women and Children, Chongqing, China
| | - Chunsong Yang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, NMPA, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China
| | - Bin Chen
- Emergency Department, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ping Xu
- Library, Sichuan University, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, NMPA, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
5
|
Tadese ZB, Hailu DT, Abebe AW, Kebede SD, Walle AD, Seifu BL, Nimani TD. Interpretable prediction of acute respiratory infection disease among under-five children in Ethiopia using ensemble machine learning and Shapley additive explanations (SHAP). Digit Health 2024; 10:20552076241272739. [PMID: 39114117 PMCID: PMC11304488 DOI: 10.1177/20552076241272739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/13/2024] [Indexed: 08/10/2024] Open
Abstract
Background Although the prevalence of childhood illnesses has significantly decreased, acute respiratory infections continue to be the leading cause of death and disease among children in low- and middle-income countries. Seven percent of children under five experienced symptoms in the two weeks preceding the Ethiopian demographic and health survey. Hence, this study aimed to identify interpretable predicting factors of acute respiratory infection disease among under-five children in Ethiopia using machine learning analysis techniques. Methods Secondary data analysis was performed using 2016 Ethiopian demographic and health survey data. Data were extracted using STATA and imported into Jupyter Notebook for further analysis. The presence of acute respiratory infection in a child under the age of 5 was the outcome variable, categorized as yes and no. Five ensemble boosting machine learning algorithms such as adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost), Gradient Boost, CatBoost, and light gradient-boosting machine (LightGBM) were employed on a total sample of 10,641 children under the age of 5. The Shapley additive explanations technique was used to identify the important features and effects of each feature driving the prediction. Results The XGBoost model achieved an accuracy of 79.3%, an F1 score of 78.4%, a recall of 78.3%, a precision of 81.7%, and a receiver operating curve area under the curve of 86.1% after model optimization. Child age (month), history of diarrhea, number of living children, duration of breastfeeding, and mother's occupation were the top predicting factors of acute respiratory infection among children under the age of 5 in Ethiopia. Conclusion The XGBoost classifier was the best predictive model with improved performance, and predicting factors of acute respiratory infection were identified with the help of the Shapely additive explanation. The findings of this study can help policymakers and stakeholders understand the decision-making process for acute respiratory infection prevention among under-five children in Ethiopia.
Collapse
Affiliation(s)
- Zinabu Bekele Tadese
- Department of Health Informatics, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Debela Tsegaye Hailu
- Department of Health Informatics, School of Public Health, Bule Hora University, Bule Hora, Ethiopia
| | - Aschale Wubete Abebe
- Department of Health Informatics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Shimels Derso Kebede
- Department of Health Informatics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Teshome Demis Nimani
- Department of Epidemiology and Biostatistics, School of Public Health College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| |
Collapse
|
6
|
Farrag NH, Haile ZT, Ice G, Berryman D, Ruhil AVS, Fadl N. Association Between Exclusive Breastfeeding and Acute Respiratory Infections Among Infants Under the Age of 6 Months. Breastfeed Med 2024; 19:26-32. [PMID: 38241131 DOI: 10.1089/bfm.2023.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Introduction: Acute respiratory infection (ARI) is the leading cause of childhood morbidity and mortality. Exclusive breastfeeding is considered the cornerstone of child health; however, the rate of exclusive breastfeeding is suboptimal in low- and middle-income countries (LMICs). This study aimed to assess the association between exclusive breastfeeding and ARI among infants under the age of 6 months in a LMIC. Methods: A secondary analysis of the 2014 Egypt Demographic Health Survey data was conducted. Mothers of infants under the age of 6 months (n = 1,340) were included. The outcome of interest was ARI symptoms among infants, defined by mother's report of a cough accompanied by fast or difficult breathing in the 2 weeks preceding the survey. The exposure variable was exclusive breastfeeding, defined by giving infants only breast milk during the first 6 months of life. Descriptive statistics and multivariate regression were performed. Results: Forty-one percent of the infants were exclusively breastfed and 9% had ARI symptoms. Exclusive breastfeeding reduced the odds of ARI symptoms (adjusted odds ratio [AOR] = 0.450, 95% confidence interval [CI]: 0.243-0.832). Infants of mothers 20-34 years of age (AOR = 0.421, 95% CI: 0.217-0.817) and ≥35 years (AOR = 0.308, 95% CI: 0.123-0.767) at childbirth were less likely to have symptoms of an ARI when compared with adolescent mothers. The likelihood of having ARI symptoms was higher among infants 2-3 months of age (AOR = 2.437, 95% CI: 1.093-5.435), and 4-5 months (AOR = 2.888, 95% CI: 1.193-6.992) compared with infants less than 2 months. Conclusion: Exclusive breastfeeding was protective against ARI symptoms among under-6-month infants, independent of potential confounders.
Collapse
Affiliation(s)
- Nada H Farrag
- Clinical Pharmacy, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Egypt
| | - Zelalem T Haile
- Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, Ohio, USA
| | - Gillian Ice
- Social Medicine and Global Health, Heritage College of Osteopathic Medicine and College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA. Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Darlene Berryman
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Anirudh V S Ruhil
- The Voinovich School of Leadership and Public Service, Ohio University, Athens, Ohio, USA
| | - Noha Fadl
- Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| |
Collapse
|
7
|
Dorta HG, Nandi A. Patterns of antibiotic use for acute respiratory infections in under-three-year-old children in India: A cross-sectional study. J Glob Health 2023; 13:04159. [PMID: 38131631 PMCID: PMC10740384 DOI: 10.7189/jogh.13.04159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background Despite its mostly viral etiology, antibiotics are frequently used to treat acute respiratory infections (ARIs) in children. India is one of the largest global consumers of antibiotics and has one of the highest rates of resistance to antimicrobial treatments. However, the epidemiology of antibiotic treatment among young children in India is poorly understood. Methods Using nationally representative household survey data from the Indian National Family Health Surveys (NFHS) conducted between 2015 and 2016 and 2019 and 2021, we estimated the prevalence of antibiotic use among 17 472 children under the age of three who reported ARI symptoms within two weeks before their mothers were interviewed. To assess the factors associated with antibiotic use for the treatment of ARI symptoms, we used multivariable logistic regression models that included sociodemographic, child-related, household, and health care related characteristics, with results reported on the prevalence difference (PD) scale. Results We estimated that 18.7% (95% CI = 17.8-19.6) of under-three-year-old (U3) children who exhibited ARI symptoms in the two weeks prior to the survey were given antibiotics as a treatment. The highest prevalence was observed in the southern and northern geographic zones of India. Furthermore, multivariable regression models indicated that children with greater access to health services were more likely to receive antibiotics for ARI treatment, regardless of the type of health care facility (public, private or pharmacy/unregulated). Additionally, the prevalence of antibiotic consumption was higher among children from families with religious affiliations other than Muslim and Hindu backgrounds (i.e. Christian, Sikh, Buddhist/neo-Buddhist, Jain, Jewish, Parsi, no religion and other) (PD = 11.7 (95% CI = 6.3-16.7)) compared to Hindu families and among mothers with a secondary or higher education (PD = 5.8 (95% CI = 1.7-9.9)) compared to mothers lacking formal education. Conclusions Our findings provide an important baseline for monitoring the use of antibiotics for the treatment of acute respiratory infections, and for designing interventions to mitigate potential misuse among young children in India.
Collapse
|
8
|
Stevens M, Yang-Huang J, Nieboer D, Zhou S, Osman KA, Raat H, van Grieken A. Multidimensional energy poverty and acute respiratory infection in children under 5 years of age: evidence from 22 low-income and middle-income countries. J Epidemiol Community Health 2023; 77:687-693. [PMID: 37620007 PMCID: PMC10579459 DOI: 10.1136/jech-2023-220540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND In low-income and middle-income countries (LMICs), energy poverty has predominantly been studied from the unidimensional perspective of indoor air pollution. Acute respiratory infection (ARI) in children under 5 years of age is the most important disease associated with indoor air pollution attributable to solid fuel use in LMICs. This study aimed to extend the existing knowledge on the association between energy poverty and ARI among children under 5 years of age in LMICs, by adopting a multidimensional perspective. METHODS Using Demographic and Health Surveys from 22 LMICs, data from 483 088 children were analysed (mean age 2.00 years (SD 1.41); 51.3% male). Energy poverty was measured using the Multidimensional Energy Poverty Index (MEPI) (range 0-1), which comprises five dimensions of essential energy services. Binary logistic regression models were conducted to study the association between MEPI and ARI, adjusting for child, maternal, household and environmental characteristics. RESULTS A 0.1 increase in MEPI score was associated with greater odds of ARI (aOR 1.05; 95% CI 1.04 to 1.07). Likewise, MEPI indicators using biomass for cooking (aOR 1.15; 95% CI 1.07 to 1.23) and lack of access to electricity (aOR 1.17; 95% CI 1.10 to 1.26), entertainment/education appliances (aOR 1.07; 95% CI 1.02 to 1.13) and household appliances (aOR 1.12; 95% CI 1.04 to 1.21) were associated with greater odds of ARI. CONCLUSION Multidimensional energy poverty was associated with greater odds of ARI in children under 5 years of age living in 22 LMICs. Hence, our findings justify the design and implementation of interventions that address energy poverty from a multidimensional perspective, integrating energy affordability and accessibility.
Collapse
Affiliation(s)
- Merel Stevens
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Daan Nieboer
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Shuang Zhou
- Department of Maternal and Child Health, Peking University, Beijing, China
| | | | - Hein Raat
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Amy van Grieken
- Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
9
|
Gebrerufael GG, Hagos BT. Prevalence and predictors of acute respiratory infection among children under-five years in Tigray regional state, northern Ethiopia: a cross sectional study. BMC Infect Dis 2023; 23:743. [PMID: 37904115 PMCID: PMC10614314 DOI: 10.1186/s12879-023-08701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Acute 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. METHODS A 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. RESULTS Overall, 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. CONCLUSION The 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.
Collapse
Affiliation(s)
| | - Bsrat Tesfay Hagos
- Department of Statistics, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia
| |
Collapse
|
10
|
Hao Y, Cheng L, Lu D. Epidemiological Study of Respiratory Virus Infections among Hospitalized Children Aged 14 Years and Younger during COVID-19 Pandemic in Wuhan, China, 2018-2022. J Glob Infect Dis 2023; 15:149-155. [PMID: 38292693 PMCID: PMC10824227 DOI: 10.4103/jgid.jgid_138_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The viral etiological characteristics and prevalence of hospitalized children with acute respiratory tract infection were preliminary studied in Wuhan City during the COVID-19 pandemic, to provide a reliable scientific basis for better understanding of the role of various pathogens in cases and for the prevention and clinical treatment of acute respiratory tract infection. Methods A total of 69,086 children with acute respiratory infections hospitalized and treated in our department from January 2018 to December 2022 were enrolled as our research subjects. Sociodemographic and clinical data as well as nasopharyngeal samples were collected from patients. Respiratory syncytial virus (RSV), adenovirus (ADV), infuenza virus A (FluA), infuenza virus B (FluB), and parainfluenza virus (PIV) were detected by direct immunofluorescence (DFA) to understand and analyze the epidemic characteristics of respiratory pathogens in children during the COVID-19 pandemic. Results The total detection rate of respiratory pathogens was 24.52% of the 69,086 hospitalized children. The frequency of respiratory viruses in those ADV, RSV, FluA, FluB, and PIV was 14.67%, 46.40%, 7.76%, 5.23%, and 25.95%. There were significant differences between the various pathogens (P < 0.001). There were the fewest pathogen-positive patients and positive detection rate in 2020 during the COVID-19 pandemic. There were significant differences in the pathogen detection rate among different years (P < 0.001). In addition, the results showed that the total detection rate of respiratory virus tested in different age groups was significantly different (P < 0.001). The positive detection rate was highest in the 1-3-year-old age group, which is prone to acute respiratory infections. We also found that different pathogens showed obvious seasonal fluctuation and epidemic. RSV reached its peak in winter. ADV is mainly prevalent in spring and summer. FluA has a high detection rate in winter. Winter and spring are the peak seasons for FluB infection, whereas PIV is detected in all seasons, with a higher incidence rate in the spring and summer. Conclusion The epidemiological distribution of pathogens of acute respiratory tract infection in hospitalized children in Wuhan from 2018 to 2022 varies with gender, age, and season. Nonpharmaceutical interventions (NPIs) were implemented as control measures worldwide and reduced the transmission of respiratory pathogens. NPIs are likely to be the primary driver of the dramatic reduction in respiratory virus infection activity in the early stages of the COVID-19 pandemic, to dissolving NPIs can lead to a recurrence of viral infection pathogens, especially in children.
Collapse
Affiliation(s)
- Yingchan Hao
- Department of Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Li Cheng
- Department of Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Dan Lu
- Department of Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| |
Collapse
|
11
|
Gaffan N, Degbey C, Kpozehouen A, Ahanhanzo YG, Paraïso MN. Exploring the association between household access to water, sanitation and hygiene (WASH) services and common childhood diseases using data from the 2017-2018 Demographic and Health Survey in Benin: focus on diarrhoea and acute respiratory infection. BMJ Open 2023; 13:e074332. [PMID: 37730407 PMCID: PMC10510876 DOI: 10.1136/bmjopen-2023-074332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The paper aimed to study the association between household access to water, sanitation and hygiene (WASH) services and the occurrence of diarrhoea and acute respiratory infection among children under 5 years in Benin. DESIGN We performed secondary analyses using Benin's Fifth Demographic and Health Survey datasets. The dependent variables were diarrhoea and acute respiratory infection (yes=1, no=0). Among the independent variables were the household access to individual WASH services, grouped as follows: 'basic', 'limited', 'unimproved' and 'no service'. Multivariate logistic regression was used to determine the association between household access to WASH services and the occurrence of diarrhoea and acute respiratory infection. Results from the multivariate logistic regression were presented using adjusted Odds Ratios (aORs) with 95% Confidence Intervals (95% CIs). SETTING Benin. PARTICIPANTS Children under 5 years successfully surveyed during Benin's Fifth Demographic and Health Survey. OUTCOME MEASURES Diarrhoea and acute respiratory infection. RESULTS In the current study, 12 034 children under 5 years met the selection criteria and were included in the analyses. The prevalence of diarrhoea and acute respiratory infection was 10.5% (95% CI=9.8% to 11.3%) and 2.9% (95% CI=2.5% to 3.4%), respectively. Children living in households without sanitation service, that is, practising open defecation (aOR=1.9, 95% CI=1.4 to 2.6), and with unimproved (aOR=1.9, 95% CI=1.3 to 2.7) and limited (aOR=1.5, 95% CI=1.1 to 2.2) services were more likely to have diarrhoea compared with children with basic sanitation services. Household access to WASH services was not associated with acute respiratory infection. CONCLUSION We suggest reinforcing household access to basic sanitation services to combat diarrhoea in children under 5 years. Further research is needed on the effects of WASH interventions on diarrhoea and acute respiratory infection in children under 5 years.
Collapse
Affiliation(s)
- Nicolas Gaffan
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Cyriaque Degbey
- Department of Environmental Health, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Alphonse Kpozehouen
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Yolaine Glele Ahanhanzo
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Moussiliou Noël Paraïso
- Department of Health Promotion, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| |
Collapse
|
12
|
Varghese JS, Muhammad T. Prevalence, potential determinants, and treatment-seeking behavior of acute respiratory infection among children under age five in India: Findings from the National Family Health Survey, 2019-21. BMC Pulm Med 2023; 23:195. [PMID: 37280601 DOI: 10.1186/s12890-023-02487-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five. STUDY DESIGN Cross-sectional study. METHODS The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed. RESULTS Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79-0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69-0.99) are less likely to seek treatment. CONCLUSION The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.
Collapse
Affiliation(s)
- Jesty Saira Varghese
- Indian Institute of Technology (IIT) Delhi, New Delhi, 110016, India.
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, 400088, Maharashtra, India.
| | - T Muhammad
- Indian Institute of Technology (IIT) Delhi, New Delhi, 110016, India
| |
Collapse
|
13
|
Sarfo JO, Amoadu M, Gyan TB, Osman AG, Kordorwu PY, Adams AK, Asiedu I, Ansah EW, Amponsah-Manu F, Ofosu-Appiah P. Acute lower respiratory infections among children under five in Sub-Saharan Africa: a scoping review of prevalence and risk factors. BMC Pediatr 2023; 23:225. [PMID: 37149597 PMCID: PMC10163812 DOI: 10.1186/s12887-023-04033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/25/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Acute lower respiratory tract infections (ALRTIs) among children under five are still the leading cause of mortality among this group of children in low and middle-income countries (LMICs), especially countries in sub-Saharan Africa (SSA). This scoping review aims to map evidence on prevalence and risk factors associated with ALRTIs among children under 5 years to inform interventions, policies and future studies. METHODS A thorough search was conducted via four main databases (PubMed, JSTOR, Web of Science and Central). In all, 3,329 records were identified, and 107 full-text studies were considered for evaluation after vigorous screening and removing duplicates, of which 43 were included in this scoping review. FINDINGS Findings indicate a high prevalence (between 1.9% to 60.2%) of ALRTIs among children under five in SSA. Poor education, poverty, malnutrition, exposure to second-hand smoke, poor ventilation, HIV, traditional cooking stoves, unclean fuel usage, poor sanitation facilities and unclean drinking water make children under five more vulnerable to ALRTIs in SSA. Also, health promotion strategies like health education have doubled the health-seeking behaviours of mothers of children under 5 years against ALRTIs. CONCLUSION ALRTIs among children under five still present a significant disease burden in SSA. Therefore, there is a need for intersectoral collaboration to reduce the burden of ALRTIs among children under five by strengthening poverty alleviation strategies, improving living conditions, optimising child nutrition, and ensuring that all children have access to clean water. There is also the need for high-quality studies where confounding variables in ALRTIs are controlled.
Collapse
Affiliation(s)
- Jacob Owusu Sarfo
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Mustapha Amoadu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
| | - Thomas Boateng Gyan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Ganiyu Osman
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Peace Yaa Kordorwu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Abdul Karim Adams
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Immanuel Asiedu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | | | | |
Collapse
|
14
|
Xie MZ, Dong M, Du J, Zhang SS, Huang F, Lu QB. Epidemiological features of Streptococcus pneumoniae in patients with acute respiratory tract infection in Beijing, China during 2009-2020. J Infect Public Health 2023; 16:719-726. [PMID: 36940499 DOI: 10.1016/j.jiph.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae (S. pneumoniae) is one of the common pathogens causing acute respiratory tract infection (ARTI). The study aimed to investigate the prevalence of S. pneumoniae in patients with ARTI in Beijing, and to provide reference evidence for prevention and control of S. pneumoniae. METHOD The patients from the surveillance data of ARTI in Beijing from 2009 to 2020 were recruited in the study. All patients were tested for S. pneumoniae and other viral and bacterial pathogens. Logistic regression model was used to explore the epidemiological features of S. pneumoniae. RESULTS Totally, 4.63% (253/5468) of the ARTI patients were positive for S. pneumoniae. The age, case type and antibiotic therapy in one week before sampling affected the positive rate of S. pneumoniae in patients. No significant difference on the positive rate of S. pneumoniae between the mild and severe pneumonia. Patients infected with S. pneumoniae had a higher risk of pneumonia in adults and the elderly, but a lower risk in children. The leading bacterial and viral pathogens in patients positive for S. pneumoniae were Haemophilus influenzae (36.36%) and human rhinovirus (35.59%), respectively. CONCLUSION This study showed that the prevalence of S. pneumoniae in the patients with ARTI was at a low level in Beijing from 2009 to 2020, which was higher in elderly patients, outpatients and patients without antibiotic therapy. It is necessary to further explore the serotype of S. pneumoniae and PCVs vaccine coverage, and rationally develop vaccine manufacture and vaccination programs to reduce the burden of pneumococcal diseases.
Collapse
Affiliation(s)
- Ming-Zhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Mei Dong
- Institute for Immunization and Prevention, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| | - Shan-Shan Zhang
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
| | - Fang Huang
- Institute for Immunization and Prevention, Beijing Center for Disease Control and Prevention, Beijing Research Center for Preventive Medicine, Beijing 100013, China.
| | - Qing-Bin Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China.
| |
Collapse
|
15
|
Acute respiratory infection and its associated factors among children under five years. ENFERMERIA CLINICA 2023. [DOI: 10.1016/j.enfcli.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
16
|
Ekholuenetale M, Nzoputam CI, Okonji OC, Barrow A, Wegbom AI, Edet CK. Differentials in the Prevalence of Acute Respiratory Infections Among Under-Five Children: An Analysis of 37 Sub-Saharan Countries. Glob Pediatr Health 2023; 10:2333794X231156715. [PMID: 36814530 PMCID: PMC9940173 DOI: 10.1177/2333794x231156715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/26/2023] [Indexed: 02/19/2023] Open
Abstract
Objective We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries. Methods 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. Results 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. Conclusion 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.
Collapse
Affiliation(s)
| | | | | | - Amadou Barrow
- University of The Gambia, Kanifing, The Gambia,Amadou Barrow, University of the Gambia, Kanifing, P.O Box 3530, Serrekunda, The Gambia.
| | | | | |
Collapse
|
17
|
Wang L, Hu X, Huang Z, Zhang Y, Zhao X, Liu X, Mao H, Hao H, Xue W. Analysis of the typing of adenovirus and its clinical characteristics in children with acute respiratory tract infection. BMC Pediatr 2023; 23:25. [PMID: 36647010 PMCID: PMC9841135 DOI: 10.1186/s12887-023-03840-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the typing of adenovirus (AdV) infection in children hospitalized with acute respiratory tract infection (ARTI) and its clinical characteristics. METHODS Samples from 7832 hospitalized children with ARTIs from January 2021 to June 2022 were tested by multiplex PCR for AdV. AdV hex neighborhood genes were amplified and sequenced for typing by nested PCR. RESULTS Three hundred twenty-eight cases were positive for AdV with rate of 4.48% (328/7832). No statistical difference in the rate of AdV detection was observed in different ages (P > 0.05). Among the 328 cases, 305 cases underwent amplification and sequence determination of AdV five-neighborhood, six-neighborhood and fibronectin genes. Only 237 cases were sequenced successfully for all 3 genetic fragments. The typing results of 231 cases with 3 genes were consistent, with 49.78% (115/231) of type 3, 41.56% (96/231) of type 7 and 8.66% (20/231) of other types identified. The main clinical symptoms in 231 children hospitalized with ARTI who were AdV positive were cough, sputum not easily coughable, Wheezing or shortness of breath and fever. Clinical diagnoses of 231 cases included: acute bronchitis 3.03% (7/231), capillary bronchitis 16.45% (38/231), pneumonia (mild/severe) 76.62% (177/231) (68.40% (158/231) in mild and 8.23% (19/231) in severe cases), bronchial asthma combined with pulmonary infection 3.46% (8/231). Higher percentage of shortness of breath, multilobar infiltration, and pleural effusion were found in type 7. Calcitoninogen in type 7 were significantly higher than those of type 3 and other types, and the white blood cell count was lower than those of type 3 and other types, and the difference was statistically significant (P < 0.05). CONCLUSION AdV type 3 and 7 were frequently found in hospitalized children with acute lower respiratory tract involvement. AdV type 7 seems to be associated with more severe outcome.
Collapse
Affiliation(s)
- Li Wang
- grid.452672.00000 0004 1757 5804Nosocomial Infection Management Office, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Xiaoting Hu
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Zhenzhen Huang
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Yangjie Zhang
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Xiaoyuan Zhao
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Xiaohua Liu
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Hua Mao
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Huixiang Hao
- grid.452672.00000 0004 1757 5804Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi China
| | - Wanli Xue
- grid.43169.390000 0001 0599 1243Department of Nutrition and Food Safety Research, School of Public Health, Xi’an Jiaotong University Health Science Center, No.76 Yanta West Road, Yanta District, Xi’an, 710061 Shaanxi China
| |
Collapse
|
18
|
Cheng X, Li D, Yang C, Chen B, Xu P, Zhang L. Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2023; 2023:CD015306. [PMCID: PMC9811920 DOI: 10.1002/14651858.cd015306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of vitamin A supplements for preventing acute upper respiratory tract infections in children up to seven years of age.
Collapse
Affiliation(s)
| | - Xiao Cheng
- Department of PharmacyWest China Second University Hospital, Sichuan UniversityChengduChina,Evidence-Based Pharmacy CenterWest China Second University Hospital, Sichuan UniversityChengduChina,Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo CorrelationNMPAChengduChina,Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationChengduChina
| | - Dan Li
- Department of PharmacyWomen and Children’s Hospital of Chongqing Medical UniversityChongqingChina,Department of PharmacyChongqing Health Center for Women and ChildrenChongqing China
| | - Chunsong Yang
- Department of PharmacyWest China Second University Hospital, Sichuan UniversityChengduChina,Evidence-Based Pharmacy CenterWest China Second University Hospital, Sichuan UniversityChengduChina,Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo CorrelationNMPAChengduChina,Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationChengduChina
| | - Bin Chen
- Emergency DepartmentWest China Second University Hospital, Sichuan UniversityChengduChina
| | - Ping Xu
- LibrarySichuan UniversityChengduChina
| | - Lingli Zhang
- Department of PharmacyWest China Second University Hospital, Sichuan UniversityChengduChina,Evidence-Based Pharmacy CenterWest China Second University Hospital, Sichuan UniversityChengduChina,Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo CorrelationNMPAChengduChina,Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationChengduChina
| |
Collapse
|
19
|
Mueller AK, Matoba J, Schue JL, Hamapumbu H, Kobayashi T, Stevenson JC, Thuma PE, Wesolowski A, Moss WJ, _ _. The Unmeasured Burden of Febrile, Respiratory, and Diarrheal Illnesses Identified Through Active Household Surveillance in a Low Malaria Transmission Setting in Southern Zambia. Am J Trop Med Hyg 2022; 106:1791-1799. [PMID: 35895429 PMCID: PMC9209922 DOI: 10.4269/ajtmh.21-1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/07/2022] [Indexed: 01/25/2023] Open
Abstract
Malaria incidence has declined in southern Zambia over recent decades, leading to efforts to achieve and sustain malaria elimination. Understanding the remaining disease burden is key to providing optimal health care. A longitudinal study conducted in a rural area of Choma District, Southern Province, Zambia, assessed the prevalence of and factors associated with symptoms of non-malarial illnesses and treatment-seeking behavior. We analyzed data collected monthly between October 2018 through September 2020 from 1,174 individuals from 189 households. No incident malaria cases were detected by rapid diagnostic tests among febrile participants. Mixed-effects logistic regression identified factors associated with cough, fever, diarrhea, and treatment-seeking. Incidence rates of cough (192 of 1,000 person-months), fever (87 of 1,000 person-months), and fever with cough (37 of 1,000 person-months) were highest among adults older than 65 years. Diarrhea incidence (37 of 1,000 person-months) was highest among children younger than 5 years. For every additional symptomatic household member, one's odds of experiencing symptoms increased: cough by 47% (95% CI, 40-55), fever by 31% (95% CI, 23-40), diarrhea by 31% (95% CI, 17-46), and fever with cough by 112% (95% CI, 90-137), consistent with household clustering of illnesses. However, between 35% and 75% of participants did not seek treatment for their symptoms. Treatment-seeking was most common for children 5 to 9 years old experiencing diarrhea (adjusted odds ratio, 3.61; 95% CI, 1.42-9.18). As malaria prevalence reduces, respiratory and diarrheal infections persist, particularly among young children but, notably, also among adults older than 65 years. Increasing awareness of the disease burden and treatment-seeking behavior are important for guiding resource re-allocation as malaria prevalence declines in this region.
Collapse
Affiliation(s)
- Alexandra K. Mueller
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland;,Address correspondence to Alexandra K. Mueller, Johns Hopkins School of Medicine, 5200 Eastern Ave., Baltimore, MD 21224. E-mail:
| | | | - Jessica L. Schue
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Tamaki Kobayashi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - William J. Moss
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | |
Collapse
|
20
|
Association between the Use of Biomass as Fuel for Cooking and Acute Respiratory Infections in Children under 5 Years of Age in Peru: An Analysis of a Population-Based Survey, 2019. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:4334794. [PMID: 35646128 PMCID: PMC9142288 DOI: 10.1155/2022/4334794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/08/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022]
Abstract
Background Acute respiratory infections (ARIs) are the most frequent respiratory diseases associated with the use of biomass as fuel within the home. ARIs are the main cause of mortality in children under 5 years of age. We aimed to evaluate the association between the use of biomass as cooking fuel and ARI in children under 5 years of age in Peru in 2019. Methods A secondary data analysis of the 2019 Peru Demographic and Family Health Survey (ENDES) has been performed. The outcome variable was a history of ARI. The exposure variable was the use of biomass as fuel for cooking food. To evaluate the association of interest, generalized linear models from the Poisson family with logarithmic link function considering complex sampling to estimate crude prevalence ratio (cPR) and adjusted prevalence ratio (aPR) with their respective 95% confidence intervals have been performed. P values <0.05 were considered statistically significant. Results A total of 16,043 children were included in the analysis. Of the total, biomass was used as fuel to cook food in the homes of 3,479 (20.0%) children. Likewise, 2,185 (14.3%) of the children had a history of ARI. In the adjusted model, it was found that children living in homes in which biomass was used as cooking fuel had a greater probability of presenting ARI (aPR = 1.13; 95% CI: 1.01–1.28). Conclusions It has been found that biomass was used to cook food in two of every 10 households. Likewise, almost one-seventh of children under 5 years old presented an ARI. The use of biomass as a source of energy for cooking in the home was associated with a higher probability of presenting ARIs.
Collapse
|
21
|
Merera A, Asena T, Senbeta M. Bayesian multilevel analysis of determinants of acute respiratory infection in children under the age of five years in Ethiopia. BMC Pediatr 2022; 22:123. [PMID: 35272658 PMCID: PMC8908561 DOI: 10.1186/s12887-022-03187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute respiratory tract infection (ARI) is one of the leading causes of illness and mortality in children under the age of five worldwide. Pneumonia, which is caused by a respiratory tract infection, kills about 1.9 million children under the age of 5 years around the world. The majority of these deaths occur in underdeveloped countries. According to the 2016 Ethiopia Demographic and Health Survey (EDHS), the prevalence rate of ARI in Ethiopia was 7%. Prevalence is defined as the number of infectious diseases present at a given period in relation to the total number of children under the age of five who have been exposed to ARI. The goal of this study was to determine the risk factors for acute respiratory infection among children under the age of five in Ethiopia. METHODS To provide representative samples of the population, a community-based cross-sectional sampling scheme was designed. Bayesian multilevel approach was employed to assess factors associated with the prevalence of ARI among children under age five in Ethiopia. The data was collected from 10,641 children under the age of 5 years out of which 9918 children were considered in this study. RESULTS The ARI prevalence rate in children under the age of 5 years was assessed to be 8.4%, somewhat higher than the country's anticipated prevalence rate. Children whose mothers did not have a high level of education had the highest prevalence of ARI. The key health, environmental, and nutritional factors influencing the proportion of children with ARI differed by area. Tigray (15.3%) and Oromia (14.4%) had the highest prevalence of ARI, while Benishangul Gumuz had the lowest prevalence (2.6%). The use of vitamin A was investigated, and the results revealed that roughly 43.1% of those who received vitamin A had the lowest prevalence of ARI (7.7%) as compared to those who did not receive vitamin A. Diarrhea affected 11.1% of children under the age of five, with the highest frequency of ARI (24.6%) and the highest prevalence of ARI reported in children whose drinking water source was unprotected/unimproved (9.4%). CONCLUSIONS The prevalence of ARI among children under the age of 5 years was found to be strongly affected by the child's age, household wealth index, mother's educational level, vitamin A supplement, history of diarrhea, maternal work, stunting, and drinking water source. The study also found that the incidence of ARI varies significantly between and within Ethiopian areas. When intending to improve the health status of Ethiopian children, those predictive variables should be taken into consideration.
Collapse
Affiliation(s)
- Amanuel Merera
- Department of Statistics, Mizan-Tepi University, Mizan-Tepi, Ethiopia
| | - Tilahun Asena
- Department of Statistics, Arba Minch University, Arba Minch, Ethiopia.
| | - Mebratu Senbeta
- Department of Economics, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
22
|
Wu B, Luo S, Xu C, Yang T, Chen Y. Influence factors for upper respiratory tract infection in Chinese rural children: A cross-sectional study. Front Pediatr 2022; 10:954363. [PMID: 36568418 PMCID: PMC9768359 DOI: 10.3389/fped.2022.954363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
AIM The prevalence rate of upper respiratory tract infection (URTI) is high in children. Influencing factors for URTI have been reported in Chinese urban children, but those have not been explored in rural children. In China, children in the rural areas are a disadvantaged group. Therefore, this study aims to explore influencing factors for URTI in Chinese rural children. METHODS This is a cross-sectional study based on the 1991-2015 China Health and Nutrition Survey (CHNS). In total, 5,289 children were eligible for the analysis, including 3,684 rural children and 1,605 urban children. The generalized estimating equation was used to determine the influencing factors, and results were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). RESULTS The results showed that rural children aged 7-12 and 13-17 years had lower odds of URTI than those aged 0-1 year, with OR value of 0.17 (95% CI, 0.11-0.27) and 0.12 (95% CI, 0.08-0.19), respectively. Compared with uneducated mothers, those with education level of primary school (OR: 0.59, 95% CI, 0.42-0.84), lower middle school (OR: 0.53, 95% CI, 0.38-0.73), and upper middle school and technical school (OR: 0.62, 95% CI, 0.40-0.95) were associated with the lower odds of URTI in rural children. Children, whose mothers were office workers, had 46% lower odds of URTI than those with farmer mothers (OR: 0.54, 95% CI, 0.34-0.84). CONCLUSIONS This study found that mother's education level, children's age, and mother's occupation were significant influencing factors for URTI, which suggested the importance to improve mother's health-related knowledge and working conditions in Chinese rural areas.
Collapse
Affiliation(s)
- Bichen Wu
- Respiratory Department, Hunan Children's Hospital, Changsha, China
| | - Shujuan Luo
- Respiratory Department, Hunan Children's Hospital, Changsha, China
| | - Chang Xu
- Respiratory Department, Hunan Children's Hospital, Changsha, China
| | - Ting Yang
- Respiratory Department, Hunan Children's Hospital, Changsha, China
| | - Yanping Chen
- Respiratory Department, Hunan Children's Hospital, Changsha, China
| |
Collapse
|