Acute respiratory infection in children from developing nations: a multi-level study.

Area of Science:

• Global Health
• Pediatrics
• Public Health Policy

Background:

• Acute respiratory infections (ARI) are the primary cause of mortality in children under five globally.
• Addressing under-five mortality related to ARI is crucial for achieving global health development goals.

Purpose of the Study:

• To evaluate progress towards the Millennium Development Goal for under-five mortality, focusing on ARI in developing countries.
• To investigate the links between national characteristics and ARI in young children, considering individual, maternal, and household factors.

Main Methods:

• Utilized a multilevel analysis of data from Demographic and Health Surveys and the World Bank.
• Included a representative sample of 354,633 children under five from 40 developing countries.

Main Results:

• The prevalence of ARI was 13%, with significant associations found with country-level inequalities (GINI index).
• Country GDP and health expenditure influenced the relationship between immunization and ARI.
• Factors like male gender, low birthweight, maternal employment, and indoor environment risks increased ARI; older children, immunization, breastfeeding, older maternal age, maternal education, and planned pregnancies reduced ARI.

Conclusions:

• Public health strategies targeting ARI in developing countries must incorporate macro-level national characteristics, particularly socioeconomic inequalities.
• Reducing national inequalities is an independent and important measure for decreasing ARI prevalence.
• The impact of immunization on ARI is amplified in countries with higher GDP and health expenditure, while the effect of household wealth is greater in more equitable nations.