Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia.

Background: Acute respiratory infection (ARI) and diarrhea remain critical public health concerns. In Indonesia, various interventions have been implemented to reduce the prevalence of ARIs and diarrhea among children in low- and middle-income households. Hence, the absence of detailed data on the prevalence of ARIs and diarrhea among children under five in low- and middle-income households in Indonesia restricts the formulation of targeted health interventions and policies. This study sought to evaluate the prevalence of ARI and diarrhea while examining modifiable risk factors related to malnutrition, sanitation, and social protection characteristics in Indonesia.

Methods: This study utilized a cross-sectional design based on data from the Nutrition Status Survey 2022 covering 514 districts/cities in Indonesia. It analyzed 289,631 children under five years out of 334,848 households with low and middle wealth indices. Multivariable binary logistic regression analysis was employed to calculate the risk associated with cases of ARI and diarrhea.

Results: The prevalence of ARI and diarrhea among low- and middle-wealth households were 5.7% and 6.0%, respectively, with infants under six months being the most vulnerable group to these infections, including malnutrition. The most significant risk factors for ARI and diarrhea are unclean cooking fuel [adjusted odds ratio (aOR) = 1.53, 95% CI 1.47-1.60] and shared toilet facilities (aOR = 1.45, 95% CI 1.38-1.51), with households using shared toilets having 1.45 times higher risk of diarrhea (aOR = 1.45, 95% CI 1.38-1.51) compared to those with private access. Additionally, households lacking social protection support are also at increased risk for these infections and malnutrition issues.

Conclusions: This study revealed a notable prevalence of ARI and diarrhea among low- and middle-wealth households, particularly affecting infants under six months. Vulnerable children, especially those who were stunted or underweight, and households lacking sanitation and social protection faced heightened risks for these health issues.