Impact of poverty on Acute Respiratory Infections (ARI) Among under five children in Bangladesh

Acute respiratory infection (ARI) is a major cause of under 5 childhood morbidity and mortality in the developing world. Little however is known about the socio-economic determinants of ARI in these societies. This study uses a large nationally representative dataset from Bangladesh (Bangladesh Demographic and Health Survey—2004) to explore the social determinants of ARI. The analysis (binary logistic regression adjusting for clustering) shows that the poor (lowest 60% of the population) are somewhat more likely (OR=1.53) to report ARI than their richer peers (the upper 40% of the population) adjusting just for age and sex. This disadvantage is to a large extent explained [OR: 1.25; 95% C.I. [1.037---1.501] by the greater likelihood of the poor having more malnourished children (lower wt/ht, lower rates of Vitamin A supplementation), more malnourished mothers (lower maternal BMI; lower age at marriage and childbirth), mothers with less knowledge about health care and nutrition (less educated mothers) and greater exposure to indoor air pollution (use of solid fuels for cooking). These results suggest that household poverty may not be the key factor in childhood ARI risk in Bangladesh. Instead improving nutritional status among all children, ensuring later age at marriage and childbirth, improving awareness about child nutrition and health and reducing dependence on solid fuels for cooking could have significant salubrious effects on ARI in children in Bangladesh and other parts of the developing world.