Burden of Acute Respiratory Infections Among Under-Five Children in Relation to Household Wealth and Socioeconomic Status in Bangladesh

Clinical Question

Does mother's socioeconomic situation predict the occurance of ARIs (fever and dyspnea) among under-five children (0⁻59 months)?

Bottom Line

Higher maternal educational status, access to improved water and sanitation facilities, and living in households in higher wealth quintiles had protective effects against both fever and dyspnea.

Major Points

Acute respiratory infections (ARIs), as a group of diseases and symptoms, are a leading cause of morbidity and mortality among under-five children in tropical countries like Bangladesh

Design

• Nationally-representative, population-based, cross-sectional
• N=32,998
• Setting: Urban and rural Bangladesh
• Duration: 1997-2014
• Analysis: Observational
• Primary outcome: Acute respiratory infections (fever and dyspnea)

Population

Inclusion Criteria

• Mother's age = 15-49 years
• Had a childbirth in last 5 years

Baseline Characteristics

• Overall prevalence of fever in 1997: 31.0% (95% CI = 29.9–32.4)
• Overall prevalence of fever in 2014: 36.76% (95% CI = 34.9–38.1)

• Overall prevalence of dyspnoea in 1997: 39.27% (95% CI = 38.2–41.1)
• Overall prevalence of dyspnoea in 2014: 43.27% (95% CI = 42.4–44.6)

• Combined prevalence of fever among boys and girls: 51.6% (95% CI = 50.5–52.6) and 48.4% (95% CI = 47.4–49.5)
• Prevalence of dyspnoea among boys and girls: 52.7% (95% CI = 51.0–54.3) and 47.3% (95% CI = 45.7–49.0).

Interventions

Primary Outcomes

The prevalence of both fever (31.00% in 1997 vs. 36.76% in 2014) and dyspnea (39.27% in 1997 vs. 43.27% in 2014) has increased gradually since 1997, and tended to be higher in households in the lower wealth quintiles.

Funding

Self-funded