Spatial-Temporal Patterns and Determinants of Diarrhea and Acute Respiratory Infection among Children under five years in Nepal

Main Article Content

Aashray Manandhar
Sampurna Kakchapati

Abstract

Diarrhea and acute respiratory infection (ARI) remain the leading cause of mortality and morbidity among children in Nepal. The aim of this study was to investigate the spatial and temporal patterns of diarrhea and ARI and its determinants among children from 2015 to 2018. The study used the data of diarrhea and ARI from District Health Information System 2 published by Integrated Health Information Management Section and district characteristics data from Central Bureau of Statistics. Statistical model was used for assessing diarrhea and ARI and its determinants were performed using multiple linear regression. The model provided good fit as indicated r-squared statistic (0.68) for diarrhea and r-squared statistic (0.56) for ARI. The proportion for diarrhea and ARI were 51% and 68% respectively. The multivariate analysis found that mother education and number of children was associated with diarrhea; human development index was associated with ARI and poverty gap, malnutrition and low birth weight were associated with both diarrhea and ARI. This study showed steady decreasing trend in diarrhea and ARI from 2015 to 2018; however, the cases are large and evenly distributed in Nepal. These findings provide insight to establish prevention programs based on socio economic barriers and high risky areas.

Article Details

How to Cite
1.
Manandhar A, Kakchapati S. Spatial-Temporal Patterns and Determinants of Diarrhea and Acute Respiratory Infection among Children under five years in Nepal. J Public Hlth Dev [Internet]. 2021 May 24 [cited 2024 Apr. 26];19(2):120-34. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/249754
Section
Original Articles
Author Biographies

Aashray Manandhar, MPH Candidate, Department of Public Health, Nobel College, Kathmandu, Nepal

MPH Candidate, Department of Public Health, Nobel College, Kathmandu, Nepal

Sampurna Kakchapati, Research Manager, HERD International, Kathmandu, Nepal

Research Manager, HERD International, Kathmandu, Nepal

References

UNICEF. Under-five mortality [Internet]. 2019 [cited 2020 14 June]. Available from: https://data.unicef. org/topic/child-survival/under-five-mortality/

World Health Organization. Diarrhoeal disease [Internet]. 2017 [cited 2020 14 June]. Available from: https://www. who.int/news-room/fact-sheets/ detail/diarrhoeal-disease

World Health Organization. Pneumonia [Internet]. 2019 [cited 2020 14 June]. Available from: https:// www.who.int/news-room/fact-sheets/ detail/pneumonia

Department of Health Services, Ministry of Health and Population. Annual Report 2075-76 (2018/19). Kathmandu, Nepal: Department of Health Services, Ministry of Health and Population (Nepal). 2020.

Ministry of Health, New ERA, ICF. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal. 2017

Singh S, Shrestha G, Joshi D, Gebreselassie T. Childhood Illness and Mortality in Nepal: Trends and Determinants. DHS Further Analysis Reports No. 120.January. Rockville, Maryland, USA: ICF 2019.

Central Bureau of Statistics. Nepal Multiple Indicator Cluster Survey 2019, Survey Findings Report. Kathmandu, Nepal: Central Bureau of Statistics and UNICEF Nepal. 2020.

National Planning Commission. Nepal Sustainable Development Goals Status and Roadmap: 2016-2030. Kathmandu, Nepal: Government of Nepal, National Planning Commission. 2017

Li R, Lai Y, Feng C, Dev R, Wang Y, Hao Y. Diarrhea in Under Five Year-old Children in Nepal: A Spatiotemporal Analysis Based on Demographic and Health Survey Data. International journal of environmental research and public health. 2020;17(6):2140.

Budhathoki SS, Bhattachan M, Yadav AK, Upadhyaya P, Pokharel PK. Eco-social and behavioural determinants of diarrhoea in under-five children of Nepal: a framework analysis of the existing literature. Trop Med Health 2016;44(1):1-7.

Kamal MM, Hasan MM, Davey R. Determinants of childhood morbidity in Bangladesh: evidence from the demographic and health survey 2011. BMJ open 2015;5(10):1-7.

Bbaale E. Determinants of diarrhoea and acute respiratory infection among under-fives in Uganda. The Australasian medical journal 2011; 4(7):400-409.

Troeger C, Blacker BF, Khalil IA, Rao PC, Cao S, Zimsen SR, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 2018;18(11):1211-28.

Mihrete TS, Alemie GA, Teferra AS. Determinants of childhood diarrhea among underfive children in Benishangul Gumuz regional state, North West Ethiopia. BMC pediatrics 2014;14(1):102(1-9).

Hashi A, Kumie A, Gasana J. Prevalence of diarrhoea and associated factors among under-five children in Jigjiga District, Somali Region, Eastern Ethiopia. Open J Prev Med 2016;6:233-46.

Ullah MB, Mridha MK, Arnold CD, Matias SL, Khan MS, Siddiqui Z, et al. Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh. BMC pediatrics 2019; 19(1):386.

Dhingra D, Dabas A, Anand T, Pinnamaneni R. Maternal knowledge, attitude and practices during childhood diarrhoea. Trop Doct 2018;48(4):298-300.

Karki T, Srivanichakorn S, Chompikul J. Factors related to the occurrence of diarrheal disease among under-five children in Lalitpur district of Nepal. Journal of Public Health and Development 2010;8(3):237-51.

Yadav S, Khinchi Y, Pan A, Gupta SK, Shah GS, Baral DD, et.al. Risk factors for acute respiratory infections in hospitalized under five children in central Nepal. J. Nepal Paediatr. Soc 2013;33(1):39-44.

Maharjan PL, Sharma Y. Prevalence and Determinants of Acute Respiratory Infection among Children under Age Five in Gorkha Municipality, Gorkha. Global journal of Pharmacy & pharmaceutical Science 2017;2(3):1-4

Goodarzi E, Sohrabivafa M, Darvishi I, Naemi H, Khazaei Z. Epidemiology of mortality induced by acute respiratory infections in infants and children under the age of 5 years and its relationship with the Human Development Index in Asia: an updated ecological study. Journal of Public Health From Theory to Practice 2020;1-8.

Riahi M, Mohammadi AA, Moghadam VK, Robati, ZS, Bidkhori M. Diarrhea deaths in children among countries with different levels of the human development index. Data in brief. 2018;17:954-60.

Hassen S, Getachew M, Eneyew B, Keleb A, Ademas A, Berihun G, et al. Determinants of Acute Respiratory Infection (ARI) among Under-Five Children in Rural Areas of Legambo District, South Wollo Zone, Ethiopia: A Matched Case-Control Study. Int J Infect Dis 2020;96: 688-95.

Kinyoki DK, Manda SO, Moloney GM, Odundo EO, Berkley JA, Noor AM, Kandala NB. Modelling the ecological comorbidity of acute respiratory infection, diarrhoea and stunting among children under the age of 5 years in Somalia. Int Stat Rev. 2017;85(1):164-76.

Schlaudecker EP, Steinhoff MC, Moore SR. Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries. Curr Opin Infect Dis 2011;24(5):496-502.

Tongkumchum P, McNeil D. Confidence intervals using contrasts for regression model. Songklanakarin J Sci Technol 2019;31:151-56.

Kakchapati S, Choonpradub C, Lim A. Spatial and temporal variations in Tuberculosis proportion, Nepal. Southeast Asian J Trop Med Public Health 2014;45(1):95-103

Kakchapati S, Ardkaew J. Modeling of Malaria Proportion in Nepal. J Res Health Sci 2011;11(1):7-13

Khazaei S, Ayubi E, Nematollahi S. Variations of infant and under-five child mortality rates around the world, the role of human development index (HDI). Int. J. Pediatr 2016;4(5):1671-77.

Mulatya DM, Mutuku FW. Assessing Comorbidity of Diarrhea and Acute Respiratory Infections in Children Under 5 Years: Evidence From Kenya’s Demographic Health Survey 2014. J Prim Care Community Health 2020;11:1-10.

Ahmed H. CSE Global Theme Issue on Poverty and Human Development: Effects of Poverty on Child Health and Paediatric Practice in Nigeria: An Overview. Ann Afr Med 2007;6(4):142-56.

Amugsi DA, Aborigo RA, Oduro AR, Asoala V, Awine T, Amenga-Etego L. Socio-demographic and environmental determinants of infectious disease morbidity in children under 5 years in Ghana. Glob Health Action. 2015;8(1):29349.

Ferdous F, Das SK, Ahmed S, Farzana FD, Latham JR, Chisti MJ, et al. Severity of diarrhea and malnutrition among under five-year-old children in rural Bangladesh. Am J Trop Med Hyg 2013;89(2):223-28.

Rice AL, Sacco L, Hyder A, Black RE. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull World Health Organ. 2000;78:1207-21.

Borah M, Baruah R. Morbidity status of low birth weight babies in rural areas of Assam: A prospective longitudinal study. J Family Med Prim Care 2015;4(3):380-83.

Sharma D, Kuppusamy K, Bhoorasamy A. Prevalence of acute respiratory infections (ari) and their determinants in under five children in urban and rural areas of Kancheepuram district, South India. Ann Trop Med Public Health. 2013;6(5):513-18.

Walker CLF, Perin J, Katz J, Tielsch JM, Black RE. Diarrhea as a risk factor for acute lower respiratory tract infections among young children in low income settings. J. Glob. Health 2013;3(1):1-8.

Ghimire M, Pradhan YV, Maskey MK. Community-based interventions for diarrhoeal diseases and acute respiratory infections in Nepal. Bull World Health Organ 2010;88:216-21.