Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Sampling Technique
2.2. Outcome Variable
2.3. Exposure Variable
2.4. Covariates
2.5. Statistical Analysis/Analytical Procedure
3. Results
3.1. Descriptive Statistics
3.2. Results
4. Discussion
4.1. Policy Implications
4.2. Study Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ARI | |||
---|---|---|---|
Variables | Yes | No | |
N (%) | N (%) | Total N (%) | |
Child’s age (months) | |||
0–10 | 284 (24.8) | 154 (19.6) | 438 (22.7) |
11–21 | 205 (17.9) | 176 (22.4) | 381 (19.7) |
22–32 | 203(17.7) | 167 (21.3) | 370 (19.2) |
33+ | 454 (39.6) | 288 (36.7) | 742 (38.4) |
Child’s sex | |||
Male | 866 (50.8) | 597 (50.7) | 1463 (50.8) |
Female | 838 (49.2) | 581 (49.3) | 1419 (49.2) |
Mother’s age (years) | |||
15–24 | 503 (29.5) | 384 (32.6) | 887 (30.8) |
25–34 | 843 (49.5) | 562 (47.7) | 1704 (48.8) |
35+ | 358 (21.0) | 232 (19.7) | 590 (20.4) |
Mother’s education | |||
No education | 8 (0.5) | 9 (0.8) | 17 (0.6) |
Primary | 1119 (65.6) | 751 (63.7) | 1870 (64.9) |
Secondary and higher | 577 (33.9) | 418 (35.5) | 995 (34.5) |
Place of delivery | |||
Home | 1320 (77.8) | 871 (74.1) | 2191 (76.3) |
Hospital | 377 (22.2) | 305 (25.9) | 682 (23.7) |
Media access (radio, television, and magazine) | |||
None | 1232 (72.3) | 793 (67.3) | 2024 (70.2) |
1 | 258 (15.1) | 189 (16.0) | 447 (15.5) |
2 | 50 (2.9) | 50 (4.2) | 100 (3.5) |
3 | 164 (9.6) | 147 (12.5) | 311 (10.8) |
Mother’s occupation | |||
Not working | 92 (5.5) | 77 (6.7) | 169 (6.0) |
Manual | 1272 (76.3) | 854 (74.6) | 2126 (75.6) |
Professional | 304 (18.2) | 214 (18.7) | 517 (18.4) |
Wealth index | |||
Poorest | 373 (21.9) | 225 (19.1) | 598 (20.7) |
Poorer | 329 (19.3) | 226 (19.2) | 555 (19.3) |
Middle | 375 22.0) | 239 (20.2) | 614 (21.3) |
Richer | 322 (18.9) | 215 (18.3) | 537 (18.6) |
Richest | 305 (17.9) | 273 (23.2) | 578 (20.1) |
Types of cooking fuel | |||
Polluting | 1670 (98.0) | 1136 (96.4) | 2806 (97.4) |
Clean | 34 (2.0) | 42 (3.6) | 76 (2.6) |
Parity | |||
1–3 | 645 (37.9) | 475 (40.3) | 1120 (38.9) |
4+ | 1059 (62.1) | 703 (59.7) | 1762 (61.1) |
Maternal breast-feeding status Never breastfed Ever breastfed Still breastfeeding | 75 (4.4) 896 (52.3) 742 (43.3) | 53 (4.5) 640 (54.8) 476 (40.7) | 128 (4.4) 1536 (53.3) 1218 (42.3) |
Place of residence Rural Urban | 1293 (75.9) 411 (24.1) | 853 (72.4) 325 (27.6) | 2146 (74.5) 736 (25.5) |
Neighbourhood-economic disadvantage Least disadvantaged Most disadvantage | 770 (45.2) 934 (54.8) | 572 (48.6) 606 (51.4) | 1342 (46.6) 1540 (53.4) |
Variables | Model 0 | Model 1 | Model 2 |
---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | |
(Individual Characteristics) | |||
Types of cooking fuel Clean fuel Polluting fuel | 1 (reference) 3.15 [2.41–4.13] *** | 1 (reference) 3.10 [2.39–4.10] *** | |
Parity 1–3 4+ | 1 (reference) 0.10 [0.17–0.66] * | 1 (reference) 0.10 [0.02–0.65] * | |
Highest level of education No education Primary Secondary and above | 1 (reference) 3.02 [0.73–4.60] 0.67 [0.54–0.82] *** | 1 (reference) 3.35 [0.72–5.62] 0.66 [0.72–5.62] *** | |
Media Access None 1 2 3 | 1 (reference) 0.66 [0.17–2.60] 0.91 [1.01–1.51] ** 0.18 [0.10–0.54] ** | 1 (reference) 0.67 [0.17–2.60] 0.66 [0.17–2.60] ** 0.16 [0.17–0.60] ** | |
Household wealth index Poorest Poorer Middle Richer Richest | 1 (reference) 0.78 [0.42–1.43] 0.69 [0.36–1.34] 0.42 [0.19–0.88] ** 0.34 [0.14–0.83] ** | 1 (reference) 0.76 [0.41–1.40] 0.54 [0.52–1.11] 0.40 [0.17–0.90] ** 0.34 [0.14–0.89] ** | |
Occupation Not working Manual Professional | 1 (reference) 1.14 [0.44–2.79] 0.80 [0.65–0.90] * | 1 (reference) 0.80 [0.44–2.79] 0.79 [0.63–0.91] * | |
Sex of child Male Female | 1 (reference) 0.56 [0.36–0.89] ** | 1 (reference) 0.54 [0.40–0.89] ** | |
Child′s age in months 0–10 11–21 22–32 33+ | 1 (reference) 0.56 [0.39–0.79] *** 0.59 [0.42–0.85] ** 0.75 [0.56–1.20] | 1 (reference) 0.54 [0.39–0.80] *** 0.57 [0.49–0.80] ** 0.80 [0.57–1.31] | |
Mother’s age(years) 35+ 25–34 15–24 | 1 (reference) 6.93 [10.52–12.40] *** 2.75 [1.48–5.15] *** | 1 (reference) 5.10 [3.88- 12.42] ** 2.78 [3.85- 5.20] ** | |
Breastfeeding status Not currently breastfeeding Never breastfed Still breastfeeding | 1 (reference) 3.50 [0.52–8.56] 0.48 [0.07–3.08] | 1 (reference) 2.96 [0.46–10.00] 0.68 [0.46–1.00] | |
Place of birth Delivery Home Hospital | 1 (reference) 0.90 [0.69–1.16] | 1 (reference) 0.89 [0.65–1.10] | |
Community-level variables Place of residence Urban Rural | 1 2.85 [1.73–4.75] *** | ||
Neighbourhood Economic Disadvantaged Index Most disadvantaged Least disadvantaged | 1 0.56 [0.44–0.70] *** | ||
Intercept | 0.15 [0.16–0.20] *** | 1.14 [0.03] *** | 1.12 [0.03] *** |
Neighbourhood-level variance (SE) | 1.30 [0.04] *** | 1.14 [0.03] *** | 1.12 [0.03] *** |
VPC (%) | 25 | 23.5 | 20.0 |
Explained variation PCV (%) Model fit statistics | Reference | 12.3 | 17.5 |
DIC (−2log likelihood) | 3651.40 | 3012.20 | 2601.10 |
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Aremu, O.; Aremu, O.O. Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis. Int. J. Environ. Res. Public Health 2025, 22, 710. https://doi.org/10.3390/ijerph22050710
Aremu O, Aremu OO. Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis. International Journal of Environmental Research and Public Health. 2025; 22(5):710. https://doi.org/10.3390/ijerph22050710
Chicago/Turabian StyleAremu, Olatunde, and Omolara O. Aremu. 2025. "Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis" International Journal of Environmental Research and Public Health 22, no. 5: 710. https://doi.org/10.3390/ijerph22050710
APA StyleAremu, O., & Aremu, O. O. (2025). Effect of Household Air Pollution and Neighbourhood Deprivation on the Risk of Acute Respiratory Infection Among Under-Five Children in Chad: A Multilevel Analysis. International Journal of Environmental Research and Public Health, 22(5), 710. https://doi.org/10.3390/ijerph22050710