Social, economic and environmental risk factors for acute lower respiratory infections among children under five years of age in Rwanda
Identifieur interne : 000D95 ( Main/Exploration ); précédent : 000D94; suivant : 000D96Social, economic and environmental risk factors for acute lower respiratory infections among children under five years of age in Rwanda
Auteurs : Jean-Modeste Harerimana [Rwanda] ; Leatitia Nyirazinyoye [Rwanda] ; Dana R. Thomson [Rwanda, États-Unis] ; Joseph Ntaganira [Rwanda]Source :
- Archives of Public Health [ 0778-7367 ] ; 2016.
Abstract
In low and middle-income countries, acute lower respiratory illness is responsible for roughly 1 in every 5 child deaths. Rwanda has made major health system improvements including its community health worker systems, and it is one of the few countries in Africa to meet the 2015 Millennium Development Goals, although prevalence of acute lower respiratory infections (4 %) is similar to other countries in sub-Saharan Africa. This study aims to assess social, economic, and environmental factors associated with acute lower respiratory infections among children under five to inform potential further improvements in the health system.
This is a cross-sectional study using data collected from women interviewed in the 2010 DHS about 8,484 surviving children under five. Based on a literature review, we defined 19 health, social, economic, and environmental potential risk factors, tested bivariate associations with acute lower respiratory infections, and advanced variables significant at the 0.1 confidence level to logistic regression modelling. We used manual backward stepwise regression to arrive at a final model. All analyses were performed in Stata v13 and adjusted for complex sample design.
The following factors were independently associated with acute lower respiratory infections: child’s age, anemia level, and receipt of Vitamin A; household toilet type and residence, and season of interview. In multivariate regression, being in the bottom ten percent of households (OR: 1.27, 95 % CI: 0.85-1.87) or being interviewed during the rainy season (OR: 1.61, 95 % CI: 1.24-2.09) was positively associated with acute lower respiratory infections, while urban residence (OR: 0.58, 95 % CI: 0.38-0.88) and being age 24–59 months versus 0–11 months (OR: 0.53, 95 % CI: 0.40-0.69) was negatively associated with acute lower respiratory infections.
Potential areas for intervention including community campaigns about acute lower respiratory infections symptoms and treatment, and continued poverty reduction through rural electrification and modern stove distribution which may reduce use of dirty cooking fuel, improve living conditions, and reduce barriers to health care.
Url:
DOI: 10.1186/s13690-016-0132-1
PubMed: 27217955
PubMed Central: 4876567
Affiliations:
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Thomson</name><affiliation wicri:level="1"><nlm:aff id="Aff1">University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda</nlm:aff><country xml:lang="fr">Rwanda</country><wicri:regionArea>University of Rwanda College of Medicine and Health Sciences, Kigali</wicri:regionArea><wicri:noRegion>Kigali</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health and Social Medicine, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Ntaganira, Joseph" sort="Ntaganira, Joseph" uniqKey="Ntaganira J" first="Joseph" last="Ntaganira">Joseph Ntaganira</name><affiliation wicri:level="1"><nlm:aff id="Aff1">University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda</nlm:aff><country xml:lang="fr">Rwanda</country><wicri:regionArea>University of Rwanda College of Medicine and Health Sciences, Kigali</wicri:regionArea><wicri:noRegion>Kigali</wicri:noRegion></affiliation></author></analytic><series><title level="j">Archives of Public Health</title><idno type="ISSN">0778-7367</idno><idno type="eISSN">2049-3258</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>In low and middle-income countries, acute lower respiratory illness is responsible for roughly 1 in every 5 child deaths. Rwanda has made major health system improvements including its community health worker systems, and it is one of the few countries in Africa to meet the 2015 Millennium Development Goals, although prevalence of acute lower respiratory infections (4 %) is similar to other countries in sub-Saharan Africa. This study aims to assess social, economic, and environmental factors associated with acute lower respiratory infections among children under five to inform potential further improvements in the health system.</p></sec><sec><title>Methods</title><p>This is a cross-sectional study using data collected from women interviewed in the 2010 DHS about 8,484 surviving children under five. Based on a literature review, we defined 19 health, social, economic, and environmental potential risk factors, tested bivariate associations with acute lower respiratory infections, and advanced variables significant at the 0.1 confidence level to logistic regression modelling. We used manual backward stepwise regression to arrive at a final model. All analyses were performed in Stata v13 and adjusted for complex sample design.</p></sec><sec><title>Results</title><p>The following factors were independently associated with acute lower respiratory infections: child’s age, anemia level, and receipt of Vitamin A; household toilet type and residence, and season of interview. In multivariate regression, being in the bottom ten percent of households (OR: 1.27, 95 % CI: 0.85-1.87) or being interviewed during the rainy season (OR: 1.61, 95 % CI: 1.24-2.09) was positively associated with acute lower respiratory infections, while urban residence (OR: 0.58, 95 % CI: 0.38-0.88) and being age 24–59 months versus 0–11 months (OR: 0.53, 95 % CI: 0.40-0.69) was negatively associated with acute lower respiratory infections.</p></sec><sec><title>Conclusion</title><p>Potential areas for intervention including community campaigns about acute lower respiratory infections symptoms and treatment, and continued poverty reduction through rural electrification and modern stove distribution which may reduce use of dirty cooking fuel, improve living conditions, and reduce barriers to health care.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zar, Hj" uniqKey="Zar H">HJ Zar</name></author><author><name 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Campbell</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Rwanda</li><li>États-Unis</li></country><region><li>Massachusetts</li></region><settlement><li>Boston</li></settlement></list><tree><country name="Rwanda"><noRegion><name sortKey="Harerimana, Jean Modeste" sort="Harerimana, Jean Modeste" uniqKey="Harerimana J" first="Jean-Modeste" last="Harerimana">Jean-Modeste Harerimana</name></noRegion><name sortKey="Ntaganira, Joseph" sort="Ntaganira, Joseph" uniqKey="Ntaganira J" first="Joseph" last="Ntaganira">Joseph Ntaganira</name><name sortKey="Nyirazinyoye, Leatitia" sort="Nyirazinyoye, Leatitia" uniqKey="Nyirazinyoye L" first="Leatitia" last="Nyirazinyoye">Leatitia Nyirazinyoye</name><name sortKey="Thomson, Dana R" sort="Thomson, Dana R" uniqKey="Thomson D" first="Dana R." last="Thomson">Dana R. Thomson</name></country><country name="États-Unis"><region name="Massachusetts"><name sortKey="Thomson, Dana R" sort="Thomson, Dana R" uniqKey="Thomson D" first="Dana R." last="Thomson">Dana R. Thomson</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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