Acute Respiratory Infection of under-five children associated with place of food cooking in Ethiopia: Multilevel Analysis of 2005-2016 Ethiopian Demographic Health Survey data

Abstract Background: Acute respiratory infection is the leading causes of under-five child mortality globally especially in least income countries. Exposure to toxic pollutants from solid biomass fuel in the indoor environment is the main risk factor. In Ethiopia, where more than 90% of population use this energy source and the disease is one of the top health problems, there is a paucity of evidence on the association of cooking places with the disease based on nationally representative data. Therefore, the current study is intended to at assess the association of food cooking places with acute respiratory infection based on a large-scale and time varying data.Methods: The data of Ethiopian Demographic and health surveys collected in 2005, 2011 and 2016 were used for this study. The data were obtained via online registration and analyzed using a multilevel analysis. The “svy” command in Stata was used to weight the data to adjust for cluster sampling design. Result: The total number of children included in the analysis was 30895, with 9,517 from 2005, 11,176 from 2011 and 10, 291 from 2016 survey. In total, 11.9% of children had an acute lower respiratory infection with 12.7%, 11.9% and 11.1% respectively in 2005, 2011 and 2016. In 2005, 71% of mothers cooked food inside the house and it declined to 43% in 2016. The risk of the infection to children whose mother cooked food outside the house compared to inside the house was 68% less likely (AOR = 0.32, 95% CI= 0.10, 0.98). Watching television at least once in a week had also reduced the risk of infection (AOR=0.60, 95% CI =0.38, 0.94). There was a statistically a significant difference among the children of within survey to have an infection and no difference among the children of between surveys.Conclusion: The mothers’ cooking of food outside the house lessen the risk of children to have acute respiratory infection. No difference among different surveys on the infection suggests the rareness of progress in the practices that could minimize the risk therefore measures like encouraging to cook in indoor environment of well-ventilated needs to be taken.