Background 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.
Methods 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.
Results 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.
Conclusions 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.
- CHILD HEALTH
- SOCIAL FACTORS IN
- SOCIAL INEQUALITIES
- MULTILEVEL MODELLING
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Funding The study was supported by the Ministry of Science and Technology (MOST) in Taiwan under grants 104-2628-H-010-001 and 104-2511-S-010-004-MY3.
Disclaimer The conclusions here are those of the authors and do not represent the viewpoint of the Ministry.
Competing interests None declared.
Ethics approval The study was approved by the Research Ethics Committee of National Yang-Ming University.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The Demographic and Health Surveys (DHS) data sets are publicly available and can be downloaded from the DHS Measures website: www.measuredhs.com.
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