Contextual Effect of Village on the Risk of Pneumonia in Children Under Five in Magetan, East Java
Abstract
Background: Pneumonia is a major cause of illness and death in children under five worldwide. Studies into the contextual effect of village are lacking in Indonesia. This study aimed to determine contextual effect of village on the risk of pneumonia in children under five in Magetan, East Java.
Subjects and Method: This was a case control study conducted in Magetan, East Java, from October 2018 to December 2018. A sample of 225 children under five from 25 villages was selected by fixed disease sampling. The dependent variable was pneumonia. The independent variables were nutritional status, vitamin A intake, maternal stress, maternal education, family income, family smoking, cooking fuel, house physical environment, and the presence of children in the kitchen when cooking. The data were collected by questionnaire and analyzed by a multilevel logistic regression.
Results: Maternal stress (b= 1.91; 95% CI= 0.75 to 3.06; p= 0.001), family smoking habits (b = 1.39; 95% CI = 0.46 to 2.32; p = 0.003), cooking fuel (b= 1.51; 95% CI= 0.46 to 2.55; p= 0.005), and the presence of children in the kitchen when cooking (b= 1.37; 95% CI = 0.38 to 2.35; p= 0.007) increased the risk of pneumonia in children under five. The risk of pneumonia was reduced by good nutritional status (b= -1.74; 95% CI= -2.70 to -0.78; p <0.001), complete vitamin A status (b= -1.14; 95% CI= -2.04 to -0.24; p= 0.013), high maternal education (b= -1.41; 95% CI= -2.45 to -0.37; p= 0.008), high family income (b= -0.91; 95% CI= -1.80 to -0.02; p= 0.045), and healthy home physical environment (b= -1.86; 95% CI= -3.20 to -0.52; p= 0.007). Village had a strong contextual effect on pneumonia among children under five with ICC= 21.32%.
Conclusions: Maternal stress, family smoking habits, cooking fuel, and the presence of children in the kitchen when cooking increase the risk of pneumonia in children under five. It is reduced by good nutritional status, complete vitamin A status, high maternal education, high family income, and healthy home physical environment. Village has a strong contextual effect on pneumonia among children under five
Keywords: pneumonia, children under five, biopsychosocial, environmental, determinants, multilevel analysis
Correspondence:
References
Adesanya OA, Chiao C (2016). A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria, BMC Public Health. BMC Public Health, 16(1): 1
Anwar A, Dharmayanti I (2014). Pneumonia pada Anak Balita di Indonesia. Jurnal Kesehatan Masyarakat Nasional, 8(8): 359
Ayalneh AA, Fetene DM, Lee TJ (2017). Inequalities in health care utilization for common childhood illnesses in Ethiopia: evidence from the 2011 Ethiopian Demographic and Health Survey. International Journal for Equity in Health: 1
Azab S, Sherief LM, Saleh SH, Elshafie MA, Abdelsalam SM (2014). Impact of the socioeconomic status on the severity and outcome of community acquired pneumonia among Egyptian children: a cohort study.Infectious Diseases of Poverty, 3(1): 14. doi: 10.1186/20499957314.
Budijanto D (2016). Data and information indonesia health profile 2016. http://www.depkes.go.id/resources/download/pusdatin/lainlain/Data dan Informasi Kesehatan Profil Kesehatan Indonesia 2016 smaller size web.pdf. Diakses 15 April 2018
Cardoso AM, Horta BL, Santos RV, Escobar AL, Welch JR, Coimbra CEA (2015). Prevalence of pneumonia and associated factors among indigenous children in Brazil: Results from the First National Survey of Indigenous People
Champatiray J, Sataphaty J, Kashyap B, Mondal D (2017). Clinicoaetiological study of severe and very severe pneumonia in two months to five years children in a tertiary health care centre in Odisha, India. Pediatrics Section, 11(9): 10
Dinas Kesehatan Kabupaten Magetan. (2017). Profil kesehatan, Profil Dinas Kesehatan Tahun 2017. Diakses 20 April 2018.
Dinas Kesehatan Provinsi Jatim (2017). Profil Kesehatan Provinsi Jawa Timur Tahun 2017. http://www.depkes.go.id/resources/download/profil/PROFIL_KES_PROVINSI_2017/15_Jatim_2016.pdf. Diakses 20 April 2018.
Ewnetu H (2016). Determinants of community acquired pneumonia among children in Kersa District, Southwest Ethiopia: Facility Based Case Control Study.Journal of Pediatrics & Neonatal Care, 5(2): 1
Fekadu AG (2014). Prevalence of Pneumonia among under five Children in Este Town and the Surrounding Rural Kebeles, Northwest Ethiopia; A Community Based Cross Sectional Study. Science Journal of Public Health, 2(3): 150. doi: 10.11648/j.sjph.20140203.12.
Gothankar J, Doke P, Dhumale G, Pore P, Lalwani S, Quraishi S, Murarkar S (2018). Reported incidence and risk factors of childhood pneumonia in India: a communitybased cross-sectional study.BMC Public Health. 1
Han NTN, Pongjaturawit Y, Chaimongkol N (2015). Factors related to self-efficacy in caring for young children with pneumonia among Vietnamese mothers. Moving Forward to a Prosperous and Sustainable Community: 323
Imdad A, Mayowilson E, Herzer K, Bhutta ZA (2017). Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Data base of Systematic Reviews, (3). doi: 10.1002/14651858.CD008524.pub3.
Kelly CA, Crampin AC, Mortimer K, Dube A, Malava J, Johnston D, Unterhalter E, Glynn JR (2018). From kitchen to classroom: Assessing the impact of cleaner burning biomassfuelled cookstoves on primary school attendance in Karonga district, northern Malawi.PLoS ONE, 13(4): 1
Lestari N, Salimo H, Suradi (2017). Role of Biopsychosocial Factors on the Risk of Pneumonia in Children Under-Five Years Old at Dr. Moewardi Hospital Surakarta.Journal of Maternal and Child Health, 2(2): 162
Murti B (2016). Prinsip dan Metode Riset Epidemiologi. Surakarta: Yuma Pustaka.
Nair S, Lewis LE, Godinho MA, Murthy S, Lakiang T, Venkatesh BT (2018). Factors associated with neonatal pneumonia in India: Protocol for a syste-matic review and planned meta-analysis. BMJ Open, 8(1). doi: 10.1136/bmjopen2017018790.
Nguyen TKP, Tran TH, Roberts CL, Fox GJ, Graham SM, Marais BJ (2017). Child pneumonia
PrayGod G, Mukerebe C, Magawa R, Jeremiah K, Torok ME (2016). Indoor Air Pollution and Delayed Measles Vaccination Increase the Risk of Severe Pneumonia in Children: Results from a Case-Control Study in Mwanza, Tanzania. PLoS ONE, 11(8): 1
Roomaney RA, Wyk VP, Awotiwon OF, Dhansay A, Groenewald P, Joubert JD, Nglazi MD, Nicol E, Bradshaw D (2016) Epidemiology of lower respiratory infection and pneumonia in South Africa (1997-2015): A syste-matic review protocol.BMJ Open, 6(9): 1
Tazinya AA, Ekane GEH, Mbuagbaw LT, Abanda M, Atashili J, Obama MT (2018). Risk factors for acute respiratory infections in children under five years attending the Bamenda Regional Hospital in Cameroon. BMC Pulmonary Medicine: 1
Tekle AG, Worku A, Berhane Y (2015). Factors associated with acute respiratory infection in children under the age of 5 years: evidence from the 2011 Ethiopia Demographic and Health Survey. Pediatric Health, Medicine and Therapeutics: 9. doi: 10.2147/PHMT.S77915.
UNICEF (2015). Pneumonia The Deadliest Childhood Disease. https://data.unicef.org/wpcontent/uploads/2015/12/WorldPneumoniaDayInfographic_242.pdf. Diakses 21 April 2018.
Zar HJ, Barnett W, Stadler A, Lubbe SG, Myer L, Nicol M (2016). Aetiology of childhood pneumonia in a well vaccinated South African birth cohort: A nested case-control study of the Drakenstein Child Health Study. The Lancet Respiratory Medicine. Elsevier Ltd, 4(6): 463
