Acute respiratory infections among under-five children from households using biomass fuel in Ethiopia: systematic review and meta-analysis

Acute respiratory infections are a serious public health concern across the globe, they are, however, prominently present in Sub-Saharan Africa. In Ethiopia, different primary studies were conducted in regard to the link between household biomass fuel use and acute respiratory infections among under-five children. However, there is no national study on the association between household biomass fuel use and acute respiratory is infections among under-five children. Thus, the aim of this systematic review and meta-analysis to estimate the pooled prevalence of acute respiratory infections and their predictors among under-five children in Ethiopia. The systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We systematically searched the databases: PubMed/Medline, Cochrane library, Google Scholar, Web of Science, and Scopus were searched to access potentially relevant articles conducted in Ethiopia about acute respiratory infections among under five children. Stata/SE 14.00 statistical software was used for analysis and the pooled prevalence with 95% confidence interval (CI) were presented using tables and forest plots. To assess the heterogeneity among studies, I square (I-2) tests were used. Publication bias was checked by Begg's and Egger's regression test. The random effects meta-analysis model was employed to estimate the pooled prevalence and predictors of under-five acute respiratory infections A total of 7 studies with 8,529 study participants were included in this meta-analysis. The pooled prevalence of acute respiratory infection among under five children was 17.75% (95% CI: 16.95, 18.55). Child holding during cooking (OR: 2.84, 95% CI: 1.48, 5.47) and using unclean sources of energy for cooking (OR: 0.38, 95% CI: 0.21, 0.70) were identified predictors of under-five children acute respiratory infection. In the current study, the pooled prevalence of acute respiratory infection among under-five children was relatively high. Child holding during cooking and using unclean sources of energy for cooking were significantly associated with under-five acute respiratory infections. Therefore, the policies and regulations enacted should address the barriers that impede the development of clean and efficient energy sources.