Prevalence of ARI, fever, and diarrhea among under-five children and the influencing factors in southwestern coastal region of Bangladesh.

backgroundAcute respiratory infection (ARI), fever, and diarrhea are the prominent causes of the burden of childhood communicable diseases along with mortality in developing countries which contributes to nutritional deficiencies, reduced resistance to infections and impaired growth and development. Therefore, the present study aims to investigate the prevalence of ARI, fever, and diarrhea among under-five children and the influencing factors in the southwestern coastal region of Bangladesh by incorporating the social ecological model.

methodsThe study was conducted in six villages of Dacope upazila under Khulna district of Bangladesh following cross-sectional survey method. Data were collected from 348 randomly selected caregivers with at least one child aged 6 to 59 months. A semi-structured interview schedule was used for data collection from the participants through face-to-face interviews from July to October 2024. Bivariate and multivariate analyses were conducted to determine the factors influencing the prevalence of ARI, fever, and diarrhea among under-five children.

resultsResults showed that ARI prevalence among under-five children was 64.7%, followed by fever at 42.2%, and diarrhea at 13.5% in the southwestern coastal region. Findings also revealed that various individual factors such as child sex, child feeding frequency, and birth weight; interpersonal factors like house type, type of family, and household vulnerability; and community-level factors such as place of residence and availability of qualified doctors in the locality were the significant predictors of the prevalence of these diseases. However, we did not find any significant influence of policy-level factors on the prevalence of these diseases. Children who were fed ≥ 7 times a day and those residing in Nolian village had higher odds of having ARI than their counterparts. On the other hand, children with normal birth weight, children who were fed 5-6 times and ≥ 7 times a day, and children living in Hoglabunia village had higher odds of getting fever. Nonetheless, children living in semi-pacca houses had lower odds of experiencing fever compared to their counterparts. Moreover, boys, children from higher vulnerable households, and children residing in the community where qualified doctors are available had higher odds of getting diarrhea, whereas children from nuclear families had lower odds of having diarrhea than their counterparts.

conclusionThe study suggests introducing targeted nutrition education programs for both mothers and infants through community outreach. Besides, generating sustainable income opportunities to reduce coastal households' vulnerabilities. Additionally, infrastructural development is essential to ensure access to quality healthcare services in geospatially disadvantaged regions, especially in southwestern coastal region of Bangladesh.