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Population modifiable risk factors associated with under-5 acute respiratory tract infections and diarrhoea in 25 countries in sub-Saharan Africa (2014-2021): an analysis of data from demographic and health surveys.
Ahmed, Kedir Y; Dadi, Abel F; Kibret, Getiye Dejenu; Bizuayehu, Habtamu Mellie; Hassen, Tahir A; Amsalu, Erkihun; Ketema, Daniel Bekele; Kassa, Zemenu Yohannes; Bore, Meless G; Alebel, Animut; Alemu, Addisu Alehegn; Shifa, Jemal E; Leshargie, Cheru Tesema; Thapa, Subash; Omar, Syed Haris; Ross, Allen G.
Afiliación
  • Ahmed KY; Rural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia.
  • Dadi AF; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Kibret GD; Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
  • Bizuayehu HM; Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia.
  • Hassen TA; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
  • Amsalu E; First Nations Cancer and Wellbeing (FNCW) Research Program, School of Public Health, The University of Queensland, Australia.
  • Ketema DB; Center for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, NSW, Australia.
  • Kassa ZY; Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Australia.
  • Bore MG; St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
  • Alebel A; The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia.
  • Alemu AA; School of Public Health, College of Medicine and Health Science, Debre Markos University, Ethiopia.
  • Shifa JE; College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
  • Leshargie CT; School of Nursing and Midwifery, University of Technology Sydney, Sydney, Australia.
  • Thapa S; School of Nursing and Midwifery, University of Technology Sydney, Sydney, Australia.
  • Omar SH; School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
  • Ross AG; Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia.
EClinicalMedicine ; 68: 102444, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38333537
ABSTRACT

Background:

Identifying the critical modifiable risk factors for acute respiratory tract infections (ARIs) and diarrhoea is crucial to reduce the burden of disease and mortality among children under 5 years of age in sub-Saharan Africa (SSA) and ultimately achieving the Sustainable Development Goals (SDGs). We investigated the modifiable risk factors of ARI and diarrhoea among children under five using nationally representative surveys.

Methods:

We used the most recent demographic and health survey (DHS) data (2014-2021) from 25 SSA countries, encompassing a total of 253,167 children. Countries were selected based on the availability of recent datasets (e.g., DHS-VII or DHS-VIII) that represent the current socioeconomic situations. Generalised linear latent mixed models were used to compute odds ratios (ORs). Population attributable fractions (PAFs) were calculated using adjusted ORs and prevalence estimates for key modifiable risk factors among ARI and diarrhoeal cases.

Findings:

This study involved 253,167 children, with a mean age of 28.7 (±17.3) months, and 50.5% were male. The highest PAFs for ARI were attributed to unclean cooking fuel (PAF = 15.7%; 95% CI 8.1, 23.1), poor maternal education (PAF = 13.4%; 95% CI 8.7, 18.5), delayed initiation of breastfeeding (PAF = 12.4%; 95% CI 9.0, 15.3), and poor toilets (PAF = 8.5%; 95% CI 4.7, 11.9). These four modifiable risk factors contributed to 41.5% (95% CI 27.2, 52.9) of ARI cases in SSA. The largest PAFs of diarrhoea were observed for unclean cooking fuel (PAF = 17.3%; 95% CI 13.5, 22.3), delayed initiation of breastfeeding (PAF = 9.2%; 95% CI 7.5, 10.5), household poverty (PAF = 7.0%; 95% CI 5.0, 9.1) and poor maternal education (PAF = 5.6%; 95% CI 2.9, 8.8). These four modifiable risk factors contributed to 34.0% (95% CI 26.2, 42.3) of cases of diarrhoea in SSA.

Interpretation:

This cross-sectional study identified four modifiable risk factors for ARI and diarrhoea that should be a priority for policymakers in SSA. Enhancing home-based care and leveraging female community health workers is crucial for accelerating the reduction in under-5 mortality linked to ARI and diarrhoea in SSA.

Funding:

None.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: EClinicalMedicine Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: EClinicalMedicine Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido