Incidence and risk factors of common infections among children in Wonago, southern Ethiopia: a prospective cohort study

Abstract

Objective: There are limited data in Ethiopia on common childhood illnesses. We aimed to measure the incidence and risk factors of common childhood illnesses in rural parts of southern Ethiopia.

Design: A community-based cohort study.

Participants and study setting: A total of 903 children of 5 years or younger were included between July 2017 and January 2018. We randomly selected households from three administrative units (kebeles) in Wonago district in Ethiopia.

Outcomes: Data on incidence of illnesses were collected by interviewing the mothers of the children every second week, in 6 months. Incidence densities per child-week of observation were calculated, and predictors or recurrent illnesses were evaluated in multilevel Poisson regression models.

Results: Out of 903 children, 882 were included (97.6%). At least one illness was experienced among 87.3% of the children. Overall illness incidence rate was 19.7 episodes per 100 child-weeks, 95% CI 18.4 to 20.7. The incidence rate of fever symptoms was 5.5 episodes per 100 child-weeks; of acute respiratory infections (ARIs) 4.2 episodes per 100 child-weeks; of diarrhoea, 3.4 episodes per 100 child-weeks. In the multilevel analysis, household wealth status, child age, child nutritional status, source of drinking water, place for cooking and number of children below 5 years of age in the household were main risk factors for illnesses.

Conclusions: Children below 5 years of age in Ethiopia often experience fever, ARIs and diarrhoea. The identified risk factors were related to poverty and highlighted the importance of preventive measures to reduce the incidence of these diseases.

Keywords: community child health; epidemiology; follow-up studies; infectious diseases; respiratory infections.

Figure 1. Flow chart showing the recruitment, enrolment and follow-up of children under-5 years of age in southern Ethiopia.

Figure 2. Incidence of illnesses/symptoms among children under 5 years of age in Wonago district, southern Ethiopia, reported by their mothers/caregivers in a period of 6 months. ARI, acute respiratory infection.