multilevel and interaction modelling of factors associated with acute respiratory infections (ari) among children under-five years in uganda

Description

The study aimed at determining the risk factors associated with acute respiratory infection (ARI) among children under-five years in Uganda. It was guided by the objectives;to examine the effect of childhood factors on pneumonia among children under-five years in Uganda; to examine the contribution of mother factors on acute respiratory infection among children underfive years in Uganda; and to find out whether the effect of mother’s education level and wealth index on acute respiratory infection among children under-five years in Uganda is modified by region or place of residence and/or smoking status or type of cooking fuel. The study used data collected from the Uganda demographic and healthy survey 2016 by Uganda Bureau of Statistics (UBOS). Frequency distribution tables were used to describe the data. Chisquare tests were done at bivariate to find out the association between the identified risk factors and acute respiratory infection and at multivariate level, multilevel mixed effects complementary log log regression model was fitted to assess the determinants of pneumonia. The study showed significant relationship between acute respiratory infection and age of the child, age of the mother, birth weight, toilet facility , region, breast feeding status, wealth index and education level at 5% level of significance with p-values; 0.000, 0.017, 0.000, 0.001,0.000.006, 0.043 and 0.026 respectively at bivariate analysis. At multivariate analysis, child’s age, mother’s age, region and birth weight were significant predictors of childhood pneumonia. Children aged 12 to 23 months had increased risk of pneumonia compared to children aged 0 to11 months (OR=1.435, p=0.011). Children aged 36 to 47 months and 48 to 59 months had reduced risk of pneumonia (OR=0.665, p=0.049; OR=0.504, p=0.001). Children born to mothers aged20 to 24 years,25 to 29 years, 30 to 34 years and 40 to 44 years had reduced risk of pneumonia compared children born to mothers aged 15 to 19 years (OR= 0.541,p=0.009; OR=0.608, p=0.035; OR=0.507, p=0.006;OR=0.435, p=0.004).Children with average birth weight had reduced risk of pneumonia compared to children with large birth weight (OR=0.759, p=0.011). Children born to mothers from western region had reduced risk of pneumonia compared to children born to others from central region(OR=0.211, p=0.007).However, controlling for mother level factors in model, the within childhood characteristics were also seen to be highly significant (p=0.000). Therefore, individual (child) and mother level characteristics are independent predictors of childhood pneumonia.