PREVALENCE AND ASSOCIATED FACTORS OF ACUTE LOWER RESPIRATORY INFECTION AMONG UNDER FIVE CHILDREN, YEKA SUB CITY, ADDIS ABEBA, ETHIOPIA

Addis Ababa University College of Health Science School of Public Health PREVALENCE AND ASSOCIATED FACTORS OF ACUTE LOWER RESPIRATORY INFECTION AMONG UNDER FIVE CHILDREN, YEKA SUB CITY, ADDIS ABEBA, ETHIOPIA A thesis Submitted To the School of Graduate Studies of Addis Ababa University, College of Health Sciences, School of Public Health in Partial Fulfillment of the Requirements for the Degree of Master in Public Heath BY: BASHAW WOGDERES (BSC) ADVISOR: DR.ABABI ZERGAW (MD, MPH) June, 2017 Addis Ababa, Ethiopia ADDIS ABABA UNIVERSITY SCHOOL OF GRADUATE STUDIES PREVALENCE AND ASSOCIATED FACTORS OF ACUTE LOWER RESPIRATORY INFECTION AMONG UNDER FIVE CHILDREN, YEKA SUB CITY, ADDIS ABEBA, ETHIOPIA BY BASHAW WOGDERES (BSC) School of Public health, College of Health Sciences Addis Ababa University Approved by the Examining board Advisor Dr Ababi Zergaw Signature Examiner Muluken Gizaw Signature Examine _ Signature June, 2017 Addis Ababa, Ethiopia Thesis Report Declaration I, the under signed, declared that this is my original work, has never been presented in this or any other University and that all the resources and materials used for the thesis work, have been fully acknowledged Name of student: _Signature: Date: This thesis has been submitted for examination with my approval as the student thesis work advisor Name of advisor: _Signature: _Date: _ i Acknowledgments I praise Almighty God for giving me the courage and resilience to complete this work The completion of this thesis represents a great achievement in my life in which the contribution of many people was enormous and thus deserve acknowledgement First of all I would like to express my deepest gratitude to Dr Ababi Zergaw for his unreserved and invaluable advice and comment from the development of proposal to the end of the research I would also like to extend my deepest gratitude to all those, especially to my father Wogderes Begashaw,my beloved sisters Etetu Wogdres and Bezawork Wogderes who assisted me with unreserved effort since the death of my mother at early child hood I also owe a debt of gratitude to all institutions and individuals directly or indirectly contributed to accomplishment of my thesis I thank you all! ii Dedications This paper is dedicated to all under five children living Yeka subcity, Addis Ababa, Ethiopia iii ACRONYMS AND ABBREVIATIONS ARI………Acute Respiratory Infection AA…………Addis Abeba AOR…… Adjusted Odds Ratio ALRI…… Acute Lower Respiratory Infection COR……… Crude Odds Ratio BSc………Bachelor of Science CI……… Confidence Interval HSTP…… Health Sector Transformation Plan HO……….Health Officer HH……….House Hold IMNCI… Integrated Management of Newborn and Childhood Illness IgG………Immunoglobulin m……… month MUAC… Mid Upper Arm Circumference OPD…… Outpatient Department OR………… Odds Ratio iv Table of contents I Acknowledgements………………………………………………………….… …ii II.Acronyms and Abbreviations……………………………………………………….iv III.List of table………………………………………………………………………….vi IV.List of annexes…………………………………………………………………… …ix V Abstract …………………………………………………………………………… x INTRODUCTION 1.1 Background …………………………………………………………………………1 1.2 Statement of the problem…………………………………………………………… 1.3 Significance of the study…………………………………………………………….3 1.4 Literature review…………………………………………………………… Objectives 2.1 General Objective………………………………………………………………….11 2.2 Specific Objectives………………………………………………………………….11 Methodology 3.1 Study area and period …………………………………………………………… 12 3.2 Study design…………………………………………………………………………12 3.3 Target and study population……………………………………………………… 12 v 3.4 Sample Size determination ……………………………………………………………12 3.5 Sampling procedure……………………………………………………………………13 3.6 Inclusion and exclusion criteria……………………………………………………… 15 3.6.1 Inclusion criteria…………………………………………………………………15 3.6.2 Exclusion criteria…………………………………………………………………15 3.7 Study variables ……………………………………………………………………………15 3.7.1 Dependent variable……………………………………………………………… 15 3.7.2 Independent variables………………………………………………….…… 15 3.8 Data collection procedure ……………………………………………….…………… 16 3.9 Data quality assurance …………………………………………………….… 17 3.10 Data entry and analysis…………………………………………………….……………… 17 3.11 Operational definitions………………………………………………….…….…………… 17 3.12 Ethical consideration…………………………… 18 3.13 Plan for communicating the results……………………………………….……………………18 Results…………………………………………………………………………………………….19 4.1 Socioeconomic characteristics of respondents…………………………………………………19 4.2 Sanitation characteristics of respondents……………………………………………………….20 4.3 Household characteristics of respondents…………………………………………… .21 vi 4.4 Characteristics of under five children……………………………………………………………22 4.5 Factors Associated with acute lower respiratory infection of under five children………………23 4.5.1 Bivariate analysis of acute lower respiratory infection of under-five children …………….24 4.5.2 Multivariate analysis of acute lower respiratory infection of under-five children………… 26 Discussion…………………………………………………………………………………… ….28 Strength and limitation……………………………………………………………………… ….31 Conclusion and recommendation……………………………………………………………… 32 References …………………………………………… ………………………………………….33 Annexes and questionnaires……………………………………………… .40 vii LIST OF TABLES Table 1: The prevalence and sample size for each risk factors Table 2: Socioeconomic characteristics of respondents in Yeka sub city,Addis Ababa, Ethiopia, 2017 Table 3: Household characteristics of respondents in Yeka sub city Addis Abeba, Ethiopia, 2017 Table 4: Characteristics of under five children in Yeka sub city, Addis Ababa, Ethiopia, 2017 Table 5: Bivariate analysis of acute lower respiratory infection of under-five children in Yeka sub city, Addis Abeba, Ethiopia, 2017 Table 6: Multivariate analysis acute lower respiratory infection of under five children in Yeka sub city, Addis Abeba, Ethiopia, 017 viii ANNEXES AND QUETIONAIRE Information sheet for child parent I am master of public health student at Addis Abeba University I would like to spend thirty minutes to ask you about prevalence and risks of acute lower respiratory infection among under five children Your information will help to improve the health of your child and for other children in Yeka sub city Whatever information you provide will be kept strictly confidential, and will not be shown to any other person or used for any other purpose other than for analysis You will not get any incentive that you are participating in the study rather it is full of voluntary and You don’t have to answer any question that you not to answer, and you may end this questionnaire any time you want to However, your honest responses to these questions will help us better understand risks of acute respiratory infection Do you have any questions? If you want to know more information, you can contact the principal investigator by the following address below Bashaw Wogderes (BSc) Cell phone: +251-09 20 31 90 98 E-mail: bashaw.w2000@gmail.com May I interview you questions that relates to the study? Yes No 40 Annex one structured questionnaire English version Instruction: Ask the following questions then circle their answer on the options column if it is a choice question or write their answer on the blank space if it is an open ended question PART ONE:-ENTRANCE QUESTIONS No Questions 101 Do you have under five child in your Yes -1 If ‘Yes’ skip to Q102 / if home? ‘No’ stop interview 102 Response and code No Did your child had the following Yes -1 If ‘Yes’ skip to Q103 / if symptoms in last two week? ‘No’ skip to Q104 No Cough and/ or fever 103 ASK/Check the child for the following Yes -1 sign? No short ,rapid breathing or breathlessness or wheezing and chest retractions 104 Skip Code of woreda/ Ketena 41 Part II FAMILY SOCIOECONOMIC STATUS No Questions Response and code 201 What is Family Religion? Orthodox Christian -1 Muslim -2 Protestant Catholic Other -99 202 What is Educational status of mother? Illiterate -0 Read and write Primary Secondary -3 Preparatory -4 Diploma and above 203 What is Educational status of father? Illiterate -0 Read and write Primary Secondary -3 Preparatory -4 Diploma and above 204 For mother, What is your usual work? Laborer -1 Private service -2 Govt service -3 Business -4 42 Skip Others 99 205 For father, What is your usual work? Laborer -1 Private service -2 Govt service -3 Business -4 Others 99 Part III HOUSE HOLD LEVEL FACTOR No Questions 301 How many children you have? 302 Do your Response and code living room have Yes -1 windows? 303 No -2 What type cooking of material Electricity or -1 you used? gas or Kerosene -2 Charcoal ,Wood/ Animal dung -4 Charcoal and electricity -5 Others -99 304 Where you cook family food? Separate building -1 Separate room -2 Living room 43 Skip Others 99 305 What is family Source of drinking Pipe water -1 water? Protected dug well -2 Unprotected dug well Others -99 306 What Type of toilet facility Water carriage latrine family used? Ventilated improved pit latrine Traditional latrine -3 Others -99 307 Is there any who smoke cigarettes Yes -1 at home? No -2 Part IV: CHILD RELATED FACTOR No Questions Response and code 401 How old he/she is (Age in months)? 402 What is Sex of child? M -1 F 403 Has he/she been taking to day care centre? Yes -1 No -2 404 What is the Immunization status of your child? Not started -1 Up to date Loss to follow up 44 Skip Completed -4 405 Did you give your child other food in addition Yes to breast milk before age of 6m celebration? No -2 If ‘Yes’ skip to Q 406 / if ‘No’ skip to Q407 406 When did you start? before 4months between 4-6month at 6months -3 407 How many children had been born before this child was born? 408 After how many years child was born in Less than a year -1 relative to her/his older brother/sister? From a year- two year From two year -three year three year and above -4 PART V:-ASSESS NUTRITIONAL STATUS 501 Measure MUAC for child greater or equal to six months 45 Annex 2: Structured Questionnaire Amharic Version የየየየየየየየየየየየ/የየየየ የየየየየየየ የየ የየየየየ የየየ የየየየ-የየየ የየየየየየ የየየ የየየ የየየየየ የየ የ30 የየየ የየየ የየየ የየየየየየየ የየየየየ የየየ የየየ የየየ የየ የየየየየ የየየየ የየየየየየ የየየየየየ የየ የየየየ የየየየየየ የየየየየየ የየየየ:: የየየየየ የየየ የየየየየየ የየየ የየ የየየ የየየ የየየ የየየየ የየየ የየ የየየየየ የየየየየ:: የየየየየ የየየ የየየየየየ የየየየ የየየየ የየየየ የየየየ የየ የየየ የየ የየየየየየ የየየየየየ:: የየየየ የየየየየየ የየየየየየየ የየየ የየየ የየየየ የየየ የየየየ:: የየየ የየየየ የየየየየየየ የየየ የየ የየየ የየየየየየ የየየየ::የየየየየየ የየ የየየየየ የየየየ የየየየ::የየየየየ የየየየየ የየየየየ የየየ የየየየ የየየ የየየየየየ የየየየየየ የየየየ የየየየየየ የየየየ የየየየየ::የየየየየየየ? የየየየ የየየ የየየየ የየየየየየ የየየ የየየየየየ የየየየ የየየየ የየየየ:: የየ የየየ የየየየየ (የየየየየየየየየየየየ) የየየየየየ 09 20 31 90 98 የየየ - bashaw.w2000@gmail.com የየየየ የየየ የየየየየየየ የየየየየ የየየየየየ የየየየ የየየየየ? የየየየ የየየየየ 46 የየየየ:የየየየየ የየየየየየየ የየየ የየየየ የየየየየ የየየየ የየየ የየየ የየ የየየ የየየየየ የየየ የየየየየ የየ የየ የየየ:: የየየየየየ :-የየየየየ የየየየየ የ.የ የየየየየ 101 የየየየየየ የየየ የየየየ የየየየየ የየየ የየየ የየየ የየ የየየየየ የየየ የየ የየ? የየየ የየየ -2 የየ የየየ 102 የየየ/ የየየ የየየ የየየ የየየየየ የየየየ 102 የየየ/የ የየየየየየ የየየየየ የየ - የየየየየየ/የየየ የየየየየ የየየ የየ የየየ የየ የየ /የየየ የየየየየየየ/የየየ የየ የየየ 103 የየየ/ የየየየ -2 የየየ የየየየየየየ/የየየ የየየ የየ የየየ 104 የየየ 103 የየየ/የ የ የየየየየየ የየየየየ የየ - የየየየየ/የየየ የየ የየ የየየየየ የየየ የየየ የየየየየየ የየየ የየየ -2 47 የየ የየ የየየ የየየ የየ የየየየ የየየየየ 104 የየየየየ/የየየየየየየ የየየየየየ :-የየየየየየ/የየየየየየየየየየየየ የየየ የየየየየየ የ.የ የየየየ 201 የየየየየየ የየየየ? የየየ የ የየ የየየ የየየየየየ የየየየየየየ የየየየ የየየየ -4 የየ የየ የየየየ -99 202 የየየየየየ የየየየየየ የየየ ? የየየየየየ የየየየ የየየየ የየየየየ የየየየየየ የየየ -2 የየየየ የየየ የየየየየየ -4 48 የየየየየ የየየ የየየ 203 የየየየየየ የየየየየየ የየየ የየየየየየ የየየየየየ? የየየየ የየየየ የየየየየ የየየየየየ የየየ -2 የየየየ የየየ የየየየየየ -4 የየየየየ የየየ የየየ 204 የየየየየ የየየየየ የየየ/የየየየየ የየየየ የየየየየየየየየየየየየ? -1 የየየ የየ -2 የየየየየየ የየ -3 የየየ የየየ -4 የየ የየ የየየየ 99 205 የየየየየ የየየየየ? የየየየየ የየየየየ የየ የየየ/የየየየየ የየየየ 49 የየየ የየ -2 የየየየየየ የየ -3 የየየ የየየ -4 የየ የየ የየየየ 99 የየየየየየየ- የየየየ የየየ የየየየየየ የ.የ የየየየ 301 የየየ የየየ የየየየ? 302 የየየየ የየየየ የየየ? የየየ የ የየ የየ የየየየ 303 የየየየየየየየየየ የየየየየየየ - የየየየየየ? የየ የየየ የየየየ -2 የየየየ/የየየየየ -3 የየየየ -4 50 የየየ የየየየየየየ የየ የየየየ -5 የየ የየ የየየየ 99 304 የየየየየየየ የየየየየየየ የየ የየ? የየየ የየየየ የየየየ የየየ የየየየ የየየየ የየየ የየየ -2 የየየየ የየየ የየየ የየ የየ የየየየ 99 305 የየየየየየየየየየየየየየየየ የየየየየየ -የየ የየየየየ? -1 የየየ የየየ የየየ የየ የየየ የየየየ የየየ የየ የየ የየ የየየየ -99 306 የየየየየየ የየየ የየ የየ የየየ የየየየየ የየየ የየ -የየየየ የየ? 51 የየየየየ የየየ የየ የየየየ የየየ የየ የየ የየ የየየየ -99 307 የየ የየየ የየየ የየየየየ የየ የየ -1 የየ? የየየ የየየየየየ :-የየየየየ/የየየየየየየ የ የየየየ የየየ የ የየ የ 401 የየየየ/የ የየየ የየየ የየየ የየ? 402 የየየየ/የ የየ የየየ የየ 403 የየየ የየየየ የየየ የየየየ/የየየየየ? የየ የየየየየ/የየየየየ 404 የየየየ/የ የየየየየ የየየ የየ የየ የየ? የየየየየየ/የየ 52 የየየ የየየየየ/የየየ የየየየየ የየየየ/የየየ 405 የየየየ የየ የየየየየ/የየ የየየ የየየየ የየ የየየየ/የየ -1 የየ የየየየ የየየ የየየየ/የየ? የየየየየየየየ የየየየ/የየ የየየየየየ/የየ የየየ የየ የየየ የየየ/ 406 የየየየየየየየየ/ የየ የየየ የየ የየየ 407 የየየ 406 የየየ/የየየየየ የየየየ የየየ የየየየየ/የየ? የየየየየየየየየየ/የየ የየ -1 የየየየ የየየ የየየየ የየየ የየየ የየ የየየ የየየየየ የየ የየየ 407 የየየየ/የየየየየየየየየየየየየየየ?(የየየየ የየ;የየ) 408 የየየየየ/የየ የየየየ የየየ የየየየ የየየ የየ የየየ የየየ የየየየ የየ የየየ የየየ/የየየየየ/የ? የየየ 53 የየየየ የየየ የየየ የየየ የየየ የየ የየየ የየየየ የየየ የየየ የየየ የየየ የየ የየየ የየየየ የየየ የየየ የየየየየየየየ- የየየየየ/የየ የየየ የየየ የየየየየየ 501 የየየየ የየየ የየ የየየ የየየየ/የየ የየየ የየየ የየየ 54 _ .. .ADDIS ABABA UNIVERSITY SCHOOL OF GRADUATE STUDIES PREVALENCE AND ASSOCIATED FACTORS OF ACUTE LOWER RESPIRATORY INFECTION AMONG UNDER FIVE CHILDREN, YEKA SUB CITY, ADDIS ABEBA, ETHIOPIA. .. acute lower respiratory infection of under- five children in Yeka sub city, Addis Abeba, Ethiopia, 2017 Table 6: Multivariate analysis acute lower respiratory infection of under five children in Yeka. .. Yeka sub city, Addis Abeba, Ethiopia 2.2 Specific objectives  To determine the prevalence of acute lower respiratory infection among under five children in Yeka sub city, Addis abeba, Ethiopia