Evidence map›Paper›PMID 38333537›Full record

ArticleEClinicalMedicine2024

Population modifiable risk factors associated with under-5 acute respiratory tract infections and diarrhoea in 25 countries in sub-Saharan Africa (2014-2021): an analysis of data from demographic and health surveys.

Kedir Y Ahmed, Abel F Dadi, Getiye Dejenu Kibret, Habtamu Mellie Bizuayehu, Tahir A Hassen, Erkihun Amsalu, Daniel Bekele Ketema, Zemenu Yohannes Kassa, Meless G Bore, Animut Alebel and 6 more

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Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kedir Y AhmedRural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia.
Abel F DadiMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Getiye Dejenu KibretFaculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia.
Habtamu Mellie BizuayehuFirst Nations Cancer and Wellbeing (FNCW) Research Program, School of Public Health, The University of Queensland, Australia.
Tahir A HassenCenter for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, NSW, Australia.
Erkihun AmsaluFaculty of Medicine and Health, Sydney Medical School, University of Sydney, Australia.
Daniel Bekele KetemaThe George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia.
Zemenu Yohannes KassaCollege of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Meless G BoreSchool of Nursing and Midwifery, University of Technology Sydney, Sydney, Australia.
Animut AlebelFaculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia.
Addisu Alehegn AlemuSchool of Women's and Children's Health, University of New South Wales Sydney, Kensington, Australia.
Jemal E ShifaSchool of Nursing and Midwifery, University of Technology Sydney, Sydney, Australia.
Cheru Tesema LeshargieFaculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia.
Subash ThapaRural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia.
Syed Haris OmarSchool of Dentistry and Medical Sciences, Charles Sturt University, Orange, NSW 2800, Australia.
Allen G RossRural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Identifying the critical modifiable risk factors for acute respiratory tract infections (ARIs) and diarrhoea is crucial to reduce the burden of disease and mortality among children under 5 years of age in sub-Saharan Africa (SSA) and ultimately achieving the Sustainable Development Goals (SDGs). We investigated the modifiable risk factors of ARI and diarrhoea among children under five using nationally representative surveys. Methods: We used the most recent demographic and health survey (DHS) data (2014-2021) from 25 SSA countries, encompassing a total of 253,167 children. Countries were selected based on the availability of recent datasets (e.g., DHS-VII or DHS-VIII) that represent the current socioeconomic situations. Generalised linear latent mixed models were used to compute odds ratios (ORs). Population attributable fractions (PAFs) were calculated using adjusted ORs and prevalence estimates for key modifiable risk factors among ARI and diarrhoeal cases. Findings: This study involved 253,167 children, with a mean age of 28.7 (±17.3) months, and 50.5% were male. The highest PAFs for ARI were attributed to unclean cooking fuel (PAF = 15.7%; 95% CI: 8.1, 23.1), poor maternal education (PAF = 13.4%; 95% CI: 8.7, 18.5), delayed initiation of breastfeeding (PAF = 12.4%; 95% CI: 9.0, 15.3), and poor toilets (PAF = 8.5%; 95% CI: 4.7, 11.9). These four modifiable risk factors contributed to 41.5% (95% CI: 27.2, 52.9) of ARI cases in SSA. The largest PAFs of diarrhoea were observed for unclean cooking fuel (PAF = 17.3%; 95% CI: 13.5, 22.3), delayed initiation of breastfeeding (PAF = 9.2%; 95% CI: 7.5, 10.5), household poverty (PAF = 7.0%; 95% CI: 5.0, 9.1) and poor maternal education (PAF = 5.6%; 95% CI: 2.9, 8.8). These four modifiable risk factors contributed to 34.0% (95% CI: 26.2, 42.3) of cases of diarrhoea in SSA. Interpretation: This cross-sectional study identified four modifiable risk factors for ARI and diarrhoea that should be a priority for policymakers in SSA. Enhancing home-based care and leveraging female community health workers is crucial for accelerating the reduction in under-5 mortality linked to ARI and diarrhoea in SSA. Funding: None.

Indexed as

Acute respiratory tract infectionsChildrenDiarrhoeaModifiable risk factorsPopulation attributable fractionsSub-Saharan Africa

Identifiers

PMID38333537
PMCPMC10850409

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.