Household passive smoking and Acute Respiratory Infection (ARI) among under five children attending Kanti Children's Hospital, Kathmandu.

Thesis Report.

SUMMARY: Association between children's household passive smoking and acute respiratory infection is well established in literature. Studies with various designs from different cultures and geographic regions have found association of acute respiratory infection with smoking of household members. Studies on association between passive smoking and ARI are limited and insufficiently explored in Nepal. Objective of this study was to determine association between household passive smoking and acute respiratory infection among under-five children. A descriptive, cross-sectional study using quantitative method was employed to meet the study objectives. Kanti Children's Hospital, Kathmandu was selected as a study site. Study population was 198 under-five children attending Kanti Children's Hospital during the period of survey. Information was collected by face-to-face interview from 198 respondents (190 mothers and eight fathers) of under-five children. Data entry and analysis was done in statistical package of social sciences full version 19. In this study, 25.8% children had acute respiratory infection at any time in last two weeks preceding the survey. Study found that 39.9% children were exposed to passive smoking with presence of smoker in their house. Among children exposed to passive smoking, 72.15% children were exposed to low level with one smoker in their house and 27.85% children were exposed to high level of passive smoking with more than one smoker in their house. Among children exposed to passive smoking, 50.0% children were exposed to low amount of passive smoking (one to nine cigarettes per day) and 50.0% were exposed to high amount of passive smoking (more than nine cigarettes per day). Similarly, among children exposed to passive smoking, paternal smoking was reported highest (39.2%), followed by other member's smoking (22.8%), parental smoking (18.9%) and maternal smoking (15.8%). Study did not find significant association between household passive smoking and acute respiratory infection among under-five children. Level of exposure, amount of exposure and type of exposure to household passive smoking were also not associated with acute respiratory infection among under-five children. Major factors need to be considered while interpreting these findings, because observed association may have been underestimated due to various factors. Selection and information bias were major sources of systematic errors that might have underestimated the association between household passive smoking and acute respiratory infection. Further, there might be role of different residual confounders on underestimating the association as well. Though, the study did not find significant association between household passive smoking and acute respiratory infection, passive smoking's independent effect on acute respiratory infection needs more investigation, especially because there are limited studies on effect of household passive smoking on acute respiratory infection among under-five children in Nepal. Moreover, population based studies, large prospective studies with more sample size are necessary to confirm causal relation between household passive smoking and acute respiratory infection.