Risk factors Contributing to Acute Respiratory Infections among Under 5 children at Rural Hospitals in Trichy.

Abstract

Background: Acute respiratory infections (ARIs) are a major global public health concern, responsible for approximately 94.037 million disabilityadjusted life years (DALYs) and 1.9 million deaths worldwide. They represent one of the leading causes of morbidity and mortality among children younger than five years. On average, children in this age group experience approximately three to six episodes of ARI each year, irrespective of their geographical location. The burden of ARIs is considerably greater in developing countries, where it has been estimated to be 10–50 times higher than in developed nations. Therefore, this study was conducted to identify the risk factors associated with acute respiratory infections among under-five children attending rural hospitals, Trichy. Methods: An institution-based case-control study was carried out between November 2025 and June 2026. Data were collected from 286 children younger than five years, comprising 94 cases and 192 controls, using a structured questionnaire administered by trained interviewers. Study participants were selected through systematic random sampling. The collected data were entered and analysed using SPSS version 20. Both bivariate and multivariate analyses were performed to determine the association between the outcome variable and the selected independent variables at a 95% confidence level. Statistical significance was considered at a p-value of less than 0.05. The findings were summarized and presented using tables, figures, and narrative descriptions. Result: Multivariate analysis revealed that malnutrition (AOR = 2.89; 95% CI: 1.584–8.951; p = 0.039), cow dung use (AOR = 2.21; 95% CI: 1.121– 9.373; p = 0.014), the presence of a smoker in the household (AOR = 0.638; 95% CI: 0.046–0.980; p = 0.042), and maternal literacy (AOR = 3.098; 95% CI: 1.387–18.729; p = 0.021) were identified as statistically significant predictors of acute respiratory infection among children under five years of age. Conclusion: The findings of this study indicate that maternal literacy level, exposure to smoking, the use of cow dung, and the nutritional status of children were significantly associated with an increased risk of acute respiratory infections among children. Healthcare professionals should collaborate with communities to promote awareness and disseminate evidence-based information and practical guidelines on appropriate measures for preventing acute respiratory infections.