Burden of acute infections (except respiratory and diarrheal) and its risk factors among under-five children in India: A systematic review and meta-analysis.

Indian Journal of Child Health Pub Date : 2016-01-01 Epub Date: 2016-03-15
Enakshi Ganguly, Pawan K Sharma, Clareann H Bunker
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Abstract

Context: Acute infections of eyes, ears, skin, and others are a common cause of morbidity in under-five children. The overall burden of other infections and their risk factors is not known.

Evidence acquisition: Available literature was searched comprehensively using PubMed for acute infections (except acute respiratory and diarrheal diseases) using the relevant medical subject heading terms. Extracted articles were independently reviewed against inclusion/exclusion criteria and rated for quality. 10 articles were abstracted and reviewed to identify the reported prevalence and risk factors for acute infections among children.

Results: The pooled prevalence of infections (not including acute respiratory and diarrhea) between 2002 and 2013 was 18.42 (95% confidence interval: 9.30-30.62), with reported range of 3.7-50.8%. The significantly positively associated factors reported in single studies were young age of the child, malnutrition, poor breastfeeding, low socio-economic status, animal rearing near household and mothers' illiteracy for independent morbidities.

Conclusion: The evidence on risk factors including breastfeeding, vaccination, age, and sex that predispose under-five Indian children to different infections is inconclusive. There is a need to conduct more studies on acute infections other than acute respiratory and diarrhea, to establish their determinants in Indian children.

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印度五岁以下儿童急性感染负担(呼吸道和腹泻除外)及其危险因素:系统回顾和荟萃分析
背景:眼睛、耳朵、皮肤和其他部位的急性感染是五岁以下儿童发病的常见原因。其他感染的总体负担及其危险因素尚不清楚。证据获取:使用相关医学主题术语,在PubMed上全面检索急性感染(急性呼吸道和腹泻疾病除外)的现有文献。根据纳入/排除标准对提取的文章进行独立审查,并对其质量进行评级。对10篇文章进行了摘要和回顾,以确定报告的儿童急性感染的患病率和危险因素。结果:2002 - 2013年感染(不包括急性呼吸道感染和腹泻感染)的总患病率为18.42(95%可信区间:9.30 ~ 30.62),报告范围为3.7 ~ 50.8%。在单一研究中报告的显著正相关因素是儿童年龄小、营养不良、母乳喂养不良、社会经济地位低、在家庭附近饲养动物和母亲不识字。结论:关于包括母乳喂养、疫苗接种、年龄和性别在内的危险因素使五岁以下印度儿童易患不同感染的证据尚无定论。有必要对急性呼吸道和腹泻以外的急性感染进行更多的研究,以确定印度儿童的决定因素。
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