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Published on: December 10, 2013
Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda
Yassin Nshimiyimana1, Yingchun Zhou2
1School of Statistics, East China Normal University, Shanghai, China.
Insights
Acute respiratory infections (ARI) affect over 40% of young children in Uganda. Key risk factors include young age and teenage mothers, while breastfeeding and using clean cooking fuel reduce ARI risk.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Infectious diseases are a leading cause of mortality in children under 5 globally.
- Acute respiratory infections (ARI) are the primary cause of child morbidity and mortality in Sub-Saharan Africa and South Asia.
- Uganda faces a significant burden of childhood ARI, necessitating an analysis of its risk factors.
Purpose of the Study:
- To analyze the risk factors associated with acute respiratory infection (ARI) symptoms in children under 5 years old in Uganda.
- To identify demographic, socioeconomic, and environmental factors contributing to ARI prevalence.
- To inform targeted public health interventions for reducing childhood ARI.
Main Methods:
- A cross-sectional study utilizing data from the 2016 Uganda Demographic and Health Survey (UDHS).
- Analysis of data from 13,493 children under 5 years old.
- Comparison of predictive models including logistic regression, elastic net, decision tree, and random forest to identify significant risk factors for ARI symptoms.
Main Results:
- Approximately 40.3% of children under 5 in Uganda reported ARI symptoms within two weeks prior to the survey.
- The random forest model demonstrated high accuracy (88.7%) in predicting ARI symptoms, outperforming logistic regression (62.0%).
- Risk factors for ARI included younger age (under 24 months), maternal teenage status, and parental occupation as farm workers. Protective factors included older age (48-59 months), breastfeeding, charcoal use for cooking, and the rainy season.
Conclusions:
- Targeted interventions addressing child healthcare, environmental conditions, and childcare are crucial.
- Promoting breastfeeding and enhancing maternal education are recommended strategies for early childhood care and ARI prevention.
- Public health policies should consider identified risk and protective factors to mitigate ARI burden in Ugandan children.
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.
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