The wealth gradient in diarrhoea, acute respiratory infections, and malaria in childhood over time

A descriptive analysis using DHS and Mics from Western and Central Africa between 1995 and 2017

Bibliographic Data

ID19552802
AuthorsAnn-Charline Weber (0000-0002-7250-5126, University of Göttingen), Lisa Bogler (0000-0002-5679-9777, University of Göttingen, corresponding author), Sebastian Vollmer (0000-0002-7863-0462, University of Göttingen), Aline Simen-Kapeu (0000-0003-2259-1027, United Nations Children's Fund), Rene Ekpini (United Nations Children's Fund), Rene Ehounou Ekpini (United Nations Children’s Fund (UNICEF), West and Central Africa Regional Office, Dakar, Senegal), Noel Marie Zagre, Noel Zagre (Omar Bongo University)
Year2021
Volume11
Pages13009-13009
Publication date2021-08-10
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Global Health Society (PUBLISHER)
DOI10.7189/jogh.11.13009
PMID34484716
OpenAlexW3193888107
LanguageEN
Citations received4
References cited16

BACKGROUND: While the prevalence of childhood diseases and related mortality have been decreasing over the past decades, progress has been unequally distributed. The poorest households often carry the highest disease burden. As morbidity and mortality also decline most slowly among children of the poorest households, socioeconomic status may become a more relevant risk factor for childhood diseases. METHODS: We analysed the association between socioeconomic status and highly prevalent childhood diseases, specifically diarrhoea, acute respiratory infections (ARI), and malaria, and how this association changed over time. For this observational study, we used repeated cross-sectional data, namely all available Demographic and Health Surveys as well as Multi-Indicator Cluster Surveys from Western and Central Africa between 1995 and 2017. We estimated the predicted prevalence of each disease for the entire region in three time periods. We repeated the analysis separately for each country to highlight heterogeneity between countries. RESULTS: A notable wealth gradient can be seen in the prevalence rates of diarrhoea, ARI, and malaria in Western and Central Africa. Children in the poorest quartile have a much higher morbidity than children in the richest quartile and have experienced a considerably slower decline in prevalence rates. In the period 2010-2017, predicted prevalence of diarrhoea was 17.5% for children in the poorest quartile and 12.5% for children in the richest quartile. Similarly, the predicted prevalence was 11.1% and 8.6% for ARI, and 54.1% and 24.4% for malaria in endemic countries. The pattern does not differ between boys and girls. While exact prevalence rates vary between countries, only few countries have seen a decline in the wealth gradient for childhood diseases. CONCLUSIONS: The increasing wealth gradient in health raises concerns of increasing inequality that goes beyond wealth. It suggests a need to further improve targeting of health programmes. Moreover, these programmes should be adapted to address the interlinked challenges which burden the poorest households

Acute diarrhea · Diarrhea · Malaria · Respiratory system · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Zoonotic diseases and public health · Immunology · Internal Medicine · Pediatrics

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