Journal of epidemiology and community health 2016 9 20() pii 10.1136/jech-2015-206605
As a consequence of the global spread of HIV infection in sub-Saharan Africa, the impact of the AIDS pandemic has contributed to more than 40 million orphaned and vulnerable children (OVC) in sub-Saharan Africa. The children’s vulnerability is hypothesised to increase the risk of acute respiratory infection (ARI), which remains one of the major infectious causes of child mortality and morbidity in this region. This study examines the linkages between children’s vulnerability and ARI symptoms, with a focus on the individual as well as community levels.
Using population-based Demographic and Health Surveys of preschool age children (0-59 months old) from the Democratic Republic of Congo (n=7755), Malawi (n=17 559) and Nigeria (n=28 049), multilevel logistic models were conducted to establish the relationships between ARI symptoms among OVC and community-level vulnerability, adjusting for children’s and household characteristics and a season variation.
The child’s OVC status and community vulnerability were shown to be significantly associated with an increased likelihood of the child suffering from ARI symptoms in three countries. In contrast, the relationship between ARI symptoms and some selected variables associated with community development was not consistent across the 3 countries.
Community vulnerability demonstrates a significant influence on whether or not the child exhibits ARI symptoms. Being OVC contributes to differences in children’s likelihood of ARI symptoms between communities. In addition to industrial pollution, specific components, such as community development, vary in their associations with the ARI symptoms across different countries. The large differences in childhood ARI symptoms across countries suggests that policies aimed at promoting child health need to be context specific.