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      Acute respiratory infection and its associated factors among children under-five years attending pediatrics ward at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: institution-based cross-sectional study

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          Abstract

          Background

          Acute respiratory infection is manifested by cough accompanied by short rapid breathing which may be associated with death especially when there are other co-morbidities. From an estimated 5.4 million children under –five years that died in 2017—roughly half of those deaths occurred in sub-Saharan Africa and acute respiratory infection contributed to the highest number of deaths. The current study aimed at evaluating the prevalence of, and risk factors associated with, acute respiratory infection hospitalization in under-five years children hospitalized at the University of Gondar Comprehensive Specialized Hospital.

          Method

          An institution-based cross-sectional study was carried out from May 01/2019 to July 10/2019. After the selection of participants using simple random sampling, face to face interview was performed using a semi-structured pre-tested questionnaire. Data were also extracted from medical registration charts. We used EPI Info 7 for data entry and exported into SPSS 21 for analysis. Results were presented by simple frequency, percentage and mean for descriptive variables. Binary logistic regression analysis was used to test the association of covariates and outcome variable. Variables with a p < 0.2 during the bivariable binary logistic regression analysis were included in the multivariable logistic regression analysis. Variables with p < 0.05 were considered as significantly associated with acute respiratory infection. This study is reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

          Results

          Four hundred and twenty-two under-five years’ children attending the Pediatrics ward were included in this study. The prevalence of acute respiratory infection among under-five years’ children in this study was 27.3%. Children aged below 12 months (AOR:3.39, 95% CI: 1.19, 9.65), maternal age of 16 to 27 years (AOR: 1.95, 95% CI: 1.03, 3.70), maternal age of 28 to 33 years (AOR: 2.73, 95% CI: 1.40, 5.34), lack of maternal awareness of handwashing (AOR: 2.79, 95% CI: 1.15, 6.76), rural residence (AOR:2.27, 95% CI: 1.18, 4.39), and lack of meningitis (AOR: 0.22, 95% CI: 0.08, 0.55), were significantly associated with acute respiratory infection.

          Conclusion

          Acute respiratory infection was common among children under-five years. Child and maternal age, residence and maternal hand hygiene information were significant factors identified to be associated with an acute respiratory infection.

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          Most cited references40

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          Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis

          Summary Background The annual number of hospital admissions and in-hospital deaths due to severe acute lower respiratory infections (ALRI) in young children worldwide is unknown. We aimed to estimate the incidence of admissions and deaths for such infections in children younger than 5 years in 2010. Methods We estimated the incidence of admissions for severe and very severe ALRI in children younger than 5 years, stratified by age and region, with data from a systematic review of studies published between Jan 1, 1990, and March 31, 2012, and from 28 unpublished population-based studies. We applied these incidence estimates to population estimates for 2010, to calculate the global and regional burden in children admitted with severe ALRI in that year. We estimated in-hospital mortality due to severe and very severe ALRI by combining incidence estimates with case fatality ratios from hospital-based studies. Findings We identified 89 eligible studies and estimated that in 2010, 11·9 million (95% CI 10·3–13·9 million) episodes of severe and 3·0 million (2·1–4·2 million) episodes of very severe ALRI resulted in hospital admissions in young children worldwide. Incidence was higher in boys than in girls, the sex disparity being greatest in South Asian studies. On the basis of data from 37 hospital studies reporting case fatality ratios for severe ALRI, we estimated that roughly 265 000 (95% CI 160 000–450 000) in-hospital deaths took place in young children, with 99% of these deaths in developing countries. Therefore, the data suggest that although 62% of children with severe ALRI are treated in hospitals, 81% of deaths happen outside hospitals. Interpretation Severe ALRI is a substantial burden on health services worldwide and a major cause of hospital referral and admission in young children. Improved hospital access and reduced inequities, such as those related to sex and rural status, could substantially decrease mortality related to such infection. Community-based management of severe disease could be an important complementary strategy to reduce pneumonia mortality and health inequities. Funding WHO.
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            Seasonal influenza epidemiology in sub-Saharan Africa: a systematic review.

            Acute respiratory infection (ARI) is a leading cause of mortality worldwide, of which influenza is an important cause that can be prevented with vaccination. We did a systematic review of research published from 1980 to 2009 on seasonal influenza epidemiology in sub-Saharan Africa to identify data strengths and weaknesses that might affect policy decisions, to assess the state of knowledge on influenza disease burden, and to ascertain unique features of influenza epidemiology in the region. We assessed 1203 papers, reviewed 104, and included 49 articles. 1-25% of outpatient ARI visits were caused by influenza (11 studies; mean 9·5%; median 10%), whereas 0·6-15·6% of children admitted to hospital for ARI had influenza identified (15 studies; mean 6·6%; median 6·3%). Influenza was highly seasonal in southern Africa. Other data were often absent, particularly direct measurement of influenza incidence rates for all ages, within different patient settings (outpatient, inpatient, community), and for all countries. Data from sub-Saharan Africa are insufficient to allow most countries to prioritise strategies for influenza prevention and control. Key data gaps include incidence and case-fatality ratios for all ages, the contribution of influenza towards admission of adults to hospital for ARI, representative seasonality data, economic burden, and the interaction of influenza with prevalent disorders in Africa, such as malaria, HIV, and malnutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Risk factors for pneumonia among children in a Brazilian metropolitan area.

              To investigate risk factors for pneumonia for infants < 2 years of age. Hospital-based, case-control study with neighborhood control subjects. Urban area in southern Brazil. Five hundred ten infants with radiologically confirmed pneumonia who were admitted to a pediatric hospital. One age-matched neighborhood control subject was selected for each case. Multiple conditional regression modeling was used to control for confounding, taking into account the hierarchical relationships between risk factors. The incidence of radiologically confirmed pneumonia was associated with low paternal education, the number of persons in the household, young maternal age, attendance at day-care centers, low birth weight and weight-for-age, lack of breast-feeding and of non-milk supplements, and a history of previous pneumonia or wheezing. Day-care center attendance showed the highest risk, with an adjusted odds ratio of 11.75. In addition to continued efforts toward appropriate case management, actions directed against the above risk factors may help prevent the major cause of deaths of children younger than 5 years.
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                Author and article information

                Contributors
                enoch2313@gmail.com
                zewuduandualem12@gmail.com
                bayedagnew7@gmail.com
                asiemagna21@gmail.com
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                28 February 2020
                28 February 2020
                2020
                : 20
                : 93
                Affiliations
                [1 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Environmental and Occupational Health and Safety, Institute of Public Health, , University of Gondar, ; P.O.Box 196, Gondar, Ethiopia
                [2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Human Physiology, School of Medicine, , University of Gondar, ; P.O.Box 196, Gondar, Ethiopia
                [3 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Epidemiology and Biostatistics, Institute of Public Health, , University of Gondar, ; P.O.Box 196, Gondar, Ethiopia
                Article
                1997
                10.1186/s12887-020-1997-2
                7047350
                32111196
                fb946252-69a6-4c3a-9e6d-87d4414fec7a
                © The Author(s). 2020

                Open AccessThis 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
                : 15 September 2019
                : 24 February 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Pediatrics
                acute respiratory infection,under-five years,ethiopia
                Pediatrics
                acute respiratory infection, under-five years, ethiopia

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