Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda.

backgroundGlobally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda.

methodsA cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years.

resultsIn Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12-1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06-1.53), and farm workers (1.25; 95% CI: 1.11-1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48-59 months (OR: 0.69; 95% CI: 0.60-0.80), breastfed children (OR: 0.83; 95% CI: 0.76-0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69-0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61-0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda.

conclusionPolicy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children's healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education.