Determinants of Acute Respiratory Infection Among Children in Ethiopia: A Multilevel Analysis from Ethiopian Demographic and Health Survey

Figures & data

Table 1 Sociodemographic Characteristics of the Respondent/Household

Variable	Categories	Frequency	Percentage
Age of mother	15–24	2414	24.1
	25–29	2978	29.8
	30–34	2238	22.4
	35–49	2376	23.7
Marital status	Never married	59	0.6
	Married	9518	95.1
	Widowed	125	1.2
	Divorced	304	3.0
Highest education of mother	No education	6387	63.8
	Primary	2538	25.4
	Secondary	697	7.0
	Higher	384	3.8
Father’s educational level	No education	4604	48.9
	Primary	3034	32.2
	Secondary	972	10.3
	Higher	734	7.8
	Do not know	73	0.8
Religion	Muslim	5068	50.6
	Orthodox	2944	29.4
	Protestant	1761	17.6
	Catholic	61	0.6
	Traditional	96	1.0
	Other	76	0.8
Place of residence	Urban	1907	19.1
	Rural	8099	80.9
Number of children under five	At most one	3677	36.7
	Two	4375	43.7
	Three and above	1954	19.5
Wealth index	Poorest	3706	37.0
	Poorer	1670	16.7
	Middle	1386	13.9
	Richer	1227	12.3
	Richest	2017	20.2
Cooking fuel (n=9884)	Electricity and gas	518	5.2
	Kerosene	37	0.4
	Charcoal	896	9.1
	Wood, straw	8111	82.1
	Animal dung	319	3.2
	Others	3	0.0
Type of toilet facility	No facility	4355	44.1
	Not improved	3781	38.3
	Improved	1748	17.7
Water source	Unimproved	3912	39.6
	Improved	5972	60.4
Smoke cigarettes	No	9913	99.1
	Yes	93	0.9
Media exposure	No	7964	79.6
	Yes	1960	20.4
Radio	No	8810	88.0
	Yes	1196	12.0
Magazine	No	9827	98.2
	Yes	179	1.8
TV	No	8705	87.0
	Yes	1301	13.0

Table 2 Sociodemographic Characteristics of Children less than 59 Months of Age in Ethiopia

Variable	Categories	Frequency	Percentage
Age in months	Less than 6	1093	11.3
	6 to 24	2923	30.1
	24 and above	5680	58.6
Sex	Male	5107	51.0
	Female	4899	49.0
Birth order	First	2031	20.3
	Second	1706	17.0
	3 to 4	2707	27.1
	5 and above	3562	35.6
Succeeding	Last	7012	70.1
	<20	632	6.3
	20+	2362	23.6
Preceding	First born	2040	20.4
	<18 months	1052	10.5
	18 to 23 months	862	8.6
	24 to 35 months	2550	25.5
	36 and above	3502	35.0
Twin	Single birth	9786	97.8
	1st of multiple	116	1.2
	2nd of multiple	104	1.0
Anaemia	Severe	311	4.0
	Moderate	2531	32.5
	Mild	1849	23.7
	Not anemic	3104	39.8
Underweight	Yes	2281	25.3
	No	6752	74.7
Stunting	Yes	3223	36.4
	No	5632	63.6
Wasting	Yes	1080	12.1
	No	7839	87.9
Size at birth (n=9905)	Large	3021	30.5
	Average	4196	42.4
	Small	2688	27.1
Vitamin A last 6 months (n=9805)	No	4380	44.7
	Yes	5425	55.3
Drugs for IP last 6 months (n=9808)	No	8632	88.0
	Yes	1176	12.0
Taking iron pills last 7 days (n=9838)	No	9125	92.8
	Yes	713	7.2

Table 3 Frequency of Childhood Morbidities in Children less than 59 Months of Age in Ethiopia

Symptoms	Presence	Frequency	Percent
Cough	No	8337	83.3
	Yes, last two weeks	1586	15.9
	Do not know	83	0.8
Short rapid breaths	No	9028	90.2
	Yes	891	8.9
	Do not know	87	0.9
Chest complaint	No	9115	91.1
	Yes	884	8.8
	Do not know	7	0.1
Over all ARI	Yes	885	8.8
	No	9121	91.2
Fever	No	8564	85.6
	Yes	1354	13.5
	Do not know	88	0.9
Diarrhea	No	8826	88.2
	Yes, last two weeks	1090	10.9
	Do not know	90	0.9
Morbidity combined	No morbidity	7417	74.1
	One morbidity	1097	11.0
	Multiple morbidity	1492	14.9

Abbreviation: ARI, acute respiratory infections.

Table 4 Frequency Distributions of Childhood Morbidities across Regions in Ethiopia

Region	Morbidity in the Last Two Weeks
	Cough N (%)	Fever N (%)	Shortness of Breath N (%)	Chest N (%)	ARI Combined N (%)
Tigray	302 (30.4)	234 (23.6)	161 (16.2)	161 (16.2)	167 (16.8)
Afar	163 (16.8)	152 (15.6)	72 (7.4)	71 (7.3)	95 (9.8)
Amhara	158 (17.0)	113 (12.2)	109 (11.7)	107 (11.5)	77 (8.3)
Oromia	347 (23.2)	221 (14.8)	224 (15.0)	224 (15.0)	157 (10.5)
Somali	125 (8.9)	114 (8.1)	66 (4.7)	66 (4.7)	81 (5.8)
Benishangul	41 (5.0)	59 (7.2)	21 (2.6)	20 (2.5)	26 (3.2)
SNNPR	211 (17.5)	188 (15.6)	121 (10.0)	120 (10.0)	112 (9.3)
Gambela	55 (8.2)	95 (14.2)	40 (6.0)	40 (6.0)	41 (6.1)
Harari	41 (7.3)	53 (9.4)	17 (3.0)	17 (3.0)	30 (5.3)
Addis Ababa	68 (15.2)	66 (14.8)	29 (6.5)	27 (6.0)	51 (11.4)
Dire Dawa	75 (14.5)	59 (11.4)	31 (6.0)	31 (6.0)	48 (9.3)
Total	1586 (15.9)	1354 (13.5)	891 (8.9)	884 (8.8)	885 (8.8)

Figure 1  The maps of regional states in Ethiopia. Image courtesy with permission from https://www.ethiovisit.com/addis-ababa/65/.

Table 5 Association between Acute Respiratory Infection and Predictor Variables among Children under five in Ethiopia

Variables	Levels	COR	AOR
Sex	Boy	1	1
	Girl	0.980 (0.883–1.088)	0.994 (0.883–1.119)
Child age (months)	<6		1
	6–11	1.502 (1.206–1.872)	1.466 (1.143–1.881)*
	12–23	1.410 (1.160–1.715)	1.390 (1.109–1.742)*
	24–35	1.168 (0.957–1.426)	1.238 (0.982–1.561)
	36–47	0.973 (0.794–1.193	0.980 (0.773–1.242)
	48–59	0.708 (0.574–0.873)	0.727 (0.571–0.925)*
Birth size	Average		1
	Smaller	1.340 (1.181–1.520)	1.387 (1.198–1.605)*
	Larger	1.036 (0.911–1.177)	1.144 (0.988–1.323)
Child is twin	Single birth		1
	1st of multiple	1.096 (0.681–1.763)	0.977 (0.571–1.670)
	2nd of multiple	0.968 (0.574–1.633)	0.930 (0.519–1.668)
Stunting	No		1
	Yes	0.930 (0.831–1.042)	0.941 (0.814–1.088)
Underweight	No		1
	Yes	0.991 (0.875–1.122)	0.955 (0.815–1.119)
Read magazine	No		1
	Yes		0.675 (0.399–1.142)
Education of mother	No education		1
	Primary	1.216 (1.080–1.370)	1.18 (1.02–1.36)
	Secondary	0.901 (0.724–1.121)	1.00 (0.76–1.33)
	Higher	0.769 (0.567–1.042)	0.95 (0.62–1.45)
Place of residence	Urban		1
	Rural	1.151 (1.003–1.320)	0.931 (0.689–1.259)
Cooking fuel	Electric and gas		1
	Kerosene	0.807 (0.306–2.123)	0.802 (0.244–2.64)
	Charcoal	0.957 (0.712–1.285)	1.01 (0.697–1.464)
	Wood, straw	1.031 (0.810–1.311)	1.267 (0.869–1.848)
	Animal dung	1.565 (1.100–2.213)	1.904 (1.152–3.146)*
	Others	0	0
Toilet facility	No facility	1	1
	Not improved	1.024 (0.911–1.150)	0.908 (0.775–1.063)
	Improved	0.985 (0.848–1.144)	1.047 (0.830–1.322)
Altitude (meters)	<1000	1	1
	1000–1999	1.701 (1.468–1.970)	1.805 (1.403–2.322)*
	2000–2999	1.780 (1.515–2.090)	1.882 (1.427–2.483)*
	≥3000	1.885 (1.205–2.950)	2.241 (1.023–4.907)*

Notes: *Statistically significant at p-value of 0.05 (95%CI not including 1)

Abbreviations: CO, crude odds ratio; AOR, adjusted odds ratio.