Respiratory symptoms and associated risk factors among under-five children in Northwest Ethiopia: community based cross-sectional study

Abstract

Introduction: Acute respiratory infections are still a major public health problem resulting in morbidity and mortality among under-five children. This study aims to assess the extent of respiratory symptoms and associated risk factors among under-five children in Gondar city, Northwest Ethiopia. 
Methods: A community-based cross-sectional study was carried out from February to June 2019. From 792 study participants, data were collected via face to face interviews by using a semi-structured pre-tested questionnaire. Data were entered in Epi Info version 7 then exported to Stata 14.00 for analysis. Binary (Bivariable and Multivariable) logistic regression analysis was used to test the association of explanatory and outcome variables. Variables with p<0.05 were considered as significantly associated with the outcome variable.
Results: The prevalence of respiratory symptoms among under-five children was 37.5% at [95% (CI: 34.3-41)]. Uterine irritability during pregnancy [AOR = 1.89 at 95% CI: (1.11-3.23)], physical exercise during pregnancy [AOR = 0.60 at 95% CI: (0.41-0.89)], using wood and coal for heating [AOR = 2.42 at 95% CI: (1.65-3.53)], cockroaches infestation [AOR = 1.95 at 95% CI: (1.36 – 2.90)], presence of new carpets [AOR = 2.38 at 95% CI: (1.33-4.29)], damp stain [AOR = 2.45 at 95% CI: (1.02-2.69)], opening windows during cooking [AOR = 0.58 at 95% CI: (0.36 - 0 .93)], living less than 100 m heavy traffic [AOR = 1.94 at 95% CI: (1.16-3.27)], and living less than 100 m (unpaved roads/streets) [AOR= 2.89 at 95% CI: (1.89-4.55)] were significantly associated with respiratory symptoms.
Conclusion: The prevalence of respiratory symptoms among under-five children was relatively high in the study area. Personal and environmental characteristics influencing symptom occurrence were identified. Respiratory symptoms will be minimized by reducing exposure to indoor and outdoor air pollution and enhancing housing quality.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H. Global estimate of the incidence of clinical pneumonia among children under five years of age. Bull World Health Organ 2004;82:895-903.

Leowski J. Mortality from acute respiratory infections in children under 5 years of age: global estimates. World Health Stat Q 1986;39:138-44.

Adesanya OA, Darboe A, Rojas BM, Abiodun DE, Beogo I. Factors contributing to regional inequalities in acute respiratory infections symptoms among under-five children in Nigeria: a decomposition analysis. Int J Equity Health 2017;16:140. DOI: https://doi.org/10.1186/s12939-017-0626-7

Accinelli RA, Leon‐Abarca JA, Gozal D. Ecological study on solid fuel use and pneumonia in young children: A worldwide association. Respirology 2017;22:149-56. DOI: https://doi.org/10.1111/resp.12865

Ramani VK, Pattankar J, Puttahonnappa SK. Acute respiratory infections among under-five age group children at urban slums of gulbarga city: A longitudinal study. J Clin Diagn Res: 2016;10:LC08. DOI: https://doi.org/10.7860/JCDR/2016/15509.7779

Seidu A-A, Dickson KS, Ahinkorah BO, Amu H, Darteh EKM, Kumi-Kyereme A. Prevalence and determinants of acute lower respiratory infections among children under-five years in sub–Saharan Africa: evidence from demographic and health surveys. SSM Popul Health 2019;8:100443. DOI: https://doi.org/10.1016/j.ssmph.2019.100443

Nandasena S, Wickremasinghe AR, Sathiakumar N. Indoor air pollution and respiratory health of children in the developing world. World J Clin Pediatr 2013;2:6. DOI: https://doi.org/10.5409/wjcp.v2.i2.6

Akinyemi JO, Morakinyo OM. Household environment and symptoms of childhood acute respiratory tract infections in Nigeria, 2003–2013: a decade of progress and stagnation. BMC Infect Dis 2018;18:296. DOI: https://doi.org/10.1186/s12879-018-3207-5

Quintussi M, Van de Poel E, Panda P, Rutten F. Economic consequences of ill-health for households in northern rural India. BMC Health Serv Res 2015;15:179. DOI: https://doi.org/10.1186/s12913-015-0833-0

Miller NP, Amouzou A, Tafesse M, Hazel E, Legesse H, Degefie T, et al. Integrated community case management of childhood illness in Ethiopia: implementation strength and quality of care. Am J Trop Med Hyg 2014;91:424-34. DOI: https://doi.org/10.4269/ajtmh.13-0751

Kolawole O, Oguntoye M, Dam T, Chunara R. Etiology of respiratory tract infections in the community and clinic in Ilorin, Nigeria. BMC Rese Notes 2017;10:712. DOI: https://doi.org/10.1186/s13104-017-3063-1

Ujunwa F, Ezeonu C. Risk Factors for acute respiratory tract infections in under‑five children in Enugu Southeast Nigeria. Ann Med Health Sci Res 2014;4:95-9. DOI: https://doi.org/10.4103/2141-9248.126610

Arifin WN. Introduction to sample size calculation. Educ Med J 2013;5:130. DOI: https://doi.org/10.5959/eimj.v5i2.130

Woldeamanuel BT, Gebreyesus HL. Prevalence and risk factors for chest-related symptoms of acute respiratory tract infections among under five children: Case of Ethiopia. J Tre Bio Res 2019;2:1-7.

Sharma D, Kuppusamy K, Bhoorasamy A. Prevalence of acute respiratory infections (ARI) and their determinants in under five children in urban and rural areas of Kancheepuram district, South India. Ann Trop Med Public Health 2013;6:513. DOI: https://doi.org/10.4103/1755-6783.133700

Yousef FM, Hamed AF. Prevalence of acute respiratory infection and related risk factors in school-age children in Egypt: a cross-sectional study. Int J Curr Res Med Sci 2016;2:50-8.

Hasan M, Tasfina S, Haque SR, Saif-Ur-Rahman K, Khalequzzaman M, Bari W, et al. Association of biomass fuel smoke with respiratory symptoms among children under 5 years of age in urban areas: results from Bangladesh Urban Health Survey, 2013. Environ Health Prev Med 2019;24:65. DOI: https://doi.org/10.1186/s12199-019-0827-3

Benefits Bridge. United Concordia [Internet]. 6 common respiratory disease symptoms to be aware of. 2019. Accessed on: 8 February 2019. Available from: https://benefitsbridge.unitedconcordia.com/6-common-respiratory-disease-symptoms-to-be-aware-of/

Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989;129:125-37. DOI: https://doi.org/10.1093/oxfordjournals.aje.a115101

Dagne H, Andualem Z, Dagnew B, Taddese AA. Acute respiratory infection and its associated factors among children under-five years attending pediatrics ward at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: institution-based cross-sectional study. BMC Pediatr 2020;20:1-7. DOI: https://doi.org/10.1186/s12887-020-1997-2

Savitha AK, Gopalakrishnan S. Determinants of acute respiratory infections among under five children in a rural area of Tamil Nadu, India. J Family Med Prim Care 2018;7:1268-73. DOI: https://doi.org/10.4103/jfmpc.jfmpc_131_18

Maharjan PL, Sharma Y. Prevalence and determinants of acute respiratory infection among children under age five in Gorkha Municipality, Gorkha. Glob J Pharmaceu Sci 2017;2:555588.

Nagdyman N, Kömen W, Ko HK, Müller C, Obladen M. Early biochemical indicators of hypoxic-ischemic encephalopathy after birth asphyxia. Pediatr Res 2001;49:502-6. DOI: https://doi.org/10.1203/00006450-200104000-00011

Moyer C, Reoyo OR, May L. The influence of prenatal exercise on offspring health: A review. Clin Med Insights Womens Health 2016;9:37-42. DOI: https://doi.org/10.4137/CMWH.S34670

The New Work Times [Internet]. Exercise during pregnancy may have lasting benefits for babies (G. Reynolds). 2019. Accessed on: 19 August 2019. Available from: https://www.nytimes.com/2019/08/07/well/move/exercise-during-pregnancy-may-have-lasting-benefits-for-babies.html

National Center for Biotechnology Information (US). Genes and Disease [Internet]. 1998. Accessed on: 15 March 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK22167/

Triche EW, Belanger K, Beckett W, Bracken MB, Holford TR, Gent J, et al. Infant respiratory symptoms associated with indoor heating sources. Am J Respir Crit Care Med 2002;166:1105-11. DOI: https://doi.org/10.1164/rccm.2202014

WHO. Residential heating with wood and coal: health impacts and policy options in Europe and North America. 2015. Avilable from: https://www.euro.who.int/__data/assets/pdf_file/0009/271836/ResidentialHeatingWoodCoalHealthImpacts.pdf

Riddervold I, Bønløkke J, Olin A-C, Grønborg T, Schlünssen V, Louring-Skogstrand K, et al. Effects of wood smoke particles from wood-burning stoves on the respiratory health of atopic humans. ParticFibre Toxicol 2012;9:12. DOI: https://doi.org/10.1186/1743-8977-9-12

Do DC, Zhao Y, Gao P. Cockroach allergen exposure and risk of asthma. Allergy 2016;71:463-74. DOI: https://doi.org/10.1111/all.12827

Gold DR, Burge HA, Carey V, Milton DK, Platts-Mills T, Weiss ST. Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Critic Care Med 1999;160:227-36. DOI: https://doi.org/10.1164/ajrccm.160.1.9807104

Moges F, Eshetie S, Endris M, Huruy K, Muluye D, Feleke T, et al. Cockroaches as a source of high bacterial pathogens with multidrug resistant strains in Gondar town, Ethiopia. BioMed Res Int 2016;2016:2825056. DOI: https://doi.org/10.1155/2016/2825056

MedicineNet [Internet]. New carpet allergy. 2017. Accessed on: 15 March 2020. Available from: https://www.medicinenet.com/script/main/art.asp?articlekey=21803

WHO. Report of the International Conference on Environmental threats to the health of children: Hazards and vulnerability, Bangkok, 3-7 March 2002. Genwva: World Health Organization; 2002.

Garrett MH, Rayment PR, Hooper MA, Abramson MJ, Hooper BM. Indoor airborne fungal spores, house dampness and associations with environmental factors and respiratory health in children. Clin Experim Allergy 1998;28:459-67. DOI: https://doi.org/10.1046/j.1365-2222.1998.00255.x

Li C-S, Hsu L-Y. Home dampness and childhood respiratory symptoms in a subtropical climate. Arch Environm Health 1996;51:42-6. DOI: https://doi.org/10.1080/00039896.1996.9935992

Abuka T. Prevalence of pneumonia and associated factors among children 2-59 months old in Wondo Genet district, Sidama zone, SNNPR, Ethiopia. Curr Pediatr Res 2017;21.

Fekadu GA, Terefe MW, Alemie GA. Prevalence of pneumonia among under-five children in Este Town and the surrounding rural Kebeles, Northwest Ethiopia: a community based cross sectional study. Sci J Public Health 2014;2:150-5. DOI: https://doi.org/10.11648/j.sjph.20140203.12

Rumchev K, Spickett J, Brown H, Mkhweli B. Indoor air pollution from biomass combustion and respiratory symptoms of women and children in a Zimbabwean village. Indoor Air 2008;17:468-74.

Shah SD, Cocker DR, Miller JW, Norbeck JM. Emission rates of particulate matter and elemental and organic carbon from in-use diesel engines. Environ Sci Technol 2004;38:2544-50. DOI: https://doi.org/10.1021/es0350583

Tong H, Hung W, Cheung C. On-road motor vehicle emissions and fuel consumption in urban driving conditions. J Air Waste Manage Assoc 2000;50:543-54. DOI: https://doi.org/10.1080/10473289.2000.10464041

Ryan PH, LeMasters G, Biagini J, Bernstein D, Grinshpun SA, Shukla R, et al. Is it traffic type, volume, or distance? Wheezing in infants living near truck and bus traffic. J Allergy Clin Immunol 2005;116:279-84. DOI: https://doi.org/10.1016/j.jaci.2005.05.014

Garshick E, Laden F, Hart JE, Caron A. Residence near a major road and respiratory symptoms in U.S. veterans. Epidemiology 2003;14:728-36. DOI: https://doi.org/10.1097/01.ede.0000082045.50073.66

Khan RK, Strand MA. Road dust and its effect on human health: a literature review. Epidemiol Health 2018;40:e2018013. DOI: https://doi.org/10.4178/epih.e2018013

Sarmiento-Suárez R, Medina K. Prevalence of respiratory symptoms associated with outdoor and indoor air pollution in Bogota 2012. WIT Trans Built Environ 2013;134:713-24. DOI: https://doi.org/10.2495/SAFE130641

Published
2020-10-02
Info
Issue
Section
Original Research Articles
Keywords:
Air pollution, respiratory symptoms, cross-sectional study, under-five children, Ethiopia
Statistics
  • Abstract views: 972

  • PDF: 133
  • HTML: 0
How to Cite
Andualem, Z., Taddese, A. A., Azene, Z. N., Azanaw, J., & Dagne, H. (2020). Respiratory symptoms and associated risk factors among under-five children in Northwest Ethiopia: community based cross-sectional study. Multidisciplinary Respiratory Medicine, 15. https://doi.org/10.4081/mrm.2020.685