Risk Factors Related to Complications of Acute Respiratory Infections among Children under Five Years Old in Yerevan, Armenia: A Case-Control Study

Abstract

Acute respiratory infections (ARI) are infections of any part of respiratory system (from para nasal sinuses to pleural cavity) lasting less than 30 days. ARI is the leading cause of morbidity and mortality in children under five years old worldwide. ARI is classified into upper and lower respiratory tract infections depending on the major affected part of the respiratory tract and anatomical localization. Upper respiratory tract infections cause fewer complications, mainly ear infections and tonsilopharyngitis which may lead to serious complications such as deafness and acute rheumatic fever. Lower respiratory tract infections (LRTI) are generally more severe and are responsible for the large majority of complications especially in young children. The complications of ARI, which include the lower respiratory tract, are severe pneumonia, obstructive bronchitis, severe bronchiolitis, respiratory deficiency, acute respiratory distress syndrome, emphysema or lung abscesses, and meningoencephalitis. Although there are some risk factors identified for complications of ARI in the published findings, the published research evaluating risk factors of complications of acute respiratory infections among children under five years old is limited. Further clarification and evaluation of risk factors could lead to interventions that prevent complications of ARI, thus reducing ARI-caused mortality. A case-control study was designed for a study population of children under five years old with present/recent (30 days prior to the day of interview) ARI with/without complications living in Yerevan. ARI cases are children under-five years old with a diagnosis of LRTI and hospitalized with/without complications within 30 days of the time of the interview during data collection. Cases will be identified through random sampling of children with/without LRTI complications from the two Yerevan sentinel pediatric hospitals. The control group are children who received a diagnosis of ARI and had ARI within 30 days of the interview, showing recovery and having no ARI complications. These children with ARI will be 2 identified by a census of eligible children from six randomly selected polyclinics in Yerevan. The calculated sample size is 426 total. A trained study team will conduct telephone interviews with case and control participants. The study questionnaire includes 57 questions and includes the following domains: socio-demographic questions, knowledge, attitude and practice of management of disease and potential risk factors for complications of ARI. The estimated budget of the study is 2,128,800 AMD. The Institutional Review Board (IRB)/ Committee on Human Research of the American University of Armenia has approved the study proposal.