Occurrence of Acute Respiratory Tract Infections among Children Under Five Years Attending Kinango Sub-County Hospital, Kenya

Research Article

Austin J Public Health Epidemiol. 2021; 8(3): 1105.

Occurrence of Acute Respiratory Tract Infections among Children Under Five Years Attending Kinango Sub-County Hospital, Kenya

Betty Muriithi1,2*, Simon Karanja1, Mohamed Karama3, Collins Okoyo4, Morris Ndemwa2, Yoshio Ichinose2 and Satoshi Kaneko2

1School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya

2Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya

3Umma University, Kajiado, Kenya

4Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya

*Corresponding author: Betty Muriithi, Nagasaki University, Institute of Tropical Medicine, Kenya Medical Research Institute Project, Nairobi, Kenya

Received: June 08, 2021; Accepted: July 16, 2021; Published: July 23, 2021


Objective: To examine occurrence of Acute Respiratory tract Infections (ARIs) and determine factors associated with ARIs among children under five years attending Kinango Sub-County Hospital.

Methods: A cross-sectional survey was conducted among mother-child aged between 0-59 month’s pairs attending outpatient care. Participants were recruited using systematic sampling method. Data was collected using an interviewer-administered structured questionnaire. Descriptive statistics were used to summarize child, parental and environmental characteristics. Factors associated with ARIs were established using binary logistic regression analysis. Odds Ratio (OR), at 95% Confidence Interval (CI) and p <0.05 significant level was used to describe an association between covariates and the outcome variable. Independent factors associated with occurrence of ARIS were determined by stepwise logistic regression.

Results: 385 children participated in this study. 228 children (59.2%) presented with ARIs, of which 90.8% were due to acute upper respiratory tract infections. 9.2% of the cases were due to pneumonia. Female gender aOR 3.39 [1.21-9.46], stunting aOR 3.62 [1.04-12.61], high parity aOR 11.45 [2.38-55.09], low maternal education aOR 3.54 [1.10-11.32] and recent hospitalization aOR 8.19 [1.75-38.43] increased the odds of occurrence of an ARI while normal birth weight aOR0.06 [0.01-0.62] was protective of ARIs.

Conclusion: A high prevalence of ARIs among children aged below five years was observed in this study, associated with gender, stunting, parity, maternal education, birth weight and recurring hospitalization. Improvements in literacy levels, child nutrition and maternal and child health at large could help to reduce morbidity due to ARIs in this population.

Keywords: Prevalence; Children under five years; Acute respiratory tract infections


Acute Respiratory Tract Infections (ARIs) are infections of the respiratory tract of ranging severity that affect both upper and lower respiratory structures, and related organs [1]. They are among the most common causes of morbidity and mortality among children under the age of five years. They account for up to 50% of all diseases that children under five years encounter [2] and a third of underfives deaths in developing countries [3,4]. According to GBD 2017, mortalities due to acute lower respiratory tract infections only were 118.9 per 100,000 children under five years globally, representing 15% of all under-fives deaths [5]. Over half of all diagnosis among children presenting with ARI symptoms are usually due to acute upper respiratory tract infections [6,7]. A child can experience up to eight episodes of ARIs of varying severity in a year [8-10].

Although ARIs are common among both children and adults, universal treatment is still lacking due to the nature of their causative agents and diagnostic uncertainty. Symptoms of common infections such as the common cold typically clear in one to two weeks but the symptoms can be quite distressing to both the child and caregiver. Moreover, the infection can spread to other parts of the body resulting to more serious clinical disease and even fatality. Respiratory viruses have been shown to have neuroinvasive capacity [11] that results to various types of encephalopathy, alongside other systemic effects due to extension of microbial toxins, inflammation and reduced lung function [12]. ARIs are also a common reason for administration of antibiotics. Approximately 33% of consultations for a child with an upper respiratory tract infection specifically ends up with an antibiotic prescription [13]. Such irrational administration of antibiotics is steadily yielding resistance to convectional antibiotics, reducing therapeutic options for management of bacterial infections [13,14].

Given the nature of childhood ARIs, prevention and control present more viable options for management of ARIs. Several risk factors for ARIs have been postulated [15,16], that modulate occurrence of ARIs, although these differ widely. Proper understanding of the drivers of occurrence of ARIs in particular settings is therefore necessary for development of appropriate prevention and control algorithms. The aim of this study was to examine occurrence of ARIs among children aged below five years attending Kinango Sub-County hospital and determinants of their occurrence.


Study site

The study was conducted in Kinango Sub-County Hospital, located in Kinango town within Kinango Sub-County in Kwale County, Kenya (Figure 1). The hospital is a level 4 facility with a 94- bed capacity. It has a dedicated maternal and child health clinic, and an outpatient department that serves both adults and children. The hospital’s community linkage is well developed, with the community health volunteers actively involved in linking the community to primary care. The hospital’s catchment area covers both rural and semi-urban settlements, with varying levels of access by the community.