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Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis
BACKGROUND: Acute Respiratory Infections (ARIs) account for more than 6% of the worldwide disease burden in children under the age of five, with the majority occurring in Sub-Saharan Africa. Rural children are more vulnerable to and disproportionately affected by ARIs. As a result, we examined the r...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632025/ https://www.ncbi.nlm.nih.gov/pubmed/36324089 http://dx.doi.org/10.1186/s12889-022-14421-0 |
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author | Tesema, Getayeneh Antehunegn Worku, Misganaw Gebrie Alamneh, Tesfa Sewunet Teshale, Achamyeleh Birhanu Yeshaw, Yigizie Alem, Adugnaw Zeleke Ayalew, Hiwotie Getaneh Liyew, Alemneh Mekuriaw Tessema, Zemenu Tadesse |
author_facet | Tesema, Getayeneh Antehunegn Worku, Misganaw Gebrie Alamneh, Tesfa Sewunet Teshale, Achamyeleh Birhanu Yeshaw, Yigizie Alem, Adugnaw Zeleke Ayalew, Hiwotie Getaneh Liyew, Alemneh Mekuriaw Tessema, Zemenu Tadesse |
author_sort | Tesema, Getayeneh Antehunegn |
collection | PubMed |
description | BACKGROUND: Acute Respiratory Infections (ARIs) account for more than 6% of the worldwide disease burden in children under the age of five, with the majority occurring in Sub-Saharan Africa. Rural children are more vulnerable to and disproportionately affected by ARIs. As a result, we examined the rural–urban disparity in the prevalence of ARI symptoms and associated factors among children under the age of five in Sub-Saharan Africa. METHODS: We used the most recent Demographic and Health Survey (DHS) data from 36 countries in Sub-Saharan Africa. The study included 199,130 weighted samples in total. To identify variables associated with ARIs symptoms, a multilevel binary logistic regression model was fitted. The Adjusted Odds Ratio (AOR) with a 95% CI was used to determine the statistical significance and strength of the association. To explain the rural–urban disparity in ARI prevalence, a logit-based multivariate decomposition analysis was used. RESULTS: Being female, ever breastfeeding, belonging to a poorer, better wealth status, and having better maternal educational status were significantly associated with lower odds of ARIs among under-five children. Whereas, small size or large size at birth, not taking vitamin A supplementation, being severely underweight, having diarrhea, didn’t have media exposure, never had the vaccination, being aged 36–47 months, and being aged 48–59 months were significantly associated with higher odds of ARIs among under-five children. The multivariate decomposition analysis revealed that the difference in characteristics (endowment) across residences explained 64.7% of the overall rural–urban difference in the prevalence of ARIs, while the difference in the effect of characteristics (change in coefficient) explained 35.3%. CONCLUSION: This study found that rural children were highly affected by ARIs in SSA. To reduce the excess ARIs in rural children, public health interventions aimed at impoverished households, home births, and unvaccinated and malnourished children are crucial. |
format | Online Article Text |
id | pubmed-9632025 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96320252022-11-04 Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis Tesema, Getayeneh Antehunegn Worku, Misganaw Gebrie Alamneh, Tesfa Sewunet Teshale, Achamyeleh Birhanu Yeshaw, Yigizie Alem, Adugnaw Zeleke Ayalew, Hiwotie Getaneh Liyew, Alemneh Mekuriaw Tessema, Zemenu Tadesse BMC Public Health Research BACKGROUND: Acute Respiratory Infections (ARIs) account for more than 6% of the worldwide disease burden in children under the age of five, with the majority occurring in Sub-Saharan Africa. Rural children are more vulnerable to and disproportionately affected by ARIs. As a result, we examined the rural–urban disparity in the prevalence of ARI symptoms and associated factors among children under the age of five in Sub-Saharan Africa. METHODS: We used the most recent Demographic and Health Survey (DHS) data from 36 countries in Sub-Saharan Africa. The study included 199,130 weighted samples in total. To identify variables associated with ARIs symptoms, a multilevel binary logistic regression model was fitted. The Adjusted Odds Ratio (AOR) with a 95% CI was used to determine the statistical significance and strength of the association. To explain the rural–urban disparity in ARI prevalence, a logit-based multivariate decomposition analysis was used. RESULTS: Being female, ever breastfeeding, belonging to a poorer, better wealth status, and having better maternal educational status were significantly associated with lower odds of ARIs among under-five children. Whereas, small size or large size at birth, not taking vitamin A supplementation, being severely underweight, having diarrhea, didn’t have media exposure, never had the vaccination, being aged 36–47 months, and being aged 48–59 months were significantly associated with higher odds of ARIs among under-five children. The multivariate decomposition analysis revealed that the difference in characteristics (endowment) across residences explained 64.7% of the overall rural–urban difference in the prevalence of ARIs, while the difference in the effect of characteristics (change in coefficient) explained 35.3%. CONCLUSION: This study found that rural children were highly affected by ARIs in SSA. To reduce the excess ARIs in rural children, public health interventions aimed at impoverished households, home births, and unvaccinated and malnourished children are crucial. BioMed Central 2022-11-03 /pmc/articles/PMC9632025/ /pubmed/36324089 http://dx.doi.org/10.1186/s12889-022-14421-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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. |
spellingShingle | Research Tesema, Getayeneh Antehunegn Worku, Misganaw Gebrie Alamneh, Tesfa Sewunet Teshale, Achamyeleh Birhanu Yeshaw, Yigizie Alem, Adugnaw Zeleke Ayalew, Hiwotie Getaneh Liyew, Alemneh Mekuriaw Tessema, Zemenu Tadesse Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title | Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title_full | Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title_fullStr | Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title_full_unstemmed | Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title_short | Understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in Sub-Saharan Africa: a multivariate decomposition analysis |
title_sort | understanding the rural–urban disparity in acute respiratory infection symptoms among under-five children in sub-saharan africa: a multivariate decomposition analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632025/ https://www.ncbi.nlm.nih.gov/pubmed/36324089 http://dx.doi.org/10.1186/s12889-022-14421-0 |
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