Family Health Behavior: Preventive Measures against Acute Respiratory Infections in Under‑5 Children

Mardiana Dwi Puspitasari, Mugia Bayu Rahardja

Abstract


Background: The under‑5 mortality rate in Indonesia is 32 per 1,000 live births, still higher than the SDG target. Acute respiratory infections (ARIs), as one of the leading causes of death, must be prevented. Arguments emerge concerning the association of home crowding, health behavior, and the incidence of ARI. Methods: A cross‑section analysis with the Indonesia Demographic and Health Survey (IDHS) 2017 dataset is performed. Samples are restricted to 16,555 children aged 0–59 months who lived with their mother (eligible women interviewed) during the survey. For each of the variables observed during this study, missing data must be omitted as exclusion criteria. A 100 per cent answer rate was achieved. Logistic regression was used to determine ARI‑associated factors, by examining the effect of each explanatory factor (independent variables) on the odds ratio of ARI (one dependent binary variable). Results: The prevalence of ARI was more common among children living in the poorest households (AOR 1.66; 95% CI, 1.20 – 2.28) and those exposed to indoor tobacco smoke pollution (AOR 1.27; 95% CI, 1.04–1.56). On the other hand, those aged 0–5 months (AOR 0.59; 95% CI, 0.43–0.82), living at home with improved sanitation (AOR 0.74; 95% CI, 0.61–0.89), and exclusively breastfed (AOR 0.85; 95% CI, 0.73–0.99) were less likely to have ARI. Conclusions: Home crowding is not associated with ARI. Efforts should be focused on preserving family health behavior. The family functioned as a health‑support system for their under‑5 children by establishing an indoor tobacco smoking‑free zone, practicing exclusive breastfeeding, and enhancing hygiene facilities.

Keywords


Breastfeeding; crowding; family health; tobacco smoke pollution

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References


United Nations Inter‑agency Group for Child Mortality

Estimation (UN IGME). Levels & Trends in Child Mortality:

Report 2019, Estimates developed by the United Nations

Inter‑agency Group for Child Mortality Estimation. New York:

UNICEF, WHO. Pneumonia: The Forgotten Killer of Children.

New York: UNICEF; 2006.

International Vaccine Access Center (IVAC). Pneumonia and

Diarrhea Progress Report 2020. Johns Hopkins Bloomberg

School of Public Health; 2020.

National Population and Family Planning Board (BKKBN),

Statistics Indonesia (BPS), Ministry of Health (Kemenkes),

ICF. Indonesia Demographic and Health Survey 2017. Jakarta,

Indonesia: BKKBN, BPS, Kemenkes, and ICF; 2018.

Cox M, Rose L, Kalua K, de Wildt G, Bailey R, Hart J. The

prevalence and risk factors for acute respiratory infections in

children aged 0‑59 months in rural Malawi: A cross‑sectional

study. Influenza Other Respi Viruses 2017;11:489‑96.

Firdaus G, Ahmad A. Relationship between housing and health:

A cross‑sectional study of an urban centre of India. Indoor Built

Environ 2013;22:498‑507.

Lobato‑Cordero A, Quentin E, Lobato‑Cordero G. Spatiotemporal

analysis of influenza morbidity and its association with climatic

and housing conditions in ecuador. J Environ Public Health

;2019:6741202.

Nkosi V, Haman T, Naicker N, Mathee A. Overcrowding and

health in two impoverished suburbs of Johannesburg, South

Africa. BMC Public Health 2019;19:1‑8.

Tse SM, Weiler H, Kovesi T. Food insecurity, vitamin D

insufficiency and respiratory infections among inuit children. Int

J Circumpolar Health 2016;75:29954.

Swope CB, Hernández D. Housing as a determinant of health

equity: A conceptual model. Soc Sci Med 2019;243:112571.

Herrin WE, Amaral MM, Balihuta AM. The relationships

between housing quality and occupant health in Uganda. Soc Sci

Med 2013;81:115‑22.

Kohen DE, Bougie E, Guèvremont A. Housing and health among

Inuit children. Heal Reports 2015;26:21‑7.

Tustingid LS, Gething PW, Gibsonid HS, Greenwoodid B,

Knudsenid J, Lindsayid SW, et al. Housing and child health

in sub‑Saharan Africa: A cross‑sectional analysis. PLoS Med

;17:e1003055.

Pratt KJ, Sonney JT. Family science and family‑based research

in integrated and health care contexts: Future considerations for

families, systems, & health. Fam Syst Health 2020;38:1‑5.

Dai L, Wang L. Review of family functioning. Open J Soc Sci

;3:134‑41.

Miller IW, Ryan CE, Keitner GI, Bishop DS, Epstein NB. The

McMaster approach to families: Theory, assessment, treatment

and research. J Fam Ther 2000;22:168‑89.

Jones LL, Hashim A, McKeever T, Cook DG, Britton J,

Leonardi‑Bee J. Parental and household smoking and the

increased risk of bronchitis, bronchiolitis and other lower

respiratory infections in infancy: Systematic review and

meta‑analysis. Respir Res 2011;12:1‑11.

Miyahara R, Takahashi K, Anh NTH, Thiem VD, Suzuki M,

Yoshino H, et al. Exposure to paternal tobacco smoking

increased child hospitalization for lower respiratory infections

but not for other diseases in Vietnam. Sci Rep 2017;7:1‑7.

Zhuge Y, Qian H, Zheng X, Huang C, Zhang Y, Li B, et al.

Effects of parental smoking and indoor tobacco smoke exposure

on respiratory outcomes in children. Sci Rep 2020;10:1‑9.

Been J V., Millett C, Lee JT, Van Schayck CP, Sheikh A.

Smoke‑free legislation and childhood hospitalisations for

respiratory tract infections. Eur Respir J 2015;46:697‑706.

Ahmed KY, Page A, Arora A, Ogbo FA, Agho KE, Diallo T,

et al. Associations between infant and young child feeding

practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach. PLoS One

;15:1‑20.

Khan J, Vesel L, Bahl R, Martines JC. Timing of breastfeeding

initiation and exclusivity of breastfeeding during the first

month of life: Effects on neonatal mortality and morbidity—A

systematic review and meta‑analysis. Matern Child Health J

;19:468‑79.

Saeed OB, Haile ZT, Chertok IA. Association between exclusive

breastfeeding and infant health outcomes in Pakistan. J Pediatr

Nurs 2020;50:e62‑8.

National Population and Family Planning Board

(BKKBN) [Government of Indonesia], Statistics Indonesia

(BPS) [Government of Indonesia], Ministry of Health

(Kemenkes) [Government of Indonesia]. Indonesia Demographic

and Health Survey (IDHS) 2017 [Dataset]. IDN_2017_DHS_

v01_M2017. Available from: http://www.dhsprogram.com/[Last

accessed on 2019 Dec 7].

ICF. Demographic and Health Surveys Standard: Recode Manual

for DHS 7. In: The Demographic and Health Surveys Program.

Rockville, Maryland, USA: ICF; 2018.

Adesanya OA, Chiao C. A multilevel analysis of lifestyle

variations in symptoms of acute respiratory infection among

young children under five in Nigeria. BMC Public Health

;16:1‑12.

Amsalu ET, Akalu TY, Gelaye KA. Spatial distribution and

determinants of acute respiratory infection among under‑five

children in Ethiopia: Ethiopian demographic Health Survey

PLoS One 2019;14:45‑59.

Chiao C, Deji‑Abiodun O. A global analysis of the regional

variation in the symptoms of acute respiratory infection during

childhood: Epidemics and their association with environmental

vulnerability. Heal Place 2020;65:102400.

Statistics Indonesia (BPS). Statistik 70 Tahun Indonesia Merdeka.

Jakarta, Indonesia: Badan Pusat Statistik; 2015.

Armah FA, Ekumah B, Yawson DO, Odoi JO, Afitiri AR,

Nyieku FE. Access to improved water and sanitation in

sub‑Saharan Africa in a quarter century. Heliyon 2018;4:e00931.

Agresti A. Categorical Data Analysis. USA: John Wiley & Sons;

Hosmer DW, Lemeshow S. Applied Logistic Regression. 2nd ed.

USA: John Wiley & Sons, Inc; 2000.

Dong G‑H, Qian Z, Liu M‑M, Wang D, Ren W‑H, Bawa S,

et al. Breastfeeding as a modifier of the respiratory effects of air

pollution in children. Epidemiology 2013;24:387‑94.

Zielinska MA, Hamulka J. Protective effect of breastfeeding

on the adverse health effects induced by air pollution: Current

evidence and possible mechanisms. Int J Environ Res Public

Health 2019;16:1‑29.

Barnes MD, Hanson CL, Novilla LB, Magnusson BM,

Crandall AC, Bradford G. Family‑centered health promotion:

Perspectives for engaging families and achieving better health

outcomes. Inq J Heal Care Organ 2020;57:46958020923537.

Seidu AA, Dickson KS, Ahinkorah BO, Amu H, Darteh EKM,

Kumi‑Kyereme A. Prevalence and determinants of acute lower

respiratory infections among children under‑five years in

sub–Saharan Africa: Evidence from demographic and health

surveys. SSM‑Popul Heal 2019;8:100443.

Ullah MB, Mridha MK, Arnold CD, Matias SL, Khan MSA,

Siddiqui Z, et al. Factors associated with diarrhea and acute

respiratory infection in children under two years of age in rural

Bangladesh. BMC Pediatr 2019;19:1‑11.

Debnath SC, Haque ME, Hasan DMM, Samin S, Rouf MA,

Rabby MF. Undernutrition and morbidity profile of exclusively

breastfeeding children: A cross‑sectional study. Int J Prev Med

;9:55.

Malekzadeh J, Synai S, Ebrahimzadeh Koor B, Falsafian G,

Nakhaie M. Growth indices of exclusively breastfed until

months age and formula‑fed infants in southwest of Iran. Int J

Prev Med 2019;10:207.

Herawati P, Afriandi I, Wahyudi K. Determinan Paparan Asap

Rokok di Dalam Rumah: Analisis Data Survei Demografi dan

Kesehatan Indonesia (SDKI) 2012. Buletin Penelitian Kesehatan.

Buletin Penelitian Kesehatan 2019;47:245‑52.

Thomas TK, Ritter T, Bruden D, Bruce M, Byrd K, Goldberger R,

et al. Impact of providing in‑home water service on the rates of

infectious diseases: Results from four communities in Western

Alaska. J Water Health 2016;14:132‑41.

Irda Sari SY, Sunjaya DK, Shimizu‑Furusawa H, Watanabe C,

Raksanagara AS. Water sources quality in urban slum settlement

along the contaminated river basin in Indonesia: Application of

quantitative microbial risk assessment. J Environ Public Health

;2018:1‑7.

Krishnan D, Omprakash A, Ramaswamy P, G T, S S,

Balakrishnan K. Prevalence of acute respiratory infection in

children less than 2 years in rural and urban population in and

around Chennai, Tamil Nadu. Natl J Physiol Pharm Pharmacol

;9:804‑808.

Sharma D, Kuppusamy K, Bhoorasamy A. Prevalence of acute

respiratory infections (ARI) and their determinants in under five

children in urban and rural areas of Kancheepuram District,

South India. Ann Trop Med Public Heal 2013;6:513‑8.

Brugha R, Grigg J. Urban air pollution and respiratory infections.

Paediatr Respir Rev 2014;15:194‑9.

Rahman SRA, Ismail SNS, Sahani M, Ramli MF, Latif MT.

A case crossover analysis of primary air pollutants association

on acute respiratory infection (ARI) among children in urban

region of Klang valley, Malaysia. Ann Trop Med Public Heal

;10:1587‑90.

Hapsari D, Nainggolan O, Kusuma D. Hotspots and regional

variation in smoking prevalence among 514 districts in

Indonesia: Analysis of basic health research 2018. Glob J Health

Sci 2020;12:1‑32.