Akter Shahinur, Siriphon Aranya, Ayuttacorn Arratee, Boonchieng Waraporn
Faculty of Social Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
Sociology Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh.
BMC Public Health. 2025 Aug 27;25(1):2951. doi: 10.1186/s12889-025-24415-3.
Acute respiratory infection (ARI), fever, and diarrhea are the prominent causes of the burden of childhood communicable diseases along with mortality in developing countries which contributes to nutritional deficiencies, reduced resistance to infections and impaired growth and development. Therefore, the present study aims to investigate the prevalence of ARI, fever, and diarrhea among under-five children and the influencing factors in the southwestern coastal region of Bangladesh by incorporating the social ecological model.
The study was conducted in six villages of Dacope upazila under Khulna district of Bangladesh following cross-sectional survey method. Data were collected from 348 randomly selected caregivers with at least one child aged 6 to 59 months. A semi-structured interview schedule was used for data collection from the participants through face-to-face interviews from July to October 2024. Bivariate and multivariate analyses were conducted to determine the factors influencing the prevalence of ARI, fever, and diarrhea among under-five children.
Results showed that ARI prevalence among under-five children was 64.7%, followed by fever at 42.2%, and diarrhea at 13.5% in the southwestern coastal region. Findings also revealed that various individual factors such as child sex, child feeding frequency, and birth weight; interpersonal factors like house type, type of family, and household vulnerability; and community-level factors such as place of residence and availability of qualified doctors in the locality were the significant predictors of the prevalence of these diseases. However, we did not find any significant influence of policy-level factors on the prevalence of these diseases. Children who were fed ≥ 7 times a day and those residing in Nolian village had higher odds of having ARI than their counterparts. On the other hand, children with normal birth weight, children who were fed 5-6 times and ≥ 7 times a day, and children living in Hoglabunia village had higher odds of getting fever. Nonetheless, children living in semi-pacca houses had lower odds of experiencing fever compared to their counterparts. Moreover, boys, children from higher vulnerable households, and children residing in the community where qualified doctors are available had higher odds of getting diarrhea, whereas children from nuclear families had lower odds of having diarrhea than their counterparts.
The study suggests introducing targeted nutrition education programs for both mothers and infants through community outreach. Besides, generating sustainable income opportunities to reduce coastal households' vulnerabilities. Additionally, infrastructural development is essential to ensure access to quality healthcare services in geospatially disadvantaged regions, especially in southwestern coastal region of Bangladesh.
急性呼吸道感染（ARI）、发热和腹泻是发展中国家儿童传染病负担以及死亡率的主要原因，这些导致了营养缺乏、抗感染能力下降以及生长发育受损。因此，本研究旨在通过纳入社会生态模型，调查孟加拉国西南沿海地区五岁以下儿童中ARI、发热和腹泻的患病率及其影响因素。
本研究采用横断面调查方法，在孟加拉国库尔纳区达科普乡的六个村庄进行。从348名随机选择的照顾者那里收集数据，他们至少有一名年龄在6至59个月的儿童。2024年7月至10月，通过面对面访谈，使用半结构化访谈提纲从参与者那里收集数据。进行双变量和多变量分析，以确定影响五岁以下儿童中ARI、发热和腹泻患病率的因素。
结果显示，在西南沿海地区，五岁以下儿童中ARI的患病率为64.7%，其次是发热，为42.2%，腹泻为13.5%。研究结果还表明，各种个体因素，如儿童性别、儿童喂养频率和出生体重；人际因素，如房屋类型、家庭类型和家庭脆弱性；以及社区层面的因素，如居住地点和当地合格医生的可及性，是这些疾病患病率的重要预测因素。然而，我们没有发现政策层面的因素对这些疾病的患病率有任何显著影响。每天喂养≥7次的儿童以及居住在诺利安村的儿童患ARI的几率高于其他儿童。另一方面，出生体重正常的儿童、每天喂养5 - 6次和≥7次的儿童以及居住在霍格拉布尼亚村的儿童发烧的几率更高。尽管如此，与其他儿童相比，居住在半永久性房屋中的儿童发烧的几率较低。此外，男孩、来自高脆弱性家庭的儿童以及居住在有合格医生的社区的儿童患腹泻的几率更高，而来自核心家庭的儿童患腹泻的几率低于其他儿童。
该研究建议通过社区宣传为母亲和婴儿引入有针对性的营养教育项目。此外，创造可持续的收入机会以降低沿海家庭的脆弱性。此外，基础设施发展对于确保在地理空间条件不利的地区，特别是孟加拉国西南沿海地区获得优质医疗服务至关重要。
