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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.
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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
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Bakchi J, Rasel RA, Shammi KF, Ferdous S, Sultana S, Rabeya MR. Effect of housing construction material on childhood acute respiratory infection: a hospital based case control study in Bangladesh. Sci Rep 2024; 14:8163. [PMID: 38589435 PMCID: PMC11001851 DOI: 10.1038/s41598-024-57820-6] [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: 12/17/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Despite several studies conducted to investigate housing factors, the effects of housing construction materials on childhood ARI symptoms in Bangladesh remain unclear. Hence, the study aimed to measure such a correlation among children under the age of five. A hospital-based case-control study was conducted, involving 221 cases and 221 controls from January to April 2023. Bivariate and multivariate binary logistic regression was performed to measure the degree of correlation between housing construction materials and childhood ARI symptoms. Households composed of natural floor materials had 2.7 times (95% confidence interval 1.27-5.57) and households composed of natural roof materials had 1.8 times (95% confidence interval 1.01-3.11) higher adjusted odds of having under-five children with ARI symptoms than household composed of the finished floor and finished roof materials respectively. Households with natural wall type were found protective against ARI symptoms with adjusted indoor air pollution determinants. The study indicates that poor housing construction materials are associated with an increased risk of developing ARI symptoms among under-five children in Bangladesh. National policy regarding replacing poor housing materials with concrete, increasing livelihood opportunities, and behavioral strategies programs encouraging to choice of quality housing construction materials could eliminate a fraction of the ARI burden.
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Affiliation(s)
- Jhantu Bakchi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh.
| | - Rosul Ahmed Rasel
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Khandokar Farmina Shammi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Sumaiya Ferdous
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Shamima Sultana
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Mst Rokshana Rabeya
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
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Simanek V, Dedeckova E, Topolcan O, Kralova M, Kucera R. A Case Study of Vitamin D Supplementation Therapy and Acute Respiratory Tract Infection. In Vivo 2024; 38:949-953. [PMID: 38418127 PMCID: PMC10905438 DOI: 10.21873/invivo.13525] [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: 10/20/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Low serum concentrations of 25-hydroxyvitamin D correlate with higher susceptibility to acute respiratory tract infections (ARTIs). The case study presented here aims at sheding light on the correlation between vitamin D levels, the vitamin D supplement dose, and the incidence of ARTIs. CASE REPORT A 23-year-old female patient with a vitamin D insufficiency was able to successfully increase her vitamin D levels from 45.60 nmol/l to 85.91 nmol/l (reference ranges 75-200 nmol/l) through the use of supplements. However, it was surprising to observe a decrease in vitamin D levels even though the patient continued taking supplements. Further examination indicated that the patient was experiencing common symptoms of an acute respiratory tract infection (ARTI). This case highlights the intricate connection between ARTIs and vitamin D intake. CONCLUSION This case study clearly demonstrates the intricate connection between vitamin D levels, supplement treatment, and ARTIs. The observed decrease in vitamin D levels during the course of supplementation, while the patient was suffering from an ARTI, suggests that respiratory infections may affect vitamin D metabolism.
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Affiliation(s)
- Vaclav Simanek
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Eva Dedeckova
- Department of Pharmacology and Toxicology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ondrej Topolcan
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Marketa Kralova
- Department of Pharmacology and Toxicology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Radek Kucera
- Department of Immunochemistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic;
- Department of Pharmacology and Toxicology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
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Lutpiatina L, Sulistyorini L, Yudhastuti R, Notobroto HB. Prediction of Toddlers Acute Respiratory Infection (ARI) to Become Pneumonia in Martapura Catchment Area, Banjar District, Indonesia. Glob Pediatr Health 2024; 11:2333794X241227694. [PMID: 38405016 PMCID: PMC10894530 DOI: 10.1177/2333794x241227694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction. The pneumonia pattern in young children may vary across different catchment areas. Therefore, this study aims to analyze the predictive factors for toddlers with an Acute Respiratory Infection (ARI) developing into pneumonia in the catchment area of Banjar Regency, Indonesia. Methods. A case-control design, with 300 respondents, consisting of 106 cases and 194 controls. A questionnaire of interviews with mothers/caregivers of toddlers. Forty-one indicators data were analyzed using multiple logistic regression with backward stepwise regression to arrive at the final model. Results. The predictive factors for toddlers with pneumonia were the child's age (P-value .070), child development (P-value .007), breastfeeding (P-value .051), family income (P-value .026), and location of houses along the river (P-value .025). Conclusion. A prediction index for toddler pneumonia has been compiled, which can be applied to improve the health of lower middle-class toddlers requiring more government attention.
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Affiliation(s)
- Leka Lutpiatina
- Medical Laboratory Technology Poltekkes Kemenkes Banjarmasin, Banjarbaru, Indonesia
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Sidabutar E, Ansariadi, Wahiduddin, Bustan N, Stang, Birawida AB. Analysis of risk factor for pneumonia in children less than five years in Makassar. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:16. [PMID: 38532918 PMCID: PMC10965016 DOI: 10.4103/jehp.jehp_727_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/26/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND Pneumonia is one of the main causes of mortality in children less than five years worldwide and in Makassar City. The aim of this study was to investigate the risk factors for pneumonia in children less than five years in Makassar City. MATERIALS AND METHODS A case-control study design was used in this research. A total of 210 children with consent from the parents were included in this study, which consisted of 70 children's cases, and the data of the control group were taken by the random sampling method. All related data such as immunization record, nutritional status, birth body weight, vitamin A intake in the last six-month record, and parents' education, occupation, and monthly income were registered as independent and control variables. Data analysis was performed by the Chi-square and logistic regression model with a P value of 0.005 and odds ratio (OR) with a 95% confidence interval (CI). RESULTS Incomplete diphtheria-pertussis-tetanus-hepatitis B and Haemophilus influenzae type B (DPT-HB-Hib) immunization at the age of 2 months, 3 months, and 4 months, which had adjusted OR (AOR = 9,680; P = 0,001) and malnutrition condition (weight for age) (AOR = 5,486; P < 0,005), were associated with the incidence of pneumonia in children less than five years, whereas incomplete measles-rubella (P = 0,770), low birth weight history (P = 0,403), lack of vitamin A intake (P = 0,720), parents' education (P = 0,163), and presence of smoker inside the household (P =) were not associated with the incidence of pneumonia in children less than five years (P > 0.005) in Makassar City. CONCLUSIONS Incomplete DPT-HB-Hib immunization for three doses at the age of 2 months, 3 months, and 4 months and malnutrition were associated with pneumonia and the highest risk factors for developing pneumonia in children less than five years in Makassar City, Indonesia.
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Affiliation(s)
- Evalina Sidabutar
- Master Program in Public Health, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Ansariadi
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Wahiduddin
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Nadjib Bustan
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Stang
- Department of Biostatistics and Health Reproductive, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Agus Bintara Birawida
- Department of Health Environment, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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Turyasiima M, Kiconco G, Egesa WI, Twesigemukama S, Nduwimana M. Prevalence and Outpatient Clinical Diagnostic Approaches for Common Acute Respiratory Tract Infections in Children Under Five Years of Age: A Cross-Sectional Study. Pediatric Health Med Ther 2024; 15:49-57. [PMID: 38268971 PMCID: PMC10807262 DOI: 10.2147/phmt.s445908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024] Open
Abstract
Background Acute respiratory tract infections are among the leading causes of child morbidity and mortality worldwide. Although the diagnosis of acute respiratory tract infections requires simple outpatient medical techniques and care, it is still misdiagnosed among primary care physicians, leading to delayed treatment and increased mortality. This study described the prevalence of common acute respiratory tract infections and simple techniques that effectively detect and diagnose children presenting with acute respiratory symptoms to primary healthcare physicians in remote settings. Patients and Methods This descriptive cross-sectional study was conducted at the pediatric outpatient clinic of a tertiary hospital in western Uganda in April, May and June 2019. A total of 896 children aged 2-59 months attending the clinic were recruited consecutively into the study and examined for the presence of acute respiratory infection. Participants' sociodemographic and clinical data were collected through history taking and clinical examination using a validated Uganda Ministry of Health Uganda outpatient clinical checklist (FORM 5). The outcome variable was the presence of an acute upper or lower respiratory condition. Data was analyzed using STATA version 13.0 (StataCorp, College Station, USA) and summarized using descriptive statistics. Results The overall period prevalence of acute respiratory tract infections among children aged 2 to 59 months was 36.9% (36,942 per 100,000 population). Upper respiratory tract infections with a prevalence of 24.8% were more common than lower respiratory tract infections. The most frequent upper respiratory tract infection in this setting was common cold (52%), followed by tonsillopharyngitis (10.7%), while pneumonia (26%) was the most frequent lower respiratory tract infection. Conclusion Acute respiratory tract infections contribute to the high burden of disease in pediatric outpatient clinics. Simple, affordable, and approved diagnostic clinical techniques that involve physical examination of the upper and lower respiratory systems can precisely diagnose acute respiratory tract infections in resource-limited settings where there is no access to sophisticated diagnostic equipment.
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Affiliation(s)
- Munanura Turyasiima
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
- Department of Standards Compliance Accreditation and Patient Protection (SCAPP), Ministry of Health, Kampala, Uganda
| | - Gloria Kiconco
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
- Department of Pediatrics and Child Health, Fort Portal Regional Referral Hospital, Fort Portal, Uganda
| | - Walufu Ivan Egesa
- Department of Pediatrics, Nile International Hospital, Jinja, Uganda
| | - Sabinah Twesigemukama
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
| | - Martin Nduwimana
- Department of Pediatrics and Child Health, Kampala International University, Kampala, Uganda
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Choudhary R, Kumari S, Ali M, Thinlas T, Rabyang S, Mishra A. Respiratory tract infection: an unfamiliar risk factor in high-altitude pulmonary edema. Brief Funct Genomics 2024; 23:38-45. [PMID: 36528814 DOI: 10.1093/bfgp/elac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 01/21/2024] Open
Abstract
The dramatic changes in physiology at high altitude (HA) as a result of the characteristic hypobaric hypoxia condition can modify innate and adaptive defense mechanisms of the body. As a consequence, few sojourners visiting HA with mild or asymptomatic infection may have an enhanced susceptibility to high-altitude pulmonary edema (HAPE), an acute but severe altitude sickness. It develops upon rapid ascent to altitudes above 2500 m, in otherwise healthy individuals. Though HAPE has been studied extensively, an elaborate exploration of the HA disease burden and the potential risk factors associated with its manifestation are poorly described. The present review discusses respiratory tract infection (RTI) as an unfamiliar but important risk factor in enhancing HAPE susceptibility in sojourners for two primary reasons. First, the symptoms of RTI s resemble those of HAPE. Secondly, the imbalanced pathways contributing to vascular dysfunction in HAPE also participate in the pathogenesis of the infectious processes. These pathways have a crucial role in shaping host response against viral and bacterial infections and may further worsen the clinical outcomes at HA. Respiratory tract pathogenic agents, if screened in HAPE patients, can help in ascertaining their role in disease risk and also point toward their association with the disease severity. The microbial screenings and identifications of pathogens with diseases are the foundation for describing potential molecular mechanisms underlying host response to the microbial challenge. The prior knowledge of such infections may predict the manifestation of disease etiology and provide better therapeutic options.
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Affiliation(s)
- Raushni Choudhary
- Cardio Respiratory Disease Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India
| | - Swati Kumari
- Cardio Respiratory Disease Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Manzoor Ali
- Cardio Respiratory Disease Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Tashi Thinlas
- Department of Medicine, Sonam Norboo Memorial Hospital, Leh 194101, India
| | - Stanzen Rabyang
- Department of Medicine, Sonam Norboo Memorial Hospital, Leh 194101, India
| | - Aastha Mishra
- Cardio Respiratory Disease Unit, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Islam M, Islam K, Dalal K, Hossain Hawlader MD. In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh. BMC Pediatr 2024; 24:38. [PMID: 38216932 PMCID: PMC10787469 DOI: 10.1186/s12887-024-04525-4] [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: 03/28/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under five globally, particularly in regions like South Asia and sub-Saharan Africa. Bangladesh has made substantial progress in reducing child mortality, yet pneumonia remains a significant contributor to under-five deaths. This study aimed to investigate the association between in-house environmental factors and childhood ARI, considering factors such as household crowding, smoking, and sanitation facilities. METHODS This case-control study was conducted at a tertiary-level children's hospital in Dhaka, Bangladesh, from March to September 2019. The study included children aged 6-59 months. Cases were children with ARI symptoms, while controls were children without such symptoms. Rigorous matching by age and gender was employed to ensure comparability. Data were collected through structured questionnaires, and bivariate and conditional logistic regression analyses were performed. RESULTS Several household environmental factors were significantly associated with childhood ARIs. Children from overcrowded households (AOR = 2.66, 95% CI = 1.52-4.71; p < 0.001), those using unclean cooking fuels (OR = 2.41, 95% CI: 1.56, 3.73; p = < 0.001), those exposed to in-house smoking (AOR = 1.74, 95% CI = 1.01, 3.05; p = 0.04) and those with unimproved sanitation facilities faced higher odds (AOR = 4.35, 95% CI = 2.14-9.26) of ARIs. Additionally, preterm birth and higher birth order were associated with an increased risk of ARI. In contrast, exclusive breastfeeding was a protective factor. CONCLUSION In-house environmental factors, including sanitation, crowding and in-house smoking, significantly influence childhood ARIs. Additionally, birth order and preterm birth play a crucial role. Promoting exclusive breastfeeding is associated with a lower ARI risk among under-five children in Bangladesh. These findings can guide interventions to reduce ARIs in low-income regions, particularly in South Asia.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Kariul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Sundsvall, 851 70, Sweden.
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Noor A, Aftab A, Aslam M, Imanpour S. Household heating fuels impact on Acute Respiratory Infection (ARI) symptoms among children in Punjab, Pakistan. BMC Public Health 2023; 23:2380. [PMID: 38037002 PMCID: PMC10691043 DOI: 10.1186/s12889-023-17044-1] [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: 04/05/2023] [Accepted: 10/21/2023] [Indexed: 12/02/2023] Open
Abstract
Exposure to household air pollution (HAP) accounted for the loss of 86 million healthy lives in 2019, with almost half of all deaths due to lower respiratory infection among children under 5 years of age. Similarly, the situation in Punjab - Pakistan's largest province - is also not promising. This study was conducted to examine household energy consumption and respiratory symptoms among children under the age of five in rural and urban areas of Punjab. Using data from the Multiple Indicator Cluster Survey (MICS) 2017-18, logistic regression models were applied to the data of a sample of 35,000 children under the age of five living in households with polluting heating fuels. A hypothesis was formulated to investigate the relationship between polluting heating activities and respiratory infections among children under five. Those Children who live in households having traditional space heaters without chimneys are 50% more likely to have symptoms of Acute Respiratory Infection (ARI) compared to those whose households have chimneys with traditional space heaters. When households utilize polluting heating fuel, the likelihood of children experiencing rapid, shortness of breath increases by 49%, and the likelihood of children displaying ARI symptoms characterized by coughing rises by approximately 30%. This study proposed a complete banning of polluting heating activities and replacing it with cleaner ones using financial incentives. It is pertinent to raise awareness campaigns majorly focusing on the guidelines to adopt better heat output with less harmful emissions.
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Affiliation(s)
- Amamah Noor
- School of Humanities and Social Sciences, Department of Economics, Information Technology, University of the Punjab, Lahore, Pakistan.
| | - Ammar Aftab
- School of Humanities and Social Sciences, Department of Economics, Information Technology, University of the Punjab, Lahore, Pakistan
| | - Memuna Aslam
- School of Humanities and Social Sciences, Department of Economics, Information Technology, University of the Punjab, Lahore, Pakistan
| | - Sara Imanpour
- Department of Health Administration, Pennsylvania State University, Harrisburg, PA, United States of America
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Samuels RJ, Sumah I, Alhasan F, McHenry R, Short L, Chappell JD, Haddadin Z, Halasa NB, Valério ID, Amorim G, Grant DS, Schieffelin JS, Moon TD. Respiratory virus surveillance in hospitalized children less than two-years of age in Kenema, Sierra Leone during the COVID-19 pandemic (October 2020- October 2021). PLoS One 2023; 18:e0292652. [PMID: 37816008 PMCID: PMC10564235 DOI: 10.1371/journal.pone.0292652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021. We collected demographic and clinical characteristics and calculated each participant´s respiratory symptom severity. Nose and throat swabs were collected at enrollment. Total nucleic acid was purified and tested for multiple respiratory viruses. Statistical analysis was performed using R version 4.2.0 software. 502 children less than two-years of age were enrolled. 376 (74.9%) had at least one respiratory virus detected. The most common viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%). Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of children, respectively. Viral co-detection was common. Human metapneumovirus and RSV had more than two-fold higher odds of requiring O2 therapy while hospitalized. Viral pathogen prevalence was high (74.9%) in our study population. Despite this, 100% of children received antibiotics, underscoring a need to expand laboratory diagnostic capacity and to revisit clinical guidelines implementation in these children. Continuous surveillance and serologic studies among more diverse age groups, with greater geographic breadth, are needed in Sierra Leone to better characterize the long-term impact of COVID-19 on respiratory virus prevalence and to better characterize the seasonality of respiratory viruses in Sierra Leone.
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Affiliation(s)
- Robert J. Samuels
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Ibrahim Sumah
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Foday Alhasan
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Rendie McHenry
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Laura Short
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - James D. Chappell
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Zaid Haddadin
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Natasha B. Halasa
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Inaê D. Valério
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Gustavo Amorim
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Donald S. Grant
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - John S. Schieffelin
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Tulane University, New Orleans, Louisiana, United States of America
| | - Troy D. Moon
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Tulane University, New Orleans, Louisiana, United States of America
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
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Phetruang A, Kusol K, Eksirinimit T, Jantasuwan R. The Relationship Between Personal Factors, Smoke Exposure at Home, and Respiratory Problems in Early Childhood in Nakhon Si Thammarat Province, Thailand. J Multidiscip Healthc 2023; 16:2499-2511. [PMID: 37664801 PMCID: PMC10473245 DOI: 10.2147/jmdh.s414172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose The purpose of this study was to examine the relationship between personal factors, smoke exposure at home, and respiratory problems in early childhood in Nakhon Si Thammarat Province, Thailand. Samples and Methods This study was retrospective. There was a total of 414 samples in the study. The instruments included the questionnaire about the personal data of early childhood and their caregivers, the smoke exposure assessment form, and the early childhood respiratory problem assessment form. The relationship between personal factors, smoke exposure at home, and respiratory problems in early childhood was analyzed by the Chi-squared test and binary logistic regression. Results The results revealed that smoke exposure at home in early childhood was moderate (52.2%). There 68.8% had respiratory problems. The relationship between birth weight, and smoke exposure at home in early childhood was found to be significantly related to respiratory problems (X2 =5.014 p< 0.05 and X2 = 85.711 p< 0.001, respectively). It was found that children with a birth weight ≤2500g had respiratory problems at 2.55 times of the samples with birth weight >2500g (AOR = 2.55, 95% CI: 1.10-5.96), and moderate-high smoke exposure had respiratory problems at 8.86 times of the samples with low smoke exposure (AOR = 8.86, 95% CI: 5.39-14.60). Nutritional status and breastfeeding were not significantly related to respiratory problems in early childhood p > 0.05. Conclusion The birth weight and smoke exposure at home factors were found to be related to their respiratory problems in early childhood. Thus, it is necessary to reduce stimuli, especially smoking at home. Moreover, the standard birth weight of their early childhood will reduce the rate of respiratory problems.
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Affiliation(s)
- Apinya Phetruang
- Chulabhorn Hospital, and Graduated Master of Nursing Science Program in Community Nurse Practitioner, School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand
| | - Kiatkamjorn Kusol
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
| | - Thidarat Eksirinimit
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
| | - Rachadaporn Jantasuwan
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
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Chen JF, Ou-Yang MC, Hsia KC, Li CM, Yeh YT, Ho HH. A Three-Arm, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety of Lactobacillus salivarius AP-32 and Bifidobacterium animalis CP-9 Used Individually in Healthy Infants. Nutrients 2023; 15:3426. [PMID: 37571365 PMCID: PMC10421338 DOI: 10.3390/nu15153426] [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: 07/11/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Probiotics are considered safe and beneficial to human health. However, the safety of Lactobacillus salivarius AP-32 and Bifidobacterium animalis CP-9 in infants has not been confirmed. This study was to assess the safety of long-term oral administration of L. salivarius AP-32 and B. animalis CP-9 in healthy infants compared with placebo. A three-arm, randomized, double-blind, placebo-controlled trial was conducted in healthy, full-term infants. Eighty-eight infants between 7 days and 2 months (60 ± 7 days) of age were selected and randomized to treatment with L. salivarius AP-32, B. animalis CP-9 or placebo for 4 months. The unblinding indicated subjects were randomized to receive B. animalis CP-9 (N = 28), L. salivarius AP-32 (N = 29), or placebo (N = 31). A total of 76 infants completed the 4-month treatment with fully compliance. The primary outcome was weight gain, with no significant difference in infant weight at 4 months when comparing AP-32 or CP-9 group with the placebo group, either. The head circumference and recumbent length of the CP-9 group were not significantly different from those of the placebo group. The recumbent length of the AP-32 group was slightly lower than that in the placebo group at month 4, but there was no difference between the two groups in head circumference. Overall, the growth trend of all treatments was similar without significant difference. Furthermore, there were no apparent differences between each group in digestive tolerance, the occurrence of adverse events, crying/fussing time and episodes, alpha diversity, and beta diversity. The CP-9 group showed a significant increase in the abundance of the Bacteroides genus, while the AP-32 group demonstrated a significant increase in the abundance of the Lactobacillus genus when comparing the two probiotic groups. Our study findings indicate that the oral administration of both AP-32 and CP-9 strains has a positive impact on the maintenance of a healthy gut flora in infants. Long-term use of L. salivarius AP-32 or B. animalis CP-9 is safe for infants from 7 days to 6 months of age.
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Affiliation(s)
- Jui-Fen Chen
- Department of Research and Design, Glac Biotech Co., Ltd., Tainan 744, Taiwan; (J.-F.C.); (K.-C.H.); (C.-M.L.)
| | - Mei-Chen Ou-Yang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Ko-Chiang Hsia
- Department of Research and Design, Glac Biotech Co., Ltd., Tainan 744, Taiwan; (J.-F.C.); (K.-C.H.); (C.-M.L.)
| | | | - Ching-Min Li
- Department of Research and Design, Glac Biotech Co., Ltd., Tainan 744, Taiwan; (J.-F.C.); (K.-C.H.); (C.-M.L.)
| | - Yao-Tsung Yeh
- Aging and Disease Prevention Research Center, Fooyin University, Kaohsiung 831, Taiwan;
- Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung 831, Taiwan
| | - Hsieh-Hsun Ho
- Department of Research and Design, Glac Biotech Co., Ltd., Tainan 744, Taiwan; (J.-F.C.); (K.-C.H.); (C.-M.L.)
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13
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Fang Q, Wu Y, Lu J, Zheng H. A meta-analysis of the association between vitamin D supplementation and the risk of acute respiratory tract infection in the healthy pediatric group. Front Nutr 2023; 10:1188958. [PMID: 37408991 PMCID: PMC10318162 DOI: 10.3389/fnut.2023.1188958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
No previous meta-analysis had explored the association between vitamin D supplementation in healthy pediatrics and the risk of acute respiratory tract infections (ARTIs). Thus, we meta-analyzed the current evidence in this regard to provide sufficient knowledge about this risk-benefit ratio for vitamin D supplementation in this specific age group. We searched seven databases for randomized controlled trials (RCTs) that investigated the effect of vitamin D supplementation and ARTIs risk on a healthy pediatric population (0-18 years old). Meta-analysis was performed through R software. We included eight RCTs after the screening of 326 records according to our eligibility criteria. There were comparable infection rates between Vitamin D and placebo groups (OR = 0.98, 95% CI = 0.90-1.08, P-value = 0.62), with no significant heterogeneity among the included studies (I2 = 32%; P-value = 0.22). Moreover, there was no significant difference between the two vitamin D regimens (OR = 0.85, 95% CI = 0.64-1.12, P-value = 0.32), with no considerable heterogeneity among the included studies (I2 = 37%; P-value = 0.21). However, there was a significant reduction in Influenza A rates in the high-dose vitamin D group compared to the low dose one (OR = 0.39, 95% CI = 0.26-0.59, P-value < 0.001), with no heterogeneity among the included studies (I2 = 0%; P-value = 0.72). Only two studies of 8,972 patients reported different side effects, with overall acceptable safety profile. Regardless of the dosing regimen used or the type of infection, in the healthy pediatric group, there is no evident benefit of using vitamin D to prevent or reduce the ARTI rates.
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Affiliation(s)
- Qiongyan Fang
- Department of Pharmacy, Zhoushan Hospital of Zhejiang Province, Zhoushan, Zhejiang, China
| | - Yingting Wu
- Core Facilities Center of Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Pharmacy, Zhoushan Hospital of Zhejiang Province, Zhoushan, Zhejiang, China
| | - Huaiyu Zheng
- Department of Pharmacy, Zhoushan Hospital of Zhejiang Province, Zhoushan, Zhejiang, China
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14
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Sharan RV, Rahimi-Ardabili H. Detecting acute respiratory diseases in the pediatric population using cough sound features and machine learning: A systematic review. Int J Med Inform 2023; 176:105093. [PMID: 37224643 DOI: 10.1016/j.ijmedinf.2023.105093] [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: 03/21/2023] [Revised: 04/21/2023] [Accepted: 05/07/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Acute respiratory diseases are a leading cause of morbidity and mortality in children. Cough is a common symptom of acute respiratory diseases and the sound of cough can be indicative of the respiratory disease. However, cough sound assessment in routine clinical practice is limited to human perception and the skills of the clinician. Objective cough sound evaluation has the potential to aid clinicians in acute respiratory disease diagnosis. In this systematic review, we assess and summarize the predictive ability of machine learning algorithms in analyzing cough sounds of acute respiratory diseases in the pediatric population. METHOD Our systematic search of the Scopus, Medline, and Embase databases on 25 January 2023 identified six articles meeting the inclusion criteria. Quality assessment of the included studies was performed using the checklist for the assessment of medical artificial intelligence. RESULTS Our analysis shows variability in the input to the machine learning algorithms, such as the use of various cough sound features and combining cough sound features with clinical features. The use of the machine learning algorithms also varies from conventional algorithms, such as logistic regression and support vector machine, to deep learning techniques, such as convolutional neural networks. The classification accuracy for the detection of bronchiolitis, croup, pertussis, and pneumonia across five articles is in the range of 82-96%. However, a significant drop is observed in the detection accuracy for bronchiolitis and pneumonia in the remaining article. CONCLUSION The number of articles is limited but, in general, the predictive ability of cough sound classification algorithms in childhood acute respiratory diseases shows promise.
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Affiliation(s)
- Roneel V Sharan
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109, Australia.
| | - Hania Rahimi-Ardabili
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109, Australia
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15
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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.
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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
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16
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Santri IN, Wardani Y, Phiri YVA, Nyam G, Putri TA, Isni K, Suryani D, Sambo G. Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey. J Prev Med Public Health 2023; 56:255-263. [PMID: 37287203 DOI: 10.3961/jpmph.22.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/06/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age. METHODS A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia. RESULTS The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father's smoking frequency, which were considered the sample's socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father's smoking frequency, and a low education level were all linked to ARI symptoms. CONCLUSIONS The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father's smoking frequency and low education level were associated with ARI symptoms.
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Affiliation(s)
| | - Yuniar Wardani
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yohane Vincent Abero Phiri
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Institute for Health Research and Communication (IHRC), Lilongwe, Malawi
| | - Gunchmaa Nyam
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tyas Aisyah Putri
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Khoiriyah Isni
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Dyah Suryani
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Grace Sambo
- School of Public Health, Tzu Chi University, Hualien, Taiwan
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Uttajug A, Ueda K, Seposo X, Francis JM. 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. BMJ Open 2023; 13:e071874. [PMID: 37185183 PMCID: PMC10152048 DOI: 10.1136/bmjopen-2023-071874] [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] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Despite 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 extreme rainfall and acute respiratory infection (ARI) in children aged <5 years in sub-Saharan Africa. SETTING Study data were taken from recent (2006-2020) Demographic and Health Survey data sets from 33 countries in sub-Saharan Africa. PARTICIPANTS 280 157 children aged below 5 years were included. OUTCOME MEASURES The proportions of ARI according to individual, household and geographical characteristics were compared using the χ2 test. The association between extreme rainfall (≥90th percentile) and ARI was examined using multivariate logistic regression for 10 of 33 countries with an adequate sample size of ARI and extreme rainfall events. The model was adjusted for temperature, comorbidity and sociodemographic factors as covariates. Stratification analyses by climate zone were also performed. RESULTS The prevalence of ARI in children aged <5 years ranged from 1.0% to 9.1% across sub-Saharan Africa. By country, no significant association was observed between extreme rainfall and ARI, except in Nigeria (OR: 2.14, 95% CI 1.06 to 4.31). Larger effect estimates were observed in the tropical zone (OR: 1.13, 95% CI 0.69 to 1.84) than in the arid zone (OR: 0.72, 95% CI 0.17 to 2.95), although the difference was not statistically significant. CONCLUSION We found no association between extreme rainfall and ARI in sub-Saharan Africa. Effect estimates tended to be larger in the tropical zone where intense rainfall events regularly occur. Comprehensive studies to investigate subsequent extreme climate events, such as flooding, are warranted in the future.
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Affiliation(s)
- Athicha Uttajug
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Xerxes Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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18
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Armoh SY, Aryeetey S, Kamasah JS, Boahen KG, Owusu M, Adjei-Boateng A, Agbenyega O, Kwarteng A, Hingley-Wilson S, Obiri-Danso K, Ansong D, Sylverken AA. Solid waste motor tricycle operators in Kumasi, Ghana, harbour respiratory pathogens; a public health threat. PLoS One 2023; 18:e0284985. [PMID: 37093881 PMCID: PMC10124853 DOI: 10.1371/journal.pone.0284985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/13/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The use of motor tricycles in transporting municipal solid waste (MSW) within urban and peri-urban towns in Ghana is on the increase. This activity often leads to the introduction of pathogen-containing bioaerosols into the environment, as well as to the tricycle operators. We sought to investigate the prevalence and associated risk factors of respiratory pathogens among solid waste tricycle operators. METHODS A cross-sectional study was conducted among 155 solid waste transporters who use motor tricycles using semi-structured interviews. Nasopharyngeal swabs were obtained from participants and screened for respiratory pathogens using Polymerase Chain Reaction (PCR). RESULTS Pathogens detected in participants were SARS-CoV-2 (n = 10, 6.5%) and Streptococcus pneumoniae (n = 10, 6.5%), constituting an overall prevalence of 12.9% and co-infection rate of 1.3%. The most common self-reported symptoms were cough (n = 67, 43.2%), sore throat (n = 44, 28.4%) and difficulty in breathing (n = 22, 14.2%). Adherence to the use of gloves (n = 117, 75.5%) and nose mask (n = 110, 71.0%) was high. There was a significant association between the detection of respiratory pathogens and the use of gloves, use of more than one PPE and exposure to other pollutants (p < 0.05). Individuals who were exposed to "other pollutants" significantly had lower odds of becoming infected with respiratory pathogens (Adj. OR (95% CI): 0.119(0.015,0.938). CONCLUSION Although prevalence of respiratory pathogens is generally low, strict adherence to PPE use could further reduce its rates to even lower levels. Governmental health institutions and informal solid waste transporters should address challenges related to exposure to pollutants, use of gloves, and multiple PPE.
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Affiliation(s)
- Stephen Yaw Armoh
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sherihane Aryeetey
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Japhet Senyo Kamasah
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kennedy Gyau Boahen
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Owusu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Adjei-Boateng
- Research and Development Unit, Waste Management Department, Kumasi Metropolitan Assembly, Kumasi, Ghana
| | - Olivia Agbenyega
- Department of Agroforestry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Kwarteng
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Suzanne Hingley-Wilson
- Department of Microbial Sciences, Faculty of Health and Medical Science, University of Surrey, Guildford, United Kingdom
| | - Kwasi Obiri-Danso
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Ansong
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Angelina Sylverken
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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19
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Koltai M, Moyes J, Nyawanda B, Nyiro J, Munywoki PK, Tempia S, Li X, Antillon M, Bilcke J, Flasche S, Beutels P, Nokes DJ, Cohen C, Jit M. Estimating the cost-effectiveness of maternal vaccination and monoclonal antibodies for respiratory syncytial virus in Kenya and South Africa. BMC Med 2023; 21:120. [PMID: 37004062 PMCID: PMC10064962 DOI: 10.1186/s12916-023-02806-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 02/22/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) causes a substantial burden of acute lower respiratory infection in children under 5 years, particularly in low- and middle-income countries (LMICs). Maternal vaccine (MV) and next-generation monoclonal antibody (mAb) candidates have been shown to reduce RSV disease in infants in phase 3 clinical trials. The cost-effectiveness of these biologics has been estimated using disease burden data from global meta-analyses, but these are sensitive to the detailed age breakdown of paediatric RSV disease, for which there have previously been limited data. METHODS We use original hospital-based incidence data from South Africa (ZAF) and Kenya (KEN) collected between 2010 and 2018 of RSV-associated acute respiratory infection (ARI), influenza-like illness (ILI), and severe acute respiratory infection (SARI) as well as deaths with monthly age-stratification, supplemented with data on healthcare-seeking behaviour and costs to the healthcare system and households. We estimated the incremental cost per DALY averted (incremental cost-effectiveness ratio or ICER) of public health interventions by MV or mAb for a plausible range of prices (5-50 USD for MV, 10-125 USD for mAb), using an adjusted version of a previously published health economic model of RSV immunisation. RESULTS Our data show higher disease incidence for infants younger than 6 months of age in the case of Kenya and South Africa than suggested by earlier projections from community incidence-based meta-analyses of LMIC data. Since MV and mAb provide protection for these youngest age groups, this leads to a substantially larger reduction of disease burden and, therefore, more favourable cost-effectiveness of both interventions in both countries. Using the latest efficacy data and inferred coverage levels based on antenatal care (ANC-3) coverage (KEN: 61.7%, ZAF: 75.2%), our median estimate of the reduction in RSV-associated deaths in children under 5 years in Kenya is 10.5% (95% CI: 7.9, 13.3) for MV and 13.5% (10.7, 16.4) for mAb, while in South Africa, it is 27.4% (21.6, 32.3) and 37.9% (32.3, 43.0), respectively. Starting from a dose price of 5 USD, in Kenya, net cost (for the healthcare system) per (undiscounted) DALY averted for MV is 179 (126, 267) USD, rising to 1512 (1166, 2070) USD at 30 USD per dose; for mAb, it is 684 (543, 895) USD at 20 USD per dose and 1496 (1203, 1934) USD at 40 USD per dose. In South Africa, a MV at 5 USD per dose would be net cost-saving for the healthcare system and net cost per DALY averted is still below the ZAF's GDP per capita at 40 USD dose price (median: 2350, 95% CI: 1720, 3346). For mAb in ZAF, net cost per DALY averted is 247 (46, 510) USD at 20 USD per dose, rising to 2028 (1565, 2638) USD at 50 USD per dose and to 6481 (5364, 7959) USD at 125 USD per dose. CONCLUSIONS Incorporation of new data indicating the disease burden is highly concentrated in the first 6 months of life in two African settings suggests that interventions against RSV disease may be more cost-effective than previously estimated.
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Affiliation(s)
- Mihaly Koltai
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bryan Nyawanda
- Kenya Medical Research Institute (KEMRI) - Center for Global Health Research, Kisumu, Kenya
| | - Joyce Nyiro
- KEMRI-Wellcome Trust Research Programme, KEMRI Centre for Geographical Medicine Research-Coast, Kilifi, Kenya
| | - Patrick K Munywoki
- Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Stefano Tempia
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Xiao Li
- Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Marina Antillon
- Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Joke Bilcke
- Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Stefan Flasche
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - D James Nokes
- KEMRI-Wellcome Trust Research Programme, KEMRI Centre for Geographical Medicine Research-Coast, Kilifi, Kenya
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mark Jit
- Department for Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Nyawanda BO, Murunga N, Otieno NA, Bigogo G, Nyiro JU, Vodicka E, Bulterys M, Nokes DJ, Munywoki PK, Emukule GO. Estimates of the national burden of respiratory syncytial virus in Kenyan children aged under 5 years, 2010-2018. BMC Med 2023; 21:122. [PMID: 37004034 PMCID: PMC10067313 DOI: 10.1186/s12916-023-02787-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is among the leading childhood causes of viral pneumonia worldwide. Establishing RSV-associated morbidity and mortality is important in informing the development, delivery strategies, and evaluation of interventions. METHODS Using data collected during 2010-2018 from base regions (population-based surveillance studies in western Kenya and the Kilifi Health and Demographic Surveillance Study), we estimated age-specific rates of acute respiratory illness (ARI), severe acute respiratory illness (SARI-defined as hospitalization with cough or difficulty breathing with onset within the past 10 days), and SARI-associated deaths. We extrapolated the rates from the base regions to other regions of Kenya, while adjusting for risk factors of ARI and healthcare seeking behavior, and finally applied the proportions of RSV-positive cases identified from various sentinel and study facilities to the rates to obtain regional age-specific rates of RSV-associated outpatient and non-medically attended ARI and hospitalized SARI and severe ARI that was not hospitalized (non-hospitalized SARI). We applied age-specific RSV case fatality ratios to SARI to obtain estimates of RSV-associated in- and out-of-hospital deaths. RESULTS Among Kenyan children aged < 5 years, the estimated annual incidence of outpatient and non-medically attended RSV-associated ARI was 206 (95% credible interval, CI; 186-229) and 226 (95% CI; 204-252) per 1000 children, respectively. The estimated annual rates of hospitalized and non-hospitalized RSV-associated SARI were 349 (95% CI; 303-404) and 1077 (95% CI; 934-1247) per 100,000 children respectively. The estimated annual number of in- and out-of-hospital deaths associated with RSV infection in Kenya were 539 (95% CI; 420-779) and 1921 (95% CI; 1495-2774), respectively. Children aged < 6 months had the highest burden of RSV-associated severe disease: 2075 (95% CI; 1818-2394) and 44 (95% CI 25-71) cases per 100,000 children for hospitalized SARI and in-hospital deaths, respectively. CONCLUSIONS Our findings suggest a substantial disease burden due to RSV infection, particularly among younger children. Prioritizing development and use of maternal vaccines and affordable long-lasting monoclonal antibodies could help reduce this burden.
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Affiliation(s)
- Bryan O Nyawanda
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.
| | - Nickson Murunga
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Nancy A Otieno
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Godfrey Bigogo
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Joyce U Nyiro
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Marc Bulterys
- US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
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21
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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]
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22
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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.
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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.
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Abdulla F, Rahman A, Hossain MM. Prevalence and risk predictors of childhood stunting in Bangladesh. PLoS One 2023; 18:e0279901. [PMID: 36701381 PMCID: PMC9879476 DOI: 10.1371/journal.pone.0279901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 12/16/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The child nutritional status of a country is a potential indicator of socioeconomic development. Child malnutrition is still the leading cause of severe health and welfare problems across Bangladesh. The most prevalent form of child malnutrition, stunting, is a serious public health issue in many low and middle-income countries. This study aimed to investigate the heterogeneous effect of some child, maternal, household, and health-related predictors, along with the quantiles of the conditional distribution of Z-score for height-for-age (HAZ) of under five children in Bangladesh. METHODS AND MATERIALS In this study, a sample of 8,321 children under five years of age was studied from BDHS-2017-18. The chi-square test was mainly used to identify the significant predictors of the HAZ score and sequential quantile regression was used to estimate the heterogeneous effect of the significant predictors at different quantiles of the conditional HAZ distribution. RESULTS The findings revealed that female children were significantly shorter than their male counterparts except at the 75th quantile. It was also discovered that children aged 7-47 months were disadvantaged, but children aged 48-59 months were advantaged in terms of height over children aged 6 months or younger. Moreover, children with a higher birth order had significantly lower HAZ scores than 1st birth order children. In addition, home delivery, the duration of breastfeeding, and the BCG vaccine and vitamin A received status were found to have varied significant negative associations with the HAZ score. As well, seven or fewer antenatal care visits was negatively associated with the HAZ score, but more than seven antenatal care visits was positively associated with the HAZ score. Additionally, children who lived in urban areas and whose mothers were over 18 years and either normal weight or overweight had a significant height advantage. Furthermore, parental secondary or higher education had a significant positive but varied effect across the conditional HAZ distribution, except for the mother's education, at the 50th quantile. Children from wealthier families were also around 0.30 standard deviations (SD) taller than those from the poorest families. Religion also had a significant relationship with the conditional HAZ distribution in favor of non-Muslim children. CONCLUSIONS To enhance children's nutritional levels, intervention measures should be designed considering the estimated heterogeneous effect of the risk factors. This would accelerate the progress towards achieving the targets of Sustainable Development Goals (SDGs) related to child and maternal health in Bangladesh by 2030.
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Affiliation(s)
- Faruq Abdulla
- Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet, Bangladesh
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Md. Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Um S, Vang D, Pin P, Chau D. Trends and determinants of acute respiratory infection symptoms among under-five children in Cambodia: Analysis of 2000 to 2014 Cambodia demographic and health surveys. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001440. [PMID: 37134089 PMCID: PMC10155954 DOI: 10.1371/journal.pgph.0001440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/31/2023] [Indexed: 05/04/2023]
Abstract
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.
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Affiliation(s)
- Samnang Um
- National Institute of Public Health (NIPH), Phnom Penh, Cambodia
| | - Daraden Vang
- National Institute of Public Health (NIPH), Phnom Penh, Cambodia
| | - Punleak Pin
- Doctoral specialization in Pneumology, Faculty of Medicine at the University of Health Sciences (UHS) in Phnom Penh, Phnom Penh, Cambodia
| | - Darapheak Chau
- National Institute of Public Health (NIPH), Phnom Penh, Cambodia
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Vargas Muñoz SM, De Vivero Haddad S, Beltran AM, Bonilla Gonzalez C, Naranjo Vanegas M, Moreno-Lopez S, Rueda-Guevara P, Barrera P, Piñeros JG, Mejía LM, Mesa ML, Restrepo-Gualteros S, Baquero Castañeda OL, Ramírez Varela A. Incidence, etiology, sociodemographic and clinical characterization of acute respiratory failure in pediatric patients at a high-altitude city: A multicenter cohort study. Front Pediatr 2022; 10:1009375. [PMID: 36619524 PMCID: PMC9815757 DOI: 10.3389/fped.2022.1009375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background Acute respiratory failure is a life-threatening medical condition, associated with a variety of conditions and risk factors, including acute respiratory diseases which are a frequent cause of pediatric morbidity and mortality worldwide. In Colombia, the literature related to ARF is scarce. Objective To determine the incidence, causes, and sociodemographic and clinical characteristics of ARF in three hospitals in Bogota, a high-altitude city located in Colombia, during the COVID-19 pandemic. Methods A multicenter prospective cohort study called the FARA cohort was developed between April 2020 - December 2021. Patients older than one month and younger than 18 years with respiratory distress who developed ARF were included. Results 685 patients with respiratory distress were recruited in 21 months. The incidence density of ARF was found to be 41.7 cases per 100 person-year CI 95%, (37.3-47.7). The median age was 4.5 years.. Most of the patients consulted during the first 72 h after the onset of symptoms. Upon admission, 67.2% were potentially unstable. The most frequent pathologies were asthma, bronchiolitis, pneumonia, and sepsis. At admission, 75.6% of the patients required different oxygen delivery systems, 29,5% a low-flow oxygen system, 36,8% a high-flow oxygen system, and 9,28% invasive mechanical ventilation. SARS-COV-2, respiratory syncytial virus, rhinovirus/enterovirus, and adenovirus were the most frequently isolated viral agents. The coinfection cases were scarce. Conclusions This multicenter study, the FARA cohort, developed at 2,600 meters above sea level, shows the first data on incidence, etiology, sociodemographic and clinical characterization in a pediatric population with ARF that also concurs with the COVID-19 pandemic. These results, not only have implications for public health but also contribute to the scientific and epidemiological literature on a disease developed at a high altitude.
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Affiliation(s)
- Sarha M. Vargas Muñoz
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | - Sara De Vivero Haddad
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | - Aldo M. Beltran
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | | | - Melisa Naranjo Vanegas
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Sergio Moreno-Lopez
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Paola Rueda-Guevara
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Pedro Barrera
- Pediatric Intensive Care Unit, Medical Epidemiologist, Fundación Santa Fe de Bogotá University, Bogotá, United States, Colombia
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Prince N, Kim M, Kelly RS, Diray-Arce J, Bønnelykke K, Chawes BL, Huang M, Levy O, Litonjua AA, Stokholm J, Wheelock CE, Bisgaard H, Weiss ST, Lasky-Su JA. Reduced Steroid Metabolites Identify Infection-Prone Children in Two Independent Pre-Birth Cohorts. Metabolites 2022; 12:metabo12111108. [PMID: 36422248 PMCID: PMC9692427 DOI: 10.3390/metabo12111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Recurrent respiratory infections are a leading cause of morbidity and mortality in early life, but there is no broadly accepted means to identify infection-prone children during this highly vulnerable period. In this study, we investigated associations between steroid metabolites and incident respiratory infections in two pre-birth cohorts to identify novel metabolomic signatures of early infection proneness. Children from the Vitamin D Antenatal Asthma Reduction Trial and the Copenhagen Prospective Studies on Asthma in Childhood were included, and profiling was performed on plasma samples collected at ages 1 and 6 years. Both cohorts recorded incidence of lower respiratory infections, upper respiratory infections, ear infections, and colds. Poisson regression analysis assessed the associations between 18 steroid metabolites and the total number of respiratory infections that occurred in offspring during follow-up. We found that steroid metabolites across androgenic, corticosteroid, pregnenolone, and progestin classes were reduced in children that suffered more infections, and these patterns persisted at age 6 years, generally reflecting consistency in direction of effect and significance. Our analysis suggested steroid metabolite measurement may be useful in screening for infection proneness during this critical developmental period. Future studies should clinically evaluate their potential utility as a clinical screening tool.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Min Kim
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joann Diray-Arce
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Bo L. Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Mengna Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children’s Hospital and University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Craig E. Wheelock
- Department of Medical Biochemistry and Biophysics, Division of Physiological Chemistry 2, Karolinska Institute, 17177 Stockholm, Sweden
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, 2820 Gentofte, Denmark
| | - Scott T. Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-617-875-9992
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El-Koofy NM, El-Shabrawi MH, Abd El-alim BA, Zein MM, Badawi NE. Patterns of respiratory tract infections in children under 5 years of age in a low–middle-income country. J Egypt Public Health Assoc 2022; 97:22. [PMCID: PMC9637678 DOI: 10.1186/s42506-022-00118-0] [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: 04/23/2021] [Accepted: 09/22/2022] [Indexed: 11/09/2022]
Abstract
Background Respiratory tract infections (RTIs) are among the most commonly encountered major public health problems, with a higher prevalence of lower RTIs among children and more generally the poor. The present study aimed to describe the pattern of respiratory tract infections in Egyptian children aged under 5 years and explore possible associations between socio-demographics and nutritional status and types of RTIs. Methods Over 6 months beginning in September 2018 (including one winter season), a cross-sectional, observational, epidemiological study was conducted on a sample of patients with upper and lower RTIs diagnosed clinically and/or radiologically in the outpatient clinics at Cairo University Children’s Hospital in Egypt. An interview questionnaire was employed to collect socio-demographic and nutritional data. Heights/lengths and weights were measured and analyzed using the World Health Organization’s (WHO) Anthro Plus [Computer Program]. Patients with pneumonia (n = 28) were compared to 97 healthy children of the same age and sex. Results The total number of children diagnosed with upper and lower respiratory infections was 611. Malnutrition was present in 12.4% of all children with upper and lower RTIs. Lower RTI and malnutrition were substantially more prevalent among children aged under 2 years (p = 0.048 and p < 0.001, respectively). The strongest predictor of lower RTI was a younger age (OR 0.797, CI 0.713–0.89, p < 0.001). Conclusion At our center, approximately one-third of infections in under-fives were lower RTI. Malnutrition was one of the significant risk factors for lower RTI in children below 2 years. The nutritional status of infants and young children should be improved by encouraging exclusive breastfeeding during the first 6 months of life and strengthening the healthcare and nutritional counseling available for vulnerable children, particularly in rural regions.
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Affiliation(s)
- Nehal M. El-Koofy
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mortada H. El-Shabrawi
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Basant A. Abd El-alim
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa M. Zein
- grid.7776.10000 0004 0639 9286Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nora E. Badawi
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
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Sulistyorini L, Li CY, Lutpiatina L, Utama RD, Nurlailah. Gendered Impact of Age, Toilet Facilities, and Cooking Fuels on the Occurrence of Acute Respiratory Infections in Toddlers in Indonesia and the Philippines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14582. [PMID: 36361461 PMCID: PMC9656953 DOI: 10.3390/ijerph192114582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 09/29/2023]
Abstract
INTRODUCTION The purpose of the study was to analyze the risk factors of acute respiratory infections (ARI) in children under five in Indonesia and the Philippines and to implement a primary review of the characteristics of toddlers and their households in both countries. METHODS Data were obtained from the 2017 Demographic and Health Survey (DHS) of Indonesia and the Philippines. The characteristics of children, mothers, and households were analyzed using bivariate and multivariate logistic regression to examine the significant correlations between variables. RESULTS The percentage of children under five with ARI symptoms in 2017 was 1.51% in the Philippines and 4.22% in Indonesia. In Indonesia, males aged under one year had significantly lower occurrences of ARI symptoms (OR 0.54, 95% CI 0.36-0.82). In the Philippines, dirty cooking fuels had a significant effect on increasing the likelihood of ARI in female toddlers (OR 4.01, 95% CI 1.02-15.83). In the Philippines, the unavailability of toilet facilities had a significant effect on increasing the likelihood of ARI in male toddlers (OR 2.67, 95% CI 1.15-6.16). CONCLUSION The comparison of risk factors between male and female toddlers revealed different results in some variables, as follows: children aged under one year, dirty cooking fuels, and unavailable toilet facilities. The role of parents is fundamental in taking care of female toddlers, since they are more exposed to ARI at the age of under one year and are more prone to indoor air pollution from solid cooking fuels.
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Affiliation(s)
- Lilis Sulistyorini
- Department of Environmental Health, Faculty of Public Health, Universitas Airlangga, Jalan Mulyosari, Surabaya 60115, Indonesia
| | - Chung-Yi Li
- Department of Environmental Health, Faculty of Public Health, Universitas Airlangga, Jalan Mulyosari, Surabaya 60115, Indonesia
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Leka Lutpiatina
- Medical Laboratory Technology Poltekkes Kemenkes Banjarmasin, Mistar Cokrokusumo Street 4a, Banjarbaru 70714, Indonesia
| | - Ricko Dharmadi Utama
- Medical Laboratory Technology Poltekkes Kemenkes Banjarmasin, Mistar Cokrokusumo Street 4a, Banjarbaru 70714, Indonesia
| | - Nurlailah
- Medical Laboratory Technology Poltekkes Kemenkes Banjarmasin, Mistar Cokrokusumo Street 4a, Banjarbaru 70714, Indonesia
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Zovi A, Ferrara F, Pasquinucci R, Nava L, Vitiello A, Arrigoni R, Ballini A, Cantore S, Palmirotta R, Di Domenico M, Santacroce L, Boccellino M. Effects of Vitamin D on the Renin–Angiotensin System and Acute Childhood Pneumonia. Antibiotics (Basel) 2022; 11:antibiotics11111545. [PMID: 36358201 PMCID: PMC9686887 DOI: 10.3390/antibiotics11111545] [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: 09/30/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Vitamin D promotes kidney calcium reabsorption and regulates calcium and phosphate metabolism, as well as the intestinal absorption of calcium and phosphorus and bone mineralization events. Vitamin D is also known for its immunomodulatory properties. It has been shown in the literature that the active form of vitamin D, 1,25-dihydroxyvitamin D, performs multiple functions in the adaptive and innate immune system, as well as acting on the endothelial membrane. Recent evidence shows that vitamin D is a negative endocrine modulator of the renin–angiotensin system (RAS), with protection from diseases leading to lung damage, such as pneumonia caused by various pathogens. Vitamin D support associated with the use of antibiotics could be crucial to counteract these infectious diseases.
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Affiliation(s)
- Andrea Zovi
- Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy
| | - Francesco Ferrara
- Pharmaceutical Department, Asl Napoli 3 Sud, Dell’amicizia Street 22, Nola, 80035 Naples, Italy
- Correspondence:
| | - Roberta Pasquinucci
- Pharmaceutical Department, Asl Napoli 3 Sud, Dell’amicizia Street 22, Nola, 80035 Naples, Italy
| | - Livia Nava
- Pharmaceutical Department, Asl Napoli 2 Nord, Frattamaggiore, 80027 Naples, Italy
| | | | - Roberto Arrigoni
- CNR Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies (IBIOM), 70124 Bari, Italy
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
| | - Stefania Cantore
- Independent Researcher, Regional Dental Community Service “Sorriso&Benessere-Ricerca e Clinica”, 70129 Bari, Italy
| | - Raffele Palmirotta
- Interdisciplinary Department of Medicine, School of Medicine, University of Bari “Aldo Moro”, 70129 Bari, Italy
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
| | - Luigi Santacroce
- Interdisciplinary Department of Medicine, School of Medicine, University of Bari “Aldo Moro”, 70129 Bari, Italy
| | - Mariarosaria Boccellino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
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Tesema GA, Worku MG, Alamneh TS, Teshale AB, Yeshaw Y, Alem AZ, Ayalew HG, Liyew AM, Tessema ZT. Understanding the rural-urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis. BMC Public Health 2022; 22:2013. [PMID: 36324089 PMCID: PMC9632025 DOI: 10.1186/s12889-022-14421-0] [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: 06/16/2021] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Acute Respiratory Infections (ARIs) account for more than 6% of the worldwide disease burden in children under the age of five, with the majority occurring in Sub-Saharan Africa. Rural children are more vulnerable to and disproportionately affected by ARIs. As a result, we examined the rural–urban disparity in the prevalence of ARI symptoms and associated factors among children under the age of five in Sub-Saharan Africa. Methods We used the most recent Demographic and Health Survey (DHS) data from 36 countries in Sub-Saharan Africa. The study included 199,130 weighted samples in total. To identify variables associated with ARIs symptoms, a multilevel binary logistic regression model was fitted. The Adjusted Odds Ratio (AOR) with a 95% CI was used to determine the statistical significance and strength of the association. To explain the rural–urban disparity in ARI prevalence, a logit-based multivariate decomposition analysis was used. Results Being female, ever breastfeeding, belonging to a poorer, better wealth status, and having better maternal educational status were significantly associated with lower odds of ARIs among under-five children. Whereas, small size or large size at birth, not taking vitamin A supplementation, being severely underweight, having diarrhea, didn’t have media exposure, never had the vaccination, being aged 36–47 months, and being aged 48–59 months were significantly associated with higher odds of ARIs among under-five children. The multivariate decomposition analysis revealed that the difference in characteristics (endowment) across residences explained 64.7% of the overall rural–urban difference in the prevalence of ARIs, while the difference in the effect of characteristics (change in coefficient) explained 35.3%. Conclusion This study found that rural children were highly affected by ARIs in SSA. To reduce the excess ARIs in rural children, public health interventions aimed at impoverished households, home births, and unvaccinated and malnourished children are crucial.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.,Department of Human Physiology, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Ogunbayo AE, Mogotsi MT, Sondlane H, Nkwadipo KR, Sabiu S, Nyaga MM. Pathogen Profile of Children Hospitalised with Severe Acute Respiratory Infections during COVID-19 Pandemic in the Free State Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610418. [PMID: 36012053 PMCID: PMC9408356 DOI: 10.3390/ijerph191610418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 05/30/2023]
Abstract
Severe acute respiratory infections (SARI) contribute to mortality in children ≤5 years. Their microbiological aetiologies are often unknown and may be exacerbated in light of coronavirus disease 19 (COVID-19). This study reports on respiratory pathogens in children ≤5 years (n = 84) admitted with SARI during and between the second and third waves of COVID-19 infection in South Africa. Nasopharyngeal/oropharyngeal swabs collected were subjected to viral detection using QIAstat-Dx® Respiratory SARS-CoV-2 Panel. The results revealed viral positivity and negativity detection rates of 88% (74/84) and 12% (10/84), respectively. Of the 21 targeted pathogens, human rhinovirus/enterovirus (30%), respiratory syncytial virus (RSV; 26%), and severe acute respiratory syndrome coronavirus 2 (24%) were mostly detected, with other viruses being 20% and a co-infection rate of 64.2% (54/84). Generally, RSV-positive samples had lower Ct values, and fewer viruses were detected during the third wave. Changes in the circulation patterns of respiratory viruses with total absence of influenza virus could be attributed to measures against COVID-19 transmission, which may result in waned immunity, thereby increasing susceptibility to severe infections in the following season. High viral co-infection rate, as detected, may complicate diagnosis. Nonetheless, accurate identification of the pathogens may guide treatment decisions and infection control.
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Affiliation(s)
- Ayodeji E. Ogunbayo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Milton T. Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Hlengiwe Sondlane
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Kelebogile R. Nkwadipo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Saheed Sabiu
- Department of Biotechnology and Food Science, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Martin M. Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
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Saharudin S, Hasanuddin H, Hafid F. Physical Home Sanitation as a Risk Factor for Acute Respiratory Infection in Children under 5 at Labuan Regency, Central Sulawesi. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: The purpose of this study was to determine the risk of physical home sanitation against acute respiratory infections in children under five in Labuan Regency, Central Sulawesi.
Method: This study was done in Labuan District, Donggala Regency, from July 31 to October 28, 2021, as an observational study with a Case Control Study technique. All children under the age of five who have ARI in the Labuan Health Center Work Area, Labuan District, Donggala Regency, are included in the study. The research was approved by the Makassar Ministry of Health Poltekkes Ethics Committee Number 1068/KEPK-PTKMKS/IX/2020 on the basis of its ethical feasibility.
Results: The physical sanitation condition of the house that does not meet the requirements for dust content is 52.9%. Home ventilation 58.6%. The lighting conditions are 47.1% and the humidity of the house is 35.7%. Bivariate analysis showed that there was a relationship between dust levels and the incidence of ARI (p=0.000), ventilation conditions with the incidence of ARI (p=0.000), lighting with the incidence of ARI (p=0.001) and humidity with the incidence of ARI (p=0.005) in children. in Labuan District, Donggala Regency. The incidence of ARI is more common in children aged 0-2 years, and the incidence of ARI has no difference between male and female sexes. Multivariate analysis showed that dust content (p=0.000 CI95% OR=9.56) and ventilation (p=0.001 CI95% OR=6.08) were the main variables that caused ARI in children in Labuan District, Donggala Regency.
Conclusion: The main variables causing ARI in children in Labuan District, Donggala Regency are dust content (OR = 9.56) and ventilation (OR = 6.08)
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Fontalvo-Rivera D, Mazenett E, Àlvarez-Zambrano C, Gómez-Camargo D. Vitamin D3 in acute respiratory infections in patients under five years old (Cartagena de Indias, Colombia). JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background and Aim. Low serum levels of 25-hydroxyvitamin D3 are associated with an increased risk of Acute Respiratory Infection (ARI) that is among the most important causes of morbidity and mortality in children under 5 years old. We describe the clinical behavior of acute respiratory infections in patients under five years ago in one sanitary institution in Colombia after VD3 supplementation.
Material and Methods. A case series was conducted on 38 patients of both genders aged less to 5 years ago was included. Participants were supplied 50,000 units of VD3 orally each month for three months. The number of events, consultations for emergency services, and hospitalization due to acute respiratory infections (ARIs) before and after VD3 administration were described.
Results. The average age of the participants was 25.81 ± 17.50 months. The average clinical ARIs per month was 4.02 (95% CI 3.64-4.40) before VD3 administration. Fewer episodes at the end of the three cycles was found at 2.23/month (95% CI 1.81-2.65; p=0.0230). The average consultations for emergency services during the three months before VD3 administration was 2.15 (95% CI 1.77-2.53). After three months of treatment, the average use of emergency services decreased to 0.52 (95% CI 0.37-0.72; p=0.0180). After the administration of the three doses of VD3, only one patient required hospitalization (2.63%; : 0.026 (IC95% 0.02-0.03; p=0.0368)).
Conclusions. The administration of vitamin D3 could have a benefit in decreasing the number of episodes, emergencies, and hospitalization for ARI in children under five years old. Trial studies are required to determine this potential benefit.
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Chand V, Mohammadnezhad M. Perception of mothers about Acute Respiratory Infections (ARIs) and risk factors affecting children Under 5 Years (U5Ys) in Fiji. J Pediatr Nurs 2022; 65:44-54. [PMID: 35512607 DOI: 10.1016/j.pedn.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To explore the perception of mothers about Acute Respiratory Infections (ARIs) and their risk factors affecting children Under 5 Years (U5Ys) in Fiji. DESIGN This was a qualitative study done in the Integrated Management of Childhood Illness (IMCI) Clinic in Ba Hospital, Fiji. Mothers who had brought in their children with ARIs were selected through a purposive sampling method. A semi-structured open-ended questionnaire was used to guide in-depth interviews. The interviews were transcribed and the thematic analysis was done to look at the themes and sub-themes that emerged. RESULTS A total of 30 mothers were interviewed. There were five themes that were derived from the interviews including the mothers' perception of ARIs; treatment methods; perceived barriers; services provided by IMCI clinic; and recommendations and suggestions. The mothers were familiar with the causes, risk factors and able to recognize severity of ARIs based on the local context. They mostly relied on traditional and home remedies for ARIs. Most mothers preferred injections for treatment for their child. There were many perceived barriers of ARIs prevention such as traditional norms and poor social support. Most mothers stayed in rural areas which caused poor accessibility to health care services. Few mothers had issues with poor attitude and skills of health care workers. CONCLUSIONS There are multiple factors that are barriers in reducing the risks of ARIs. There needs to be policies implemented to support the health of children in the communities as well as social support structures. PRACTICE IMPLICATIONS This study provides a clear picture of the perception of the mothers regarding ARIs in children under five years old. With this information at hand, it is easier to answer the question regarding the perceptions of the mothers of ARIs and the risk factors and design tailored interventions to prevent ARIs among children.
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Affiliation(s)
- Vineet Chand
- School of Public Health and Primary Care, Fiji National University, Suva, Fiji
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Nshimiyimana Y, Zhou Y. Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda. BMC Public Health 2022; 22:1209. [PMID: 35715771 PMCID: PMC9205046 DOI: 10.1186/s12889-022-13532-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Globally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda. Methods A cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years. Results In Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12–1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06–1.53), and farm workers (1.25; 95% CI: 1.11–1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48–59 months (OR: 0.69; 95% CI: 0.60–0.80), breastfed children (OR: 0.83; 95% CI: 0.76–0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69–0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61–0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda. Conclusion Policy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children’s healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13532-y.
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Affiliation(s)
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China.
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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.
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Akyeampong E, Bend JR, Luginaah I, Oscar Yawson D, Jerry Cobbina S, Ato Armah F, Osei Adu M, Kofi Essumang D, Iddi S, Botwe PK, Quansah R. Urinary Pesticide Residual Levels and Acute Respiratory Infections in Children Under 5 Years of Age: Findings From the Offinso North Farm Health Study. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221094418. [PMID: 35521362 PMCID: PMC9067049 DOI: 10.1177/11786302221094418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/23/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Several environmental factors are associated with the risk of acute lower respiratory infections (ALRIs) and upper respiratory infections (URIs) in children under 5 years of age (YOA). Evidence implicating chemical pesticides remains equivocal. There are also no data on this subject in these children in Ghana. This study investigated the association between urinary pesticide residual levels and the risk for ALRIs/URIs in children under 5 YOA. METHODS The participants for this study were from the Offinso North Farm Health Study, a population-based cross-sectional study. Two hundred and fifty four parents/guardians who had answered affirmatively to the question "Has your child ever accompanied you to the farm?" were interviewed on household socio-demographic and environmental factors, being breastfed, child education, age, gender, and respiratory infection. One hundred fifty children were randomly selected to provide the first void urine. RESULTS The proportion of children with ALRI was 22.1% and those with URI was 35.8%. We observed a statistically significant exposure-response relation of p,p'-DDE (tertile) with ALRI (1.7-3.2 µg/L urine: prevalence ratio [PR] = 1.22 [1.05-1.70], ⩾3.2 µg/L urine: 1.50 [1.07-3.53] [P-for trend = .0297]). This observation was in children older than two YOA (P-for trend = .0404). Delta-HCH and beta-HCH (2-levels) were significantly associated with ALRI but not URI. The risk of ALRI increased with deltamethrin levels in an exposure-response manner (2.5-9.5 µg/L urine: 2.10 [1.37-3.24], ⩾9.5 µg/L urine: 4.38 [1.87-10.32] [P-for trend = .0011]) and this was also observed in children older than two YOA. Similar observation was noted for URI. Bifenthrin (>0.5 µg/L urine) was positively associated with ALRI and URI whereas permethrin (⩾1.2 µg/L urine) was not associated only with URI. CONCLUSIONS The present study supports the hypothesis that exposure to chemical pesticides is associated with respiratory infections in children under 5 YOA.
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Affiliation(s)
- Enoch Akyeampong
- Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - John R Bend
- Department of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Isaac Luginaah
- Department of Geography, Western University, London, ON, Canada
| | - David Oscar Yawson
- Centre for Resource Management and Environmental Studies (CERMES), The University of the West Indies, Bridgetown, St. Michael, Barbados
| | - Samuel Jerry Cobbina
- Department of Ecotourism and Environmental Management, Faculty of Natural Resources and Environment, University for Development Studies, Nyankpala, Ghana
| | - Frederick Ato Armah
- Department of Environmental Science, School of Biological Sciences, College of Agriculture & Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Osei Adu
- Department of Crop Science, School of Agriculture, College of Agriculture & Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - David Kofi Essumang
- Environmental Research Group, Department of Chemistry, School of Physical Sciences, University of Cape Coast, Ghana
| | - Samuel Iddi
- Department of Statistics and actuarial science, University of Ghana, Legon, Accra, Ghana
| | - Paul K Botwe
- Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Reginald Quansah
- Biological, Environmental & Occupational Health Sciences, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Prevalence of acute respiratory infections among children in India: Regional inequalities and risk factors. Matern Child Health J 2022; 26:1594-1602. [PMID: 35435580 PMCID: PMC9174316 DOI: 10.1007/s10995-022-03424-3] [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: 11/05/2020] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/02/2022]
Abstract
Abstract
Aim
The high incidence of acute respiratory infection (ARI)-related morbidity and mortality is a major public health concern in developing countries. This study aimed to quantify regional inequalities and the degree of association between childhood ARI and background factors.
Methods
This study utilised information of 238 945 children aged below five years extracted from the Fourth Indian National Family Health Survey conducted in 2015–16. Inter-state and regional inequality in the prevalence of ARI were quantified and presented using a map of India and forest plot. The association of background characteristics and ARI was quantified using bivariate and multivariable binary logistic regression models.
Results
Significant inequalities in the prevalence of childhood ARI were observed across the six regions of India. Considering the children from north-east region as a reference, those from north, central and east regions were 0.68, 1.02 and 0.57 times more likely to suffer from ARI. Comorbidity, sex, age and nutritional status of children were significantly associated with the prevalence of ARI.
Conclusions
ARI remains a significant public health concern among Indian children. The results of this study showed that significant regional disparities in the prevalence of ARI exist in India. This study adds value to the better understanding of inequality patterns and quantifies within- and intra-region inequalities in the prevalence of ARI in India.
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Ghimire P, Gachhadar R, Piya N, Shrestha K, Shrestha K. Prevalence and factors associated with acute respiratory infection among under-five children in selected tertiary hospitals of Kathmandu Valley. PLoS One 2022; 17:e0265933. [PMID: 35390028 PMCID: PMC8989212 DOI: 10.1371/journal.pone.0265933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is responsible for about 30-50 percent of visits to health facilities and for about 20-30 percent of admissions to hospitals in Nepal for children under 5 years old. Incidence of ARI in children among under-five years of age is 344 per 1000 in Nepal. Hence, the study aims to find out the prevalence and factors associated with acute respiratory infection among under-five children. METHODS A cross-sectional study was conducted at Nepal Medical College and Teaching Hospital and International Friendship Children's Hospital (IFCH) in Kathmandu among children of age 2-59 months attending Pediatric OPD. A total of 286 children were selected using the non-probability (convenient) sampling technique. Data were collected using pre-tested semi-structured tool through interview schedule, and descriptive and inferential statistical analyses were used. RESULTS Out of 286 children, more than half of children (60.8%) had Acute Respiratory Infection (ARI). Nearly one-fifth of the children had severe or very severe pneumonia. Acute respiratory infection was significantly associated with religion followed by the family (p = 0.009, OR = 4.59 CI = 1.47-14.36), presence of the child in the kitchen while cooking (p = 0.001, OR = 2.03 CI = 1.17-3.51), and presence of respiratory tract infection in family (p = <0.001 OR = 2.83 CI = 1.59-5.05). CONCLUSION The study concluded that male children are more susceptible to acute respiratory infection than female children. Parents and family members should be aware of the prevention of acute respiratory infection by addressing and minimizing the factors contributing to ARI.
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Affiliation(s)
- Pratima Ghimire
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Rashmi Gachhadar
- Maharajgunj Nursing Campus, Institute of Medicine/Tribhuvan University, Kathmandu, Bagmati Province, Nepal
| | - Nebina Piya
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Kunja Shrestha
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
| | - Kalpana Shrestha
- Department of Nursing, Nepal Medical College Pvt. Ltd.,/Kathmandu University, Kathmandu, Bagmati Province, Nepal
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Kundu S, Kundu S, Banna MHA, Ahinkorah BO, Seidu AA, Okyere J. Prevalence of and factors associated with childhood diarrhoeal disease and acute respiratory infection in Bangladesh: an analysis of a nationwide cross-sectional survey. BMJ Open 2022; 12:e051744. [PMID: 35387807 PMCID: PMC8987759 DOI: 10.1136/bmjopen-2021-051744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of childhood diarrhoeal diseases (CDDs) and acute respiratory infections (ARIs) and also to determine the factors associated with these conditions at the population level in Bangladesh. SETTING The study entailed an analysis of nationally representative cross-sectional secondary data from the most recent Bangladesh Demographic and Health Survey conducted in 2017-2018. PARTICIPANTS A total of 7222 children aged below 5 years for CDDs and 7215 children aged below 5 years for ARIs during the survey from mothers aged between 15 and 49 years were the participants of this study. In the bivariate and multivariable analyses, we used Pearson χ2 test and binary logistic regression, respectively, for both outcomes. RESULTS The overall prevalence of CDD and ARI among children aged below 5 years was found to be 4.91% and 3.03%, respectively. Younger children were more likely to develop both CDDs and ARIs compared with their older counterparts. Children belonging to households classified as poorest and with unimproved floor materials had a higher prevalence of diarrhoea than those from households identified as richest and with improved floor material, respectively. Stunted children had 40.8% higher odds of diarrhoea than normal children. Being male and having mothers aged below 20 years were 48.9% and two times more likely to develop ARI than female counterparts and children of mothers aged 20-34 years, respectively. Children whose mothers had no formal education or had primary and secondary education had higher odds of ARI compared with children of mothers having higher education. CONCLUSION This study found that children aged below 24 months were at higher risk of having CDDs and ARIs. Thus, programmes targeting these groups should be designed and emphasis should be given to those from poorest wealth quintile to reduce CDDs and ARIs.
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Affiliation(s)
- Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
- School of Public Health, Southeast University, Nanjing, China
| | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Abdul-Aziz Seidu
- Faculty of Built and Natural Environment, Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Lutpiatina L, Sulistyorini L, Notobroto HB, Raya RP, Utama RD, Thuraidah A. Multilevel Analysis of Lifestyle and Household Environment for Toddlers With Symptoms of Acute Respiratory Infection (ARI) in Indonesia in 2007, 2012, and 2017. Glob Pediatr Health 2022; 9:2333794X221078700. [PMID: 35342776 PMCID: PMC8941706 DOI: 10.1177/2333794x221078700] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction. The morbidity and mortality rate of Acute
Respiratory Tract Infection (ARI) in children under 5 is relatively high in
Indonesia. Socio-demographic characteristic is considered one of the factors
causing ARI in Indonesia. However, no study analyzed the prevalence of ARI among
toddlers and the differences among the determinant factors in multiple periods.
Thus, this study aimed to analyze the prevalence trends and determinant factors
associated with ARI symptoms in children under 5 in Indonesia in 2007, 2012, and
2017. Methods. This study analyzed cross-sectional survey data
from the Demographic and Health Survey (DHS) in Indonesia during 2007, 2012, and
2017. Bivariate and multivariate analysis with logistic regression was performed
using Stata version 15. The final results were expressed in Adjusted Odds Ratio
(AORs) and 95% Confidence Interval (CI). Results. The findings
showed a progress in prevalence trends with a decrease in the percentage of
children with ARI symptoms from 11.25% (2007), then 5.12% (2012) to 4.22%
(2017). Risk factors for toddlers experiencing ARI symptoms were as follows:
younger maternal age (OR: 1.13, 95% Cl 0.70-1.81 in 2007, OR: 1.72, 95% Cl
1.03-2.88 in 2012 and OR: 0.98, 95% Cl 0.48-1.97 in 2017), smoking habits of
family members (OR: 1.12, 95% Cl 0.85-1.48 in 2012, OR: 1.23, 95% Cl in 2017),
poor drinking water quality (OR: 1.12, 95% Cl 0.85-1.48 in 2012 and OR: 1.23,
95% Cl in 2017), unavailable toilet facilities (OR: 1.27, 95% Cl 1.04-1.56 in
2007, OR: 1.24, 95% Cl 0.95-1.63 in 2012 and OR: 1.28, 95% Cl 0.97-1.68 in
2017). Conclusion. There was a decrease in the prevalence of
ARI symptoms among children in 2007, 2012, and 2017, with no prominent
differences in other related factors. The lifestyle and household environmental
factors such as the use of dirty fuel, the presence of smokers in the household,
the poor quality of drinking water, unavailable toilet facilities in addition to
the maternal age and child age were the determinant factors that must be
prioritized and improved. Family self-awareness should also be enhanced for
better prospects for toddler survival.
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Affiliation(s)
- Leka Lutpiatina
- Universitas Airlangga, Surabaya, Indonesia
- Poltekkes Kemenkes Banjarmasin, Banjarbaru, Indonesia
| | | | | | - Reynie Purnama Raya
- University College London, London
- Aisyiyah Bandung Health Sciences College, Bandung, Indonesia
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Paudel G, Amatya N, Saud B, Wagle S, Shrestha V, Adhikari B. Nasal colonization by potential bacterial pathogens in healthy kindergarten children of Nepal: a prevalence study. Germs 2022; 12:86-98. [PMID: 35601953 PMCID: PMC9113680 DOI: 10.18683/germs.2022.1309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 09/29/2023]
Abstract
INTRODUCTION In low- and middle-income countries including Nepal, respiratory tract infection (RTI) is considered as one of the most prominent public health problems in children. Multiple carriage of respiratory pathogens is common in children, especially in preschoolers as they are easily transmitted through close contact and poor hygienic condition. Thus, this research is based on the study of prevalence, co-existence, associated factors and antibiogram of nasal isolates among healthy preschoolers. METHODS The study was conducted in four randomly selected kindergarten schools (two government run and two private run) of Bhaktapur Municipality. Out of a total 140 students, 136 eligible participants of age group 2-5 years old were involved in the study. Nasal swab was collected for the isolation of five target isolates (Staphylococcus aureus, Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae and Haemophilus parainfluenzae) and their antibiotic resistance determination. RESULTS Of 136 participants involved, 128 (94.5%) were positive for carriage of at least one of the target bacteria. The most common isolate was M. catarrhalis 62.5% (80/128) followed by S. aureus 43.0% (55/128). There was a significant difference in bacterial carriage with respect to type of school (p value<0.05, OR=0.50, CI=0.20-0.90). Regarding bacterial co-existence, the most common co-existence was of S. aureus and M. catarrhalis & S. pneumoniae and M. catarrhalis 48.8%. Multiple logistic regression analysis showed that S. aureus was negatively associated with S. pneumoniae, M. catarrhalis and H. influenzae and S. pneumoniae was positively associated with M. catarrhalis and H. influenzae. Multidrug resistance was seen in 63 isolates (29.4%). CONCLUSIONS Nepalese kindergarten children are at a high risk of respiratory tract infection by multidrug resistant bacteria.
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Affiliation(s)
- Govinda Paudel
- MSc, Assistant Prof, Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences (JFIHS), GPO Box 8322, Kathmandu, Nepal
| | - Neetu Amatya
- BSc, Clinical Laboratory Instructor, Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences (JFIHS), GPO Box 8322, Kathmandu, Nepal
| | - Bhuvan Saud
- MSc, Associate Professor, Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences (JFIHS), GPO Box 8322, Kathmandu, Nepal
| | - Sunita Wagle
- MSc, Laboratory Technician, Dhading Hospital Dhading, Government of Nepal. GPO box 4512, Dhading, Nepal
| | - Vikram Shrestha
- MSc, Assistant Professor, Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences (JFIHS), GPO Box 8322, Kathmandu, Nepal
| | - Bibhav Adhikari
- MM, Lecturer, College of Management, Little Angels’ College of Higher Studies, GPO Box 8322, Hattiban, Lalitpur, Nepal
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Ferreira LH, Silva BG, Giamberardino HI, Pacheco AP, Pereira LA, Genelhoud G, Petterle RR, Raboni SM. The association of breastfeeding and other factors on respiratory virus positivity and severity in hospitalized children. Microbiol Immunol 2022; 66:216-224. [PMID: 35167712 DOI: 10.1111/1348-0421.12969] [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: 11/02/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
Acute respiratory infections (ARIs) are the most prevalent diseases in children under five years old, and viruses are the leading cause. ARIs arise due to numerous factors, including age, contact with siblings or other children in daycare centers, and environmental pollution. Breastfeeding reportedly confers protection against ARIs through bioactive components related to mucous epithelial immunity. This study aimed to evaluate the frequency and severity of viral ARIs in hospitalized children, together with the status and duration of exclusive breastfeeding (EBF) and other associated factors. It comprised an epidemiological surveillance study to investigate respiratory viruses in hospitalized children, in which demographic and clinical data were collected. Overall, 279 patients were included, 190 (68%) had positive viral results, and 132 (47%) were exclusively breastfed. In an adjusted analysis, it was observed that older children, parents' educational level, and the presence of chronic disease were significantly related to EBF for more than six months. No significant differences were observed in viral positivity and disease severity concerning EBF. Whereas EBF status was associated with the positive rate of virus detection, the significance did not remain after adjustment, and it was not considered a protective factor against ARIs. On the other hand, young age and exposure to tobacco were confirmed as risk factors of frequency and severity, respectively. Such confounding factors can impact the analysis and should be considered in future studies. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- L H Ferreira
- Research and Molecular Biology of Microorganisms Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - B G Silva
- Research and Molecular Biology of Microorganisms Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - A P Pacheco
- Epidemiology Division, Hospital Pequeno Príncipe, Curitiba, Brazil
| | - L A Pereira
- Research and Molecular Biology of Microorganisms Laboratory, Universidade Federal do Paraná, Curitiba, Brazil.,Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - G Genelhoud
- Research and Molecular Biology of Microorganisms Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - R R Petterle
- Integrative Medicine, Universidade Federal do Paraná, Curitiba, Brazil
| | - S M Raboni
- Research and Molecular Biology of Microorganisms Laboratory, Universidade Federal do Paraná, Curitiba, Brazil.,Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
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Mir F, Ariff S, Bhura M, Chanar S, Nathwani AA, Jawwad M, Hussain A, Rizvi A, Umer M, Memon Z, Habib A, Soofi SB, Bhutta ZA. Risk Factors for Acute Respiratory Infections in Children Between 0 and 23 Months of Age in a Peri-Urban District in Pakistan: A Matched Case-Control Study. Front Pediatr 2022; 9:704545. [PMID: 35083182 PMCID: PMC8784846 DOI: 10.3389/fped.2021.704545] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan. Methods: A retrospective 1:2 matched case-control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the 2 weeks prior to the survey. Controls were participants without symptoms of ARI, matched based on age in months. Data analysis was conducted using STATA version 15. Univariate and multivariable conditional logistic regression analyses were used to identify factors associated with ARI, and p < 0.05 was considered statistically significant. Results: We identified 1,071 cases of ARI who were matched with 2,142 controls. Multivariable analysis revealed that female gender [odds ratio (OR) 0.78, 95% confidence interval (CI): 0.67-0.91], exclusive breastfeeding (OR 0.81, 95% CI: 0.69-0.97), and comorbidity with diarrhea (OR: 1.64, 95% CI: 1.40-1.91) were significantly associated with ARI. Conclusion: Pakistan continues to progress toward reducing childhood mortality, particularly ARI-related deaths, for which it bears a great burden. This study identifies risk factors such as the male gender, breastfeeding, and comorbidities with diarrhea, which could open grounds for further programmatic implications in targeting a multifaceted approach to reducing incidences of ARI in rural areas of the country.
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Affiliation(s)
| | - Shabina Ariff
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Abayneh M, Muleta D, Simieneh A, Duguma T, Asnake M, Teressa M, Endalkachew B, Toru M. Acute respiratory infections (ARIs) and factors associated with their poor clinical outcome among children under-five years attending pediatric wards of public hospital in Southwest district of Ethiopia: A prospective observational cohort study. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221139266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
This study was designed to assess the prevalence and factors associated with poor clinical outcome of acute respiratory infections (ARIs) among children less than five years of age at Mizan-Tepi university teaching public hospital in southwest district of Ethiopia. A prospective observational cohort study design was conducted from 01 June to August 30, 2020. Data related to socio-demographics, child nutritional status, clinical and environmental characteristics of patients were collected with structured questionnaire. Follow-up data were gathered from patient’s medical records using standard data collection tool. The data were analyzed using SPSS versions 25.0. In this study, 305 children of age less than five years were included. Of these, 124 (40.7%) of children were diagnosed with ARIs, of which 66 (53.2%) were female and 69 (55.6%) were age of 24–59 months. Of children diagnosed with ARIs, 21 (16.9%) were ended with poor clinical outcomes after completion of their treatment. In the multivariate analysis, age of children and presence of any other disease conditions (OR = 0.331; 95% CI: 0.123– 0.880; p= 0.024), exposure to indoor air pollution (OR = 0.344; 95% CI: 0.128– 0.925; p= 0.030), malnutrition (OR = 0.175; 95% CI: 0.058– 0.523; p= 0.002) and end point pneumonia (OR = 0.305; 95% CI: 0.113–0.821; p= 0.015) were found to be independent factors for poor outcome of under-five children with ARIs. Our findings highlight that timely detection, proper management and treatments as well as addressing other contributing factors are essentials in order to reduce prevalence and poor clinical outcomes of under five children with ARIs.
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Affiliation(s)
- Mengistu Abayneh
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dassaleng Muleta
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Asnake Simieneh
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Tadesse Duguma
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Molla Asnake
- College of Medicine and Health Science, Department of Medicine, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Murtii Teressa
- College of Medicine and Health Science, Department of Medicine, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Biruk Endalkachew
- College of Medicine and Health Science, Department of Biomedical Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Milkiyas Toru
- College of Health Science, Department of Medical Laboratory Sciences, Debre Markos University, Debre Marqos, Ethiopia
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Cvijić S, Mirković D, Krajišnik D. How to choose an appropriate drug dosage form for the treatment of respiratory infections in children: Facts and tips. ARHIV ZA FARMACIJU 2022. [DOI: 10.5937/arhfarm72-37643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The treatment of respiratory infections in children requires special attention, since the paediatric population has rather specific characteristics and consists of heterogenous subgroups. In this context, the choice of a suitable drug dosage form is of particular importance, depending on the active substance properties, along with the age and general condition of a paediatric patient. The most commonly used pharmaceutical products for respiratory infections in children include oral, parenteral and inhalation dosage forms, although a large number of drugs are not available in a suitable dosage form and/or strength for paediatric age, leading to the frequent use of unauthorized drugs (i.e., unlicensed use). Other important issues that should be considered when choosing the appropriate paediatric dosage form and/or compounding procedure are related to the careful considerations of the pharmaceutical product composition (safety of excipients) and the choice of administration/dosing device in relation to a child's age. This paper provides an overview of paediatric dosage forms used in the treatment of respiratory infections in children, their benefits and limitations. The review includes examples of various pharmaceutical products, along with the considerations regarding administration/dosing devices. Specific characteristics of paediatric populations affecting the decision on the choice of age-appropriate paediatric formulation are also addressed.
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Merera AM. Determinants of acute respiratory infection among under-five children in rural Ethiopia. BMC Infect Dis 2021; 21:1203. [PMID: 34847859 PMCID: PMC8631694 DOI: 10.1186/s12879-021-06864-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia. METHODS A cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection. RESULTS The total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631-2.887), mother's no education (AOR = 2.050,95% CI: 1.017-4.133), mother's Primary education (AOR = 2.387, 95% CI:1.176-4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578-2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210-0.314), mothers not working (AOR = 0.773, 95% CI:0.630-0.948), not stunted (AOR = 0.663, 95% CI: 0.552-0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395-2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI. CONCLUSIONS Childhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.
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Affiliation(s)
- Amanuel Mengistu Merera
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
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Fathmawati F, Rauf S, Indraswari BW. Factors related with the incidence of acute respiratory infections in toddlers in Sleman, Yogyakarta, Indonesia: Evidence from the Sleman Health and Demographic Surveillance System. PLoS One 2021; 16:e0257881. [PMID: 34559864 PMCID: PMC8462707 DOI: 10.1371/journal.pone.0257881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 09/14/2021] [Indexed: 12/04/2022] Open
Abstract
Various factors associated with Acute Respiratory Infections (ARI) in toddlers have been widely observed, but there are no studies using data from the Sleman Health and Demographic Surveillance System (HDSS). This study aimed to determine the factors associated with ARI in children under five in Sleman, Yogyakarta, Indonesia. This research was an observational analytic study with a cross-sectional design, using secondary data from the Sleman HDSS. Data of 463 children under five who met the inclusion and exclusion criteria were used in this study. Inclusion criteria were toddlers who have complete observed variable data. The variables observed were the characteristics of children under five, the attributes of the mother, the physical condition of the house, the use of mosquito coils, sanitation facilities, and sources of drinking water. The exclusion criteria were toddlers with pulmonary tuberculosis in the past year. Data analysis used chi-squared tests for bivariate analysis and multivariate logistic regression analysis. The results showed that working mothers had a greater risk of ARI under five children with OR 1.46 (95% CI = 1.01–2.11), and groundwater as a water source was a protective factor against the occurrence of ARI in toddlers with OR 0.46 (95% CI = 0.26–0.81). After a logistic regression analysis was performed, only the drinking water source variable had a statistically significant relationship with the incidence of ARI in children under five with OR = 0.47 (95% CI = 0.268–0.827). Research on the relationship between water quality and the incidence of ARI in children under five is needed to follow up on these findings.
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Affiliation(s)
- Fathmawati Fathmawati
- Department of Environmental Health, Politeknik Kesehatan Kemenkes Pontianak, Pontianak, Indonesia
- * E-mail: ,
| | - Saidah Rauf
- Masohi Nursing Study Program, Politeknik Kesehatan Kemenkes Maluku, Ambon, Indonesia
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Woolley KE, Bartington SE, Kabera T, Lao XQ, Pope FD, Greenfield SM, Price MJ, Thomas GN. Comparison of Respiratory Health Impacts Associated with Wood and Charcoal Biomass Fuels: A Population-Based Analysis of 475,000 Children from 30 Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179305. [PMID: 34501907 PMCID: PMC8431364 DOI: 10.3390/ijerph18179305] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The World Health Organisation reported that 45% of global acute respiratory infection (ARI) deaths in children under five years are attributable to household air pollution, which has been recognised to be strongly associated with solid biomass fuel usage in domestic settings. The introduction of legislative restrictions for charcoal production or purchase can result in unintended consequences, such as reversion to more polluting biomass fuels such as wood; which may increase health and environmental harms. However, there remains a paucity of evidence concerning the relative health risks between wood and charcoal. This study compares the risk of respiratory symptoms, ARI, and severe ARI among children aged under five years living in wood and charcoal fuel households across 30 low- and middle-income countries. METHODS Data from children (N = 475,089) residing in wood or charcoal cooking households were extracted from multiple population-based Demographic and Health Survey databases (DHS) (N = 30 countries). Outcome measures were obtained from a maternal report of respiratory symptoms (cough, shortness of breath and fever) occurring in the two weeks prior to the survey date, generating a composite measure of ARI (cough and shortness of breath) and severe ARI (cough, shortness of breath and fever). Multivariable logistic regression analyses were implemented, with adjustment at individual, household, regional and country level for relevant demographic, social, and health-related confounding factors. RESULTS Increased odds ratios of fever (AOR: 1.07; 95% CI: 1.02-1.12) were observed among children living in wood cooking households compared to the use of charcoal. However, no association was observed with shortness of breath (AOR: 1.03; 95% CI: 0.96-1.10), cough (AOR: 0.99; 95% CI: 0.95-1.04), ARI (AOR: 1.03; 95% CI: 0.96-1.11) or severe ARI (AOR: 1.07; 95% CI: 0.99-1.17). Within rural areas, only shortness of breath was observed to be associated with wood cooking (AOR: 1.08; 95% CI: 1.01-1.15). However, an increased odds ratio of ARI was observed in Asian (AOR: 1.25; 95% CI: 1.04-1.51) and East African countries (AOR: 1.11; 95% CI: 1.01-1.22) only. CONCLUSION Our population-based observational data indicates that in Asia and East Africa there is a greater risk of ARI among children aged under 5 years living in wood compared to charcoal cooking households. These findings have major implications for understanding the existing health impacts of wood-based biomass fuel usage and may be of relevance to settings where charcoal fuel restrictions are under consideration.
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Affiliation(s)
- Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (S.M.G.); (M.J.P.); (G.N.T.)
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (S.M.G.); (M.J.P.); (G.N.T.)
- Correspondence:
| | - Telesphore Kabera
- College of Science and Technology, University of Rwanda, Avenue de l’Armee, Kigali P.O. Box 3900, Rwanda;
| | - Xiang-Qian Lao
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong;
| | - Francis D. Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
| | - Sheila M. Greenfield
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (S.M.G.); (M.J.P.); (G.N.T.)
| | - Malcolm J. Price
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (S.M.G.); (M.J.P.); (G.N.T.)
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham B15 2TT, UK
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (K.E.W.); (S.M.G.); (M.J.P.); (G.N.T.)
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Windi R, Efendi F, Qona'ah A, Adnani QES, Ramadhan K, Almutairi WM. Determinants of Acute Respiratory Infection Among Children Under-Five Years in Indonesia. J Pediatr Nurs 2021; 60:e54-e59. [PMID: 33744057 DOI: 10.1016/j.pedn.2021.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Acute respiratory infection (ARI) among children under five years has been identified as a risk factor for child morbidity, leading to child mortality in Indonesia. Many factors may cause ARI; however, determinants associated with ARI remain unclear in Indonesia. OBJECTIVES This study sought to analyze the determinants of ARI among children aged under five years in Indonesia. METHODS This study was cross-sectional and utilized secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 15,993 children under five years old were selected as respondents. Chi-squared test and binary logistic regression were used to examine the determinants of ARI among children under five years in Indonesia. RESULTS Children aged 1 year [Odds Ratio (OR) = 1.43, 95% CI = 1.04-1.97], children aged 2 years [OR = 1.54, 95% CI = 1.12-2.11], mother's occupation [OR = 1.24, 95% CI = 1.01-2.154], poorest wealth index [OR = 1.91, 95% CI = 1.26-2.89], poor [OR = 1.50, 95% CI = 1.01-2.21], region of residence: Western Indonesia [OR = 1.96, 95% CI = 1.28-2.00], Middle of Indonesia [OR = 2.19, 95% CI = 1.44-3.33] were significantly associated with ARI among children under five years in Indonesia. CONCLUSIONS This study revealed that the determinants of ARI among children under five years in Indonesia remain related to the socio-demographic aspect. This research highlighted that the family's and the living area's wealth index remains essential in improving children's health outcomes. PRACTICE IMPLICATIONS Our findings support increasing awareness of the low-income family through adequate information and health promotion. Advancing the feasibility, accessibility, and affordability of health information and health services across all Indonesian regions should be strengthened.
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Affiliation(s)
- Restu Windi
- Faculty of Nursing, Universitas Airlangga, Indonesia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Indonesia.
| | - Arina Qona'ah
- Faculty of Nursing, Universitas Airlangga, Indonesia.
| | | | - Kadar Ramadhan
- Department of Midwifery, Poltekkes Kemekes Palu, Indonesia
| | - Wedad M Almutairi
- Department of Maternity and Childhood, Faculty of Nursing, King Abdulaziz University, Saudi Arabia.
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