Naslov
Incidence of acute lower respiratory infections (ALRI) in children under five years: II. Estimates for WHO regions

Autori
Rudan, Igor ; Tomaskovic, Lana ; Boschi-Pinto, Cynthia ; Campbell, Harry

Izvornik
Bulletin of the World Health Organization (0042-9686) 81 (2003), 11; 737-748

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
ALRI; incidence; children; under-fives; developing countries

Sažetak
We have previously reported an estimate for global acute lower respiratory infection (ALRI) incidence in young children under 5 years of age of 0.29 episodes/child-year or about 150 million new episodes each year. In this paper we aim to distribute these cases by the WHO regions of the world. This was performed by distributing episodes according to national under five child population data and data on the prevalence of exposure to major ALRI risk factors for each country then assembling these into regional estimates based on country membership of WHO regions. The risk factors most consistently reported to be associated with ALRI incidence and for which prevalence information for each country was available were malnutrition (weight-for-height less than -2 z-score), low birth weight (less than 2, 500 g), lack of breastfeeding (in first 4 months of life), crowding (5 or more persons per household) and lack of measles immunization. A review of the literature showed that relative risks for ALRI associated with these factors and which were available from multivariate analyses of longitudinal studies were about 1.8, 1.4, 1.3, 1.2 and 0.7, respectively. The estimated prevalence of exposure to these risk factors was available for more than 95% of under-fives in developing countries from various sources, mainly Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). We introduced a simple model to distribute the global estimate of new ALRI episodes by WHO regions according to risk factor prevalence in each country. The ALRI incidence estimates ranked in order from highest to lowest were Sear D (0.34 episodes/child-year), Afr D (0.33), Emr D (0.32), Afr E (0.31), Sear B (0.27), Amr D (0.25), Amr B (0.24), Emr B (0.23) and Wpr B (0.22). This equates to 57.6 million new ALRI episodes per year in the WHO South East Asia region (Sear D and B), 34.5 million in the African region (Afr D and E), 27.4 million in the Western Pacific region (Wpr B) and 20.3 million in the Eastern Mediterranean region (Emr D).

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

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