- Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia
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Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
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J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024
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DOI: https://doi.org/10.3961/jpmph.24.246
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 Abstract
Summary
 PDF Supplementary Material
- Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.
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Summary
Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.
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