Risk factors for acute respiratory infection among children in Yemen: a hospital based matched case-control study

Background Food insecurity is a growing public health problem, particularly in conflict-affected areas where households face multiple challenges that restrict their accessibility to food and other necessities. It can result in serious health issues and increased mortality, especially among vulnerable groups such as children. Objective This study aims to assess the effect of household food insecurity on the development of acute respiratory infections (ARIs) among children aged 6-23 months and determine the other factors associated with ARI in this age group. Methods A matched case-control study was carried out in three public hospitals in Sana'a city between March and May 2022. A total of 151 children presented to the three hospitals diagnosed with ARI (cases) and 302 children who presented to the same hospitals with non-ARI diagnoses were included in the study and matched by sex and age +/- two months. Conditional logistic regression analysis was performed to determine the crude odds ratio (COR) and adjusted odds ratio (AOR). Results Among cases, 63.6% (96/151) of households were food insecure compared to 40.7% (123/302) of the controls. Household food insecurity was a strong predictor of ARI in children (AOR 1.72, 95% confidence interval (CI) 1.10-2.70; p = 0.017). Children living in rented accommodation (AOR 2.29, 95% CI 1.40-3.74; p < 0.001) and those with relatives who smoked (AOR 1.84, 95% CI 1.17-2.90; p = 0.008) had a higher likelihood of having ARIs compared to those in non-rented dwellings and where no relatives smoked, respectively. Parental characteristics, source of water, and source of cooking fuel were not associated with ARI. Conclusion To reduce the burden of ARI among young children, it is important to prioritize the design and implementation of multi-sectoral community interventions. These interventions should include the initiation of income-generating programs aimed at alleviating household food insecurity, as well as health education campaigns to raise community awareness about the health risks associated with smoking.