Correlates of acute lower respiratory tract infections in children under 5 years of age in India

Int J Tuberc Lung Dis. 2013 Mar;17(3):418-22. doi: 10.5588/ijtld.12.0117.


Background: In developing countries, acute lower respiratory tract infections (ALRTI) cause considerable morbidity, hospitalisation and mortality in children aged <5 years.

Methods: A prospective case-control study was conducted to identify potential socio-demographic, nutritional and environmental risk factors for ALRTI. The World Health Organization definition for ALRTI was used for cases. Healthy children attending child immunisation services were enrolled as controls.

Results: A total of 214 children, 107 cases and 107 controls, were enrolled. Among the cases, pneumonia, severe pneumonia and very severe disease constituted respectively 23.3%, 47.7% and 29%. Among cases and controls, the male-to-female ratio (1.3:1 vs. 0.9:1) and the proportion of infants (64.5% vs. 70.1%) were identical. Parents' literacy level was negatively associated with ALRTI. On multivariate logistic regression analysis, low socio-economic status (OR 4.89, 95%CI 1.93-12.36), upper respiratory infections in family members (OR 5.32, 95%CI 2.11-13.45), inappropriate weaning period (OR 3.01, 95%CI 1.12-8.07), malnutrition (OR 1.75, 95%CI 1.84-3.67), pallor (OR 7.18, 95%CI 2.08-24.82) and cooking fuel other than liquid petroleum gas (OR 3.58, 95%CI 1.23-10.45) were found to be significant risk factors (P < 0.05).

Conclusions: The present study identified various risk factors for ALRTI, some of which are modifiable by effective community education and public health measures.

MeSH terms

  • Acute Disease
  • Age Factors
  • Case-Control Studies
  • Child Nutritional Physiological Phenomena*
  • Child, Preschool
  • Cooking
  • Developing Countries
  • Female
  • Housing*
  • Humans
  • India / epidemiology
  • Infant
  • Logistic Models
  • Male
  • Malnutrition / epidemiology
  • Multivariate Analysis
  • Nutritional Status
  • Odds Ratio
  • Pallor / epidemiology
  • Pneumonia / epidemiology
  • Prospective Studies
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / prevention & control
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Socioeconomic Factors*