Trends and determinants of Acute Respiratory Infection symptoms among Under-five children in Cambodia: Analysis of 2000 to 2014 Cambodia Demographic and Health Surveys

Abstract

AbstractINTRODUCTIONAcute Respiratory Infections (ARI) is public health concern. According to the World Health Organization (WHO), ARI is responsible for 3.5% of all diseases in the world and more than 808,000 (15%) of all under-five deaths worldwide in 2017. ARI continues to be one of the leading causes of childhood morbidity and mortality in Cambodia, particularly among children under five of age. We aimed to assess the trends over time of ARI symptoms and examine the socio-demographic, behavioral, and environmental factors associated with ARI symptoms among Cambodian children aged 0-59 months across 2000, 2005, 2010, and 2014.METHODSWe used existing children’s data from the Cambodia Demographic and Health Survey (CDHS) with a total of children ages 0-59 months included 7,828 in 2000, 7,621 in 2005, 7,727 in 2010, and 6,864 in 2014, respectively. All statistical estimations were carried out using STATA V16, within the survey-specific command “svy” using the standard sampling weight (v005/1,000,000), clustering, and stratification. We used simple and multiple logistic regression to determine the main predictors of ARI symptoms.RESULTSARI symptoms in the previous two weeks in children aged 0-59 months in Cambodia decreased from 19.9% in 2000 to 8.6% in 2005 to 6.4% in 2010, then fewer at 5.5% in 2014. The main factors that increased the likelihood of ARI symptoms were children ages 6-11 months [AOR=1.91; 95% CI: 1.53-2.38], 12-23 months [AOR=1.79; 95% CI: 1.46-2.20], and 24-35 months [AOR=1.41; 95% CI: 1.13-1.76], mothers who smoke cigarette [AOR=1.61; 95% CI: 1.27-2.05], and children born into households had non-improved toilets [AOR=1.20; 95% CI: 0.99-1.46]. However, the following factors were found to be associated with decreased odds of having ARI symptoms: Mothers with higher education [AOR=0.45; 95% CI: 0.21-0.94], breastfeeding children [AOR=0.87; 95% CI: 0.77-0.98], and children born into richest wealth quantile [AOR=0.73; 95% CI: 0.56-0.95], respectively. Survey years in 2005 [AOR=0.36; 95% CI: 0.31-0.42], 2010 [AOR=0.27; 95% CI: 0.22-0.33], 2014 [AOR=0.24; 95% CI: 0.19-0.30].CONCLUSIONThe trends of ARI symptoms among children under five in Cambodia significantly decreased from 2000-2014. Mothers who smoke cigarettes, young children ages (6-35 months), and household unimproved toilet facilities are factors that independently increased the likelihood that children would develop ARI symptoms. Inversely, factors were found to be associated with decreased odds of having ARI symptoms: Mothers with higher education, breastfeeding children, and children born into the richest wealth quantile and Survey years. Therefore, government and child family programs must promote maternal education, particularly infant breastfeeding. The government ought to support maternal education and infant breastfeeding in the interest of early childhood care.