Ecological zone and symptoms of acute respiratory infection among children under five in Ghana: 1993–2014

Since 1993, evidence suggest that a significant portion of Ghanaian under-five children have suffered from Acute Respiratory Infection (ARI). This study sought to examine the prevalence of ARI symptoms among under-fives across ecological zones as well as childhood and maternal factors associated with ARI between 1993 and 2014. We used data from Ghana Demographic and Health Surveys (1993–2014). The study sample included women of reproductive age who had under-five children experiencing a cough accompanied with short rapid breaths in the last two weeks preceding each of the surveys. Data were extracted and analysed using STATA version 14.2. Both bivariate and multivariate analyses were done to establish the association between the explanatory and outcome variable. Among Coastal dwellers, the prevalence of reported ARI increased from 18.7% in 1993 to 36.5% in 2014. Increment occurred between 1993 (45.2%) and 2014 (47.3%) within the Middle zone. Between 1993 and 2014, reported ARI reduced from 36.1% to 16.2% among Savanna dwellers. In addition to ecological zone, place of residence, and survey year were associated with symptoms of childhood ARIs. The multivariate results showed that children whose mothers lived in rural areas [AOR = 1.54, CI = 1.21–1.97] and those born in survey wave 1998 [AOR = 1.59, CI = 1.24–2.04] had higher odds of reporting symptoms of ARI. The study findings have demonstrated the need for public health education and sensitization on ARI to be more specific and target women with children under-five who live in the Middle zone compared to those who live in other ecological zones.