Caregivers’ Level of Knowledge on Indoor Air Pollution and Acute Respiratory Infections among Under-Fives in Informal Settlements: Nairobi City County, Kenya

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Date
2021
Authors
Muro, Maximillah Bitutu
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Publisher
Kenyatta University
Abstract
Acute Respiratory Infection (ARI) is one of the leading causes of diseases and deaths among children below five years around the world. Annually, more than four million people die from ARIs worldwide in which about two million are children aged below five years. In the developing countries including Kenya the problem is rampantdue tohigh rates of indoor air pollution coupled with poor housing, overcrowding in the houses, and lack of ventilation. Young children,particularly those below five years are susceptible to respiratory pathogens and also to air pollution due to their weak immunity and underdeveloped respiratory system. There is strong evidence that indoor air pollution, such as second-hand smoke and the use of biomass fuels such as charcoal and wood, is a risk factor for respiratory infections in children. The knowledge status of caregivers on indoor air pollution (IAP) and the risk factors of ARIs determine the severity and management of ARIs as well as reducing the risk factors associated with the diseases. The aim of this study was to determine the caregivers’ level of knowledge on indoor air pollution and risk of ARIsamong 393children below five years who live at Makadara Sub-County, Nairobi City County. Descriptive, cross-sectional study design was employed in the study. Semi-Structured questionnaires were used to collect data from the caregivers of children suffering from ARIs. The questionnaires contained both closed and open-ended questions, which helped participants to provide explanations about the infection, and the perceived risk factors. Closed ended questions were utilized to gather data such as income levels, age ranges, and religion. The questionnaires were also made up of Likert Scales, which contained a 5-point scale that varied from ―Strongly Agree‖ to ―Strongly Disagree‖. Overall knowledge level in percentages was categorized as low (<40%), moderate (41%-69%) and high (≥70%). In particular, the interviewer administered the questionnaires to the respondents and the completed questionnaires were edited for completeness and consistency. The level of particulate matter was also measured in a sub-sample of the households –twenty (20) households using Dust Truck II aerosol Monitor. Quantitative data was cleaned, coded and analysed using the SSPS version 22. Descriptive statistics was used to describe the caregivers’ socio-economic and demographic characteristics, knowledge and practices. Chi-squareand ordered logistic regression was used to determine relationships and associations between the dependent variable (ARIs) and independent variables (socio-economic and demographic factors, knowledge level, and IAP). The findings of the study will be used in the improvement of the caregivers’ level of knowledge on IAP and the risk of ARIs among children below five years. There was significant statistical differences between ARIs among children below five years and cigarette smoke exposure (χ2(1)=35.04, P<0.001), use of charcoal in cooking (χ2(2)=11.31, P=0.004), room occupancy (χ2(1)=94.74, P<0.001), lack of ventilation (χ2(1)=11.49, P=0.001). The mean for particulate matter in the households was 50.1556 while the S.D for those who use charcoal was 13.372, kerosene, 16.860 and gas was 10.388. The mean knowledge level was 5.39/14, 95% CI; 5.07-5.72. Therefore, a mean of 5.39 out of 14 represent lower knowledge level on IAP and the risk of ARIs. There was significant statistical difference between availability of windows in the house and caregivers’ level of knowledge on risk factors of IAP, χ2 (2) = 11.09, P= 0.004. The prevalence of ARIs among children below five years was high in Makadara Sub-County and IAP can be linked to ARIs. The caregivers’ level of knowledge on IAP and ARIs play a major role in the health related practices and behaviours, therefore, thecounty government of Nairobi should enhance the knowledge of IAP and the associated risk of ARIs especially among the people living in the low socio-economic areas. This can help in the minimization of IAP exposure and the risk of ARIs among children below five years thus reduction in morbodoty and mortality rates of ARIs.
Description
A Research Thesis Submitted in Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control), School of Public Health and Applied Human Sciences, Kenyatta University, September, 2021
Keywords
Caregivers’ Level, Knowledge, Indoor Air Pollution, Acute Respiratory Infections, Under-Fives, Informal Settlements, Nairobi City County, Kenya
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