A CUTE R ESPIRATORY I NFECTION

Pneumonia and other respiratory tract infections are leading causes of death among young children in Ghana. In the case of pneumonia, early diagnosis and treatment with antibiotics can prevent a large proportion of deaths due to acute respiratory infections (ARIs). The prevalence of ARI in the 2014 GDHS was estimated by asking mothers whether their children under age 5 had been ill with a cough accompanied by short, rapid breathing in the two weeks preceding the survey. These symptoms, though compatible with pneumonia, are subjective (i.e., mother’s perception of illness) and not validated by a medical examination.

Table 10.5 shows the percentage of children under age 5 who had a cough accompanied by short, rapid breathing (symptoms of ARI).

From mothers’ reports, it is estimated that 4 percent of children under age 5 had symptoms of ARI in the two weeks before the survey. A little over half of these children (53 percent) were taken to a health facility or provider (data not shown separately). This was similar to what was reported in the 2008 GDHS where half (51 percent) of the children were seen at a health facility or by a provider. There are minimal differentials in the prevalence of ARI by background characteristics, but it is worth noting that children in rural areas are almost twice as likely to have experienced symptoms of ARI as compared with children in urban areas.

47

55

62

69

79 77

GDHS 1988 GDHS 1993 GDHS 1998 GDHS 2003 GDHS 2008 GDHS 2014

Note: Children age 12-23 months who received all basic vaccinations, i.e., BCG, measles, and three doses each of DPT or pentavalent (DPT-HepB-Hib) and polio vaccine (excluding polio vaccine given at birth).

Percentage of children age 12-23 months

Table 10.5 Prevalence and treatment of symptoms of ARI

Among children under age 5, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey, according to background characteristics, Ghana 2014

Among children under age 5:

Background

characteristic Percentage with

symptoms of ARI¹ Number of children Age in months

Smokes cigarettes/tobacco * 2 Does not smoke 3.6 5,428

grass, agricultural crop 4.1 2,664 No food cooked in

Note: Total includes one child for whom information on mother’s smoking status is missing. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.

1 Symptoms of ARI (cough accompanied by short, rapid breathing that was chest-related and/or by difficult breathing that was chest-related) are considered a proxy for pneumonia.

2 Excludes pharmacy, shop, and traditional practitioner

Treatment with antibiotics can often ameliorate the symptoms of ARI, thereby saving lives. In the 2014 GDHS, 41 percent of children under age 5 who had symptoms of ARI in the two weeks before the survey received antibiotics for their illness (data not shown).

Child Health and Early Development • 135

10.5 F

Fever is a sign of malaria and other acute infections in children. Malaria and other illnesses that cause fever contribute to high levels of malnutrition and mortality. While fever can occur year-round, malaria is more prevalent after the rainy season. For this reason, temporal factors must be accounted for when interpreting fever as an indicator of malaria prevalence. Malaria is a major contributory cause of death in infancy and childhood in many developing countries. A policy of presumptive treatment of fever with antimalarial medication, once advocated in many countries where malaria is endemic, was revised in Ghana in 2010. The current policy emphasises testing before treatment. Malaria in Ghana is discussed in greater detail in Chapter 12.

Table 10.6 shows the percentage of children under 5 with fever during the two weeks preceding the survey and the percentage receiving various treatments, by selected background characteristics. A little more than one-tenth (14 percent) of all children under 5 reported having fever in the past two weeks. Fever is most common among children age 12-35 months (17 percent) and is least common (4 percent) in children less than 6 months. The prevalence of fever is similar for both sexes but slightly higher for children in rural (15 percent) compared with urban (12 percent) areas. Regional differentials show that the proportion of children with fever is highest in the Upper West region (25 percent) and lowest in the Western, Central, and Greater Accra regions (11 percent each). Fever prevalence decreases slightly as mother’s education increases but shows no clear relationship with wealth quintile of the mother.

Over half of the children with a fever (56 percent) were taken to a health facility or provider for treatment. Nearly half of the children with a fever took antimalarial medicines, and a quarter took antibiotics.

The proportion of children who were taken to a health facility was lower for older children compared with younger children. The proportion of children who were taken to a health facility or provider was slightly higher among females (59 percent) than males (54 percent) and among rural (59 percent) than urban children (51 percent). The proportion of children under age 5 with fever for whom advice was sought from a health facility or provider was slightly higher among those whose mothers have secondary education or more compared with those whose mothers have lower education. The percentage of children who took antimalarial medicines follows similar trends as treatment sought at a health facility or with a provider.

Table 10.6 Prevalence and treatment of fever

Among children under age 5, the percentage who had a fever in the two weeks preceding the survey and among children with fever, the percentage for whom advice or treatment was sought from a health facility or provider, the percentage who took antimalarial medicines, and the percentage who received antibiotics as treatment, by background characteristics, Ghana 2014

Among children under age 5: Among children under age 5 with fever

Background

took antibiotics Number of children

Middle/JSS/JHS 12.9 2,124 54.3 48.9 25.5 273

Secondary+ 12.0 748 63.8 58.3 31.9 90

Note: Figures in parentheses are based on 25-49 unweighted cases.

1 Excludes pharmacy, shop, market, and traditional practitioner