EFFECT OF AIR POLLUTION ASSOCIATED WITH ACUTE RESPIRATORY TRACT INFECTION IN CHILDREN UNDER 5 YRS OLD IN DHAKA, BANGLADESH

ARI Prevalence and Risk in Dhaka’s Children

• Current ARI prevalence in Dhaka’s children under 5 is 5.3%, showing a notable decrease from the 2014 BDHS report 6.7% in infants under 6 months (Bangladesh et al., 2016).
• Highest risk groups are infants (0-11 months) and young children (12-23 months) (Vidal et al., 2022).
• Stunting, lower economic status, and male gender are associated with increased ARI risk (Hossain et al., 2022).
• Healthcare-seeking for ARI symptoms has improved significantly to 55% in 2022, up from 40% in 2017–18 (Dhaka et al., 2023).

“In Dhaka, acute respiratory infections continue to affect the paediatric population, with a prevalence of 5.3%. Infants and young children remain at the highest risk, which aligns with global health observations that the youngest have the most developing immune systems. The trend is exacerbated among boys and lower-income families, possibly due to increased exposure to pollutants and less access to nutritious foods, leading to vulnerability. Encouragingly, our public health campaigns are resonating, with over half of the guardians now seeking professional healthcare for ARI symptoms.”

Socioeconomic Improvement and ARI Trends

• Maternal Literacy rates in Bangladesh have increased to 93% (Vidal et al., 2022).
• Poverty reduction correlates with a decrease in ARI prevalence across Bangladesh, as per aggregate data from Sylhet, Khulna, Chittagong, Dhaka, Barisal, Rajshahi, and Rangpur (Yaya & Bishwajit, 2019).
• Exclusive breastfeeding acts as a protective factor against ARIs (Hossain et al., 2022).
• Young maternal age (21.9 year mean), nuclear families (73.7%) and low birth weight are additional risk factors in the first 6 months (Ullah et al., 2019).

“With socioeconomic development, including a significant rise in literacy rates and poverty alleviation, we’ve seen an encouraging decline in ARI prevalence. Exclusive breastfeeding, a cornerstone of child health, provides immunity that guards against respiratory infections. However, we must not overlook that infants born to younger mothers or with low birth weight are still at higher risk, necessitating focused health interventions for these demographics.”

Conclusion: Targeted ARI Reduction Strategies for Under-Fives in Dhaka

• Implementing urban-specific environmental health policies to reduce children’s exposure to pollutants.
• Enhancing access to paediatric healthcare services, including ARI-focused child clinics and vaccination drives (Bangladesh, 2016).
• Nutritional interventions to combat stunting in under-fives, such as fortified foods and maternal nutrition programs (Dhaka, 2023).
• Customized public health messaging and education for parents of young children on ARI prevention and early intervention.

“In the alleged city of Rickshaws, where dense urban living and air pollution are the grim on-ground realities, we need tailored strategies to protect our youngest citizens. Initiatives must focus on reducing air pollution exposure, crucial for children whose developing lungs are most at risk. Enhancing paediatric healthcare access is vital, ensuring that parents have local and affordable options for ARI diagnosis and treatment. Nutritional programs should specifically target the under-fives, who are most vulnerable to the compounded effects of malnutrition and respiratory infections. Education campaigns must be culturally resonant, equipping parents with the knowledge to prevent ARIs and to act swiftly when symptoms arise. All these efforts combined will contribute to a robust defence against the tide of ARIs affecting children under 5 in Dhaka.”

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References

Bangladesh, N. I. of P. R. and T., Dhaka, M. and A., & ICF International, Rockville, Maryland, U.S.A., T. D. P. (2016). Bangladesh 2014 Bangladesh – demographic and Health Surveys. dhsprogram.com. https://dhsprogram.com/pubs/pdf/FR311/FR311.pdf

Dhaka, N. I. of P. R. and T., Dhaka, M. of H. and F. W., ICF, Rockville, Maryland, USA , T. D. P., & Division, M. E. and F. W. (2023). Bangladesh DHS 2022 – key indicators report [PR148]. dhsprogram.co. https://dhsprogram.com/pubs/pdf/PR148/PR148.pdf

Hossain, Md. S., Tasnim, S., Chowdhury, Md. A., Chowdhury, F. I., Hossain, D., & Rahman, M. M. (2022). Under‐five children’s acute respiratory infection dropped significantly in Bangladesh: An evidence from Bangladesh Demographic and Health Survey, 1996–2018. Acta Paediatrica, 111(10), 1981–1994. https://doi.org/10.1111/apa.16447

Ullah, M. B., Mridha, M. K., Arnold, C. D., Matias, S. L., Khan, M. S., Siddiqui, Z., Hossain, M., Paul, R. R., & Dewey, K. G. (2019). Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh. BMC Pediatrics, 19(1). https://doi.org/10.1186/s12887-019-1738-6

Vidal, K., Sultana, S., Patron, A. P., Salvi, I., Shevlyakova, M., Foata, F., Rahman, M., Deeba, I. M., Brüssow, H., Ahmed, T., Sakwinska, O., & Sarker, S. A. (2022). Changing epidemiology of acute respiratory infections in under-two children in Dhaka, Bangladesh. Frontiers in Pediatrics, 9. https://doi.org/10.3389/fped.2021.728382

Yaya, S., & Bishwajit, G. (2019). Burden of acute respiratory infections among under-five children in relation to household wealth and socioeconomic status in Bangladesh. Tropical Medicine and Infectious Disease, 4(1), 36. https://doi.org/10.3390/tropicalmed4010036

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