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      Prevalence, potential determinants, and treatment-seeking behavior of acute respiratory infection among children under age five in India: Findings from the National Family Health Survey, 2019-21

      research-article
      Author(s): 1 , 2 , , 1
      Publication date (Electronic):
      Journal: BMC Pulmonary Medicine
      Publisher: BioMed Central
      Keywords: ARI, Respiratory tract diseases, Treatment-seeking, Children, India

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          Abstract

          Background

          Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five.

          Study design

          Cross-sectional study.

          Methods

          The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed.

          Results

          Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79–0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69–0.99) are less likely to seek treatment.

          Conclusion

          The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.

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          Most cited references47

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          Handwashing and risk of respiratory infections: a quantitative systematic review

          Tamer Rabie, Valerie A Curtis (2006)
          Summary Objective  To determine the effect of handwashing on the risk of respiratory infection. Methods  We searched PubMed, CAB Abstracts, Embase, Web of Science, and the Cochrane library for articles published before June 2004 in all languages. We had searched reference lists of all primary and review articles. Studies were included in the review if they reported the impact of an intervention to promote hand cleansing on respiratory infections. Studies relating to hospital‐acquired infections, long‐term care facilities, immuno‐compromised and elderly people were excluded. We independently evaluated all studies, and inclusion decisions were reached by consensus. From a primary list of 410 articles, eight interventional studies met the eligibility criteria. Results  All eight eligible studies reported that handwashing lowered risks of respiratory infection, with risk reductions ranging from 6% to 44% [pooled value 24% (95% CI 6–40%)]. Pooling the results of only the seven homogenous studies gave a relative risk of 1.19 (95% CI 1.12%–1.26%), implying that hand cleansing can cut the risk of respiratory infection by 16% (95% CI 11–21%). Conclusions  Handwashing is associated with lowered respiratory infection. However, studies were of poor quality, none related to developing countries, and only one to severe disease. Rigorous trials of the impact of handwashing on acute respiratory tract infection morbidity and mortality are urgently needed, especially in developing countries.
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            Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers.

            B T Shaikh, J. Hatcher (2005)
            There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.
            Article 0 comments Cited 182 times – based on 0 reviews     Review now
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              Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

              Yuan-Pang Wang, Yasir Waheed, sherief abd-elsalam (2021)
              Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Funding Bill & Melinda Gates Foundation.
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                Author and article information

                Contributors
                Jesty Saira Varghese:
                ORCID: http://orcid.org/0000-0002-4091-5235
                jestysaira@gmail.com
                T. Muhammad: muhammad.iips@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Pulm Med
                Journal ID (iso-abbrev): BMC Pulm Med
                Title: BMC Pulmonary Medicine
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2466
                Publication date (Electronic): 6 June 2023
                Publication date PMC-release: 6 June 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 195
                Affiliations
                [1 ]GRID grid.417967.a, ISNI 0000 0004 0558 8755, Indian Institute of Technology (IIT) Delhi, ; New Delhi, 110016 India
                [2 ]GRID grid.419349.2, ISNI 0000 0001 0613 2600, Department of Family & Generations, , International Institute for Population Sciences (IIPS), ; Mumbai, 400088 Maharashtra India
                Author information
                http://orcid.org/0000-0002-4091-5235
                Article
                Publisher ID: 2487
                DOI: 10.1186/s12890-023-02487-4
                PMC ID: 10243276
                PubMed ID: 37280601
                SO-VID: 707ff415-3a38-45d0-a3e1-3202e9f8a38e
                Copyright © © The Author(s) 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 13 January 2023
                Date accepted : 18 May 2023
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2023

                ScienceOpen disciplines: Respiratory medicine
                Keywords: ari,respiratory tract diseases,treatment-seeking,children,india
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: ari, respiratory tract diseases, treatment-seeking, children, india

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