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Risk factors for severe acute lower respiratory tract infection in under-five children
1Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India.
Insights
Preventable factors like lack of breastfeeding, maternal and sibling upper respiratory infections, severe malnutrition, indoor air pollution from cooking fuel, and incomplete immunization increase the risk of severe acute lower respiratory infection (ALRTI) in young children.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Acute lower respiratory infection (ALRTI) is a primary cause of mortality in children under five globally.
- Identifying modifiable risk factors for severe ALRTI is crucial for disease burden reduction.
Purpose of the Study:
- To investigate significant risk factors associated with severe lower respiratory tract infection (LRTI) in children under five years of age.
- To inform public health interventions aimed at reducing childhood ALRTI.
Main Methods:
- A hospital-based case-control study was conducted.
- 201 cases of severe ALRTI and 311 healthy controls were enrolled.
- Data on potential risk factors were collected using a pre-designed proforma.
Main Results:
- Lack of breastfeeding (OR: 1.64), maternal URI (OR: 6.53), sibling URI (OR: 24), severe malnutrition (OR: 1.85), non-LPG cooking fuel (OR: 2.5), and inappropriate immunization (OR: 2.85) were significant risk factors.
- Family history of LRTI (OR: 5.15) was also a significant contributor.
- Factors like child's sex, parental age/education, and housing type were not significant.
Conclusions:
- Key modifiable risk factors for severe ALRTI in young children include feeding practices, maternal and sibling health, nutritional status, indoor air quality, and immunization coverage.
- Interventions targeting these factors can potentially decrease ALRTI incidence and severity in vulnerable populations.
Background:
Acute lower respiratory infection (ALRTI) is the leading cause of death in children below five years of age. Identification of modifiable risk factors of severe ALRTI may help in reducing the burden of disease.
Methods:
A hospital based case control study was undertaken to determine risk factors associated with severe lower respiratory tract infection (LRTI) in under-five children. A case definition of severe ALRTI as given by World Health Organization (WHO) was used for cases. Healthy children attending Pediatrics out patient department for immunization during study period were enrolled as controls. Details of potential risk factors in cases and controls were recorded in pre-designed proforma.
Results:
512 children including 201 cases and 311 controls were enrolled in the study. On stepwise logistic regression analysis it was found that lack of breastfeeding (OR: 1.64; 95 percent CI: 1.23-2.17); upper respiratory infection in mother (OR: 6.53; 95 percent CI: 2.73-15.63); upper respiratory infection in siblings (OR: 24; 95 percent CI: 7.8-74.4); severe malnutrition (OR: 1.85; 95 percent CI: 1.14-3.0); cooking fuel other than liquid petroleum gas (OR: 2.5; 95 percent CI: 1.51-4.16); inappropriate immunization for age (OR: 2.85; 95 percent CI 1.59-5.0) and history of LRTI in the family (OR 5.15, 95 percent CI 3.0-8.8) were the significant contributors of ALRTI in children under five years. Sex of the child, age of the parents, education of the parents, number of children at home, anemia, inadequate caloric intake, type of housing were not documented to be significant risk factors of ALRTI.
Conclusion:
Lack of breast-feeding, upper respiratory infection in mother, upper respiratory infection in siblings, severe malnutrition, cooking fuel other than liquid petroleum gas, inappropriate immunization for age and history of LRTI in the family were the significant risk factors associated with ALRTI