Risk Factors for Acute Respiratory Infections in Shai-Osudoku and Ningo-Prampram Districts in the Greater Accra Region of Ghana
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University of Ghana
Abstract
Background: Acute Respiratory Infections (ARIs) result in a large public health burden
worldwide, especially in developing countries. The populations at greatest risk for
developing fatal respiratory infections are the very young, the aged, and the
immunocompromised. In developing countries, 30% of all patient consultation and 25% of
all paediatric admissions are ARIs. In the Shai-Osudoku (SO) and Ningo-Prampram (NP)
districts, ARls have continuously ranked second in the top ten causes of morbidity for
hospital attendance. Despite the availability of influenza vaccines, Ghana and other West
African countries are yet to establish routine immunization policies due to limited
information. This study sought to determine the risk factors of ARls by investigating the
characteristics of patients with respiratory illness in the two districts.
Methods: A health facility-based case-control study was conducted among residents of
Shai-Osudoku (SO) and Ningo-Prampram (NP) Districts. Prospective cases were selected
from a facility-based surveillance on Acute Respiratory Infections which captured Influenzalike
Illness and Severe Acute Respiratory Infection syndromes in residents of SO and NP
Districts from April to November 2016. One hundred and forty-seven influenza viruspositive
case-patients and 294 influenza virus-negative control-patients were identified to
assess the risk factors of influenza among Influenza-like Illness patients. The study also
investigated factors for Severe Acute Respiratory Infection (SARI) by identifying 134 SARI
patients and 402 out-patients with non-respiratory illness as controls. Crude and adjusted
odds ratios were calculated. A purposive selection logistic regression was used for the
adjusted modelling.
Results: The study identified Influenza A(H3N2) and Influenza B subtypes as the
predominant circulating influenza viruses in the two districts from March to November of
2016. Study participants had poor knowledge on the causes and prevention of acute
respiratory illness. The Osudoku Health Centre in Shai-Osudoku district reported the highest
proportion (29.9%, p = 0.01) of influenza-positive III cases. The crude analysis had the
highest odds of an influenza-positive infection in the 5 to <15 years age group (OR:7.80;
95%CI: 2.52 - 24.12). Factors associated with influenza virus infection among Ills were
Chills (aOR:4.57; 95%CI: l.51 - 13.76) and a recent travel history in past 2 weeks
(aOR:3.05; 95%CI: 1.07 - 8.73). For SARI, Males were more at risk (OR:2.13; 95%CI: 1.40
- 3.23). Just as has been found in some studies, the less than 5-year group formed the
majority (42.5%; p<O.OOOI)of SARI case-patients and had an odds ratio of 5.83 (95%CI:
2.89 - 11.86) with ~ 60 years as the reference group. In the adjusted risk factor model for
SARI, 8 factors were significantly associated in the presence of other confounders or
covariates. They were Sex (Males), (aOR:5.07; 95%CI: 2.28 - 11.25), Diabetes (aOR:4.52;
95%CI:1.17- 17.45), Sore throat (aOR:2.51; 95%CI: 1.20 - 5.24), Diarrhoea (aOR:4.09;
95%CI: 1.38 - 12.08), Chills (aOR: 4.27; 95%CI: 1.74 - 10.49), Perception of cause of SARI
as Curse (aOR: 2.44; 95%CI: 1.08 - 5.54) and Onset of SARI occurring in Wet Season (aOR:
2.91; 95%CI: 1.27 - 6.67). The use of LPG (aOR: 0.37; 95%CI: 0.15 - 0.93) as a domestic
fuel for cooking on the other hand appeared protective in relation to an outcome of SARI.
Conclusion: The study identified factors associated with influenza in patients with
influenza-like illness and SARI in Shai-Osudoku and Ningo-Prampram Districts. This
important knowledge about associated factors will inform appropriate health interventions to
reduce the occurrence of acute respiratory illnesses.
Description
PhD