Individual and community-level factors associated with symptoms of acute lower respiratory infections among children under 5 years of age in Eswatini

M S Simelane, K Vermaak


Background. Despite initiatives and efforts implemented over the years that would impact positively on child health, acute lower respiratory infections (ALRIs) remain a serious challenge for under-5s.
Objective. To investigate the individual- and community-level factors associated with child ALRIs in Eswatini.
Methods. Using the combined data for 2010 and 2014 Eswatini Multiple Indicator Cluster Surveys, data for 4 265 children under 5 years of age were analysed. Univariable, bivariable and multivariable multilevel logistic regression analyses were conducted.
Results. We found that the prevalence of ALRIs was 11.1% (95% confidence interval (CI) 10.0 - 12.4). Higher odds of ALRIs were observed among children who had reported diarrhoea in the same time period (adjusted odds ratio (aOR) 1.75; 95% CI 1.37 - 2.23) compared with those who did not report diarrhoea, and those born to women with no formal education (aOR 2.16; 95% CI 1.13 - 4.16) and those with primary education (aOR 2.60; 95% CI 1.34 - 5.04) compared with those born to women with tertiary education. Place of residence was a community-level variable associated with higher odds of ALRIs among children from urban areas (aOR 1.59; 95% CI 1.15 - 2.20) compared with rural residents. Those from Manzini (aOR 2.19; 95% CI 1.59 - 3.12), Shiselweni (aOR 1.73; 95% CI 1.23 - 2.44) and Lubombo (aOR 1.77; 95% CI 1.25 - 2.51) were more likely to be infected with ALRIs compared with those from the Hhohho region. In addition, higher odds of ALRIs were observed in children from communities with a low proportion of households with electricity (aOR 1.46; 95% CI 1.10 - 1.95) compared with those from communities with high access to electricity.
Conclusions. We found that individual- and community-level factors were associated with child ALRIs across communities in Eswatini.
Programmes and policies that aim to mitigate child morbidity due to ALRIs should integrate the individual and community factors.

Authors' affiliations

M S Simelane, School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa

K Vermaak, Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini

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Cite this article

South African Journal of Child Health 2021;15(2):66-73.

Article History

Date submitted: 2021-07-21
Date published: 2021-07-21

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