ArticleBMJ global health2025
The burden of acute respiratory infection in children under 5 attributable to economic inequality in low- and middle-income countries.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between caesarean birth and childhood acute respiratory infection in low- and middle-income countries: a meta-analysis of population-based data.BMC medicine · 2026Pooled it
- Mapping the Burden of Ischemic Stroke Attributable to Temperature Variation under Climate Change Scenarios Accounting for Long-Term Adaptation.Environmental health perspectives · 2026Article
- Temporal Trends in Lower Respiratory Infection Mortality in Ecuador, 2012-2022.Tropical medicine and infectious disease · 2026Article
- Clinical and epidemiological profiles of six respiratory pathogens in hospitalized children in Lixin County, Anhui, China (2024-2025).Frontiers in pediatrics · 2026Article
- Assessment of childhood disease patterns in outpatient settings: a retrospective study from 2016 to 2020.Frontiers in pediatrics · 2026Article
- Article
- Acute respiratory infections and associated factors among under-five children in sub-Saharan Africa: a multilevel modified Poisson regression analysis of the latest DHS data.Therapeutic advances in infectious diseaseArticle
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13 authors.
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Abstract
backgroundQuantifying the disease burden among children that could potentially be reduced through improvements in individual economic status and regional economic equality can greatly benefit policy making and resource allocation. However, such quantification has rarely been done. This study aimed to assess the inequality-related burden of acute respiratory infection (ARI) (the leading cause of child mortality in low- and middle-income countries (LMICs)) among under five children.
methodsThis study integrated the Demographic and Health Survey data from 53 countries and linked individual records to a novel proxy of economic development status, the satellite night-time light (NTL). We assessed the number of children affected by ARI attributable to within-country economic disparities (eg, NTL<the country-specific 90th percentile) or within-country inequality (eg, NTL<the annual country-specific 90th percentile) from 2001 to 2019 in 133 LMICs, based on the exposure-response relationship between NTL and ARI derived from the study participants.
resultsThe odds of experiencing ARI were decreased significantly (3.5% ((95% confidence interval (CI) 1.4% to 4.4%)) for every 10-digit number increase in NTL. The exposure-response function showed constant decreasing in the risk of ARI as NTL level increases. It is estimated that within-country economic disparities contributed to 11.0% (95% CI 6.1% to 15.6%) of all children affected by ARI in 2001, which was decreased to 8.1% (95% CI 4.2% to 11.8%) in 2019. In contrast, the inequality-related burden remained stable. In sub-Saharan Africa, it increased from 4.8% (95% CI 1.7% to 8.0%) in 2001 to 6.8% (95% CI 3.0%-9.8%) in 2019. Eliminating within-country inequality would have avoided 522 136 (95% CI 2 66 760 to 7 57 414) cases of ARI among children across the 133 LMICs in 2019.
conclusionOur study revealed a protective effect of economic status on preventing ARI in children under 5 years of age. The considerable burden of childhood ARI was attributable to the economic inequality in LMICs. Optimising the allocation of economic resources can safeguard child health.
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