A spatio-temporal mapping and bayesian modelling of risk factors of pneumonia symptoms in under-five children in Nigeria.

Pneumonia remains a public health challenge in most parts of the world, with Nigeria having the highest number of pneumonia-related deaths. Understanding the geographical distribution, trends and risk factors associated with pneumonia symptoms will aid an appropriate intervention of pneumonia and subsequently reduce its burden in Nigeria. This cross-sectional study used data from the 2008, 2013 and 2018 Nigeria Demographic Health Survey. In each of the survey round, a multi-stage cluster sampling technique was used to select the eligible respondents who are women of reproductive age. The outcome variables are the presence of key symptoms of pneumonia: fever, cough, and short rapid breaths. Optimized hotspot analysis was used to identify states with a significantly high prevalence of pneumonia symptoms, MCMC mixed-effect models were fitted to each symptom. The prevalence of cough was 12.1%, 10.1% and 16.9% in 2008, 2013 and 2018 respectively, 16.2%, 13.3%, and 25.7% for fever; and 41.7%, 42.5% and 6.5% for short rapid breaths respectively with variations across the states. The adjusted odds of having a cough among the children aged 6-11, 12-23, 24-35 and 36-47 months were 95% higher (adjusted odds ratio (aOR) =1.95, 95% Credible Interval (CrI): 1.77, 2.18), 92% higher (aOR=1.92, 95% CrI: 1.73, 2.12), 45% higher (aOR=1.45, 95% CrI: 1.31, 1.62) and 15% higher (aOR=1.15, 95% CrI: 1.03, 1.27) respectively, relative to ages 0-5 months. Similar patterns were noticed for fever and short rapid breaths. Mothers' education was significant for cough and fever but not for short rapid breaths. Mothers age was significant only for short rapid breaths at higher odds. Other significantly associated factors with symptoms include residence type, housing quality, wealth index and region. Fever, cough, and short rapid Breaths are prevalent among under-five children in Nigeria. These symptoms are associated with different characteristics and varied across states in Nigeria. Therefore, it is pertinent that mothers improve on the available preventive and management strategies with the view to mitigating the consequences of pneumonia symptoms among under-five children in Nigeria.