Distance from Healthcare Facilities Is Associated with Increased Morbidity of Acute Infection in Pediatric Patients in Matiari, Pakistan

Elise Corden, Saman Hasan Siddiqui, Yash Sharma, Muhammad Faraz Raghib, William Adorno, Fatima Zulqarnain, Lubaina Ehsan, Aman Shrivastava, Sheraz Ahmed, Fayaz Umrani, Najeeb Rahman, Rafey Ali, Najeeha T. Iqbal, Sean R. Moore, Syed Asad Ali and Sana Syed
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Elise Corden: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Saman Hasan Siddiqui: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Yash Sharma: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Muhammad Faraz Raghib: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
William Adorno: Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA 22903, USA
Fatima Zulqarnain: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Lubaina Ehsan: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Aman Shrivastava: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Sheraz Ahmed: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Fayaz Umrani: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Najeeb Rahman: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Rafey Ali: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Najeeha T. Iqbal: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Sean R. Moore: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
Syed Asad Ali: Department of Paediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan
Sana Syed: Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA

IJERPH, 2021, vol. 18, issue 21, 1-12

Abstract: The relationship between environmental factors and child health is not well understood in rural Pakistan. This study characterized the environmental factors related to the morbidity of acute respiratory infections (ARIs), diarrhea, and growth using geographical information systems (GIS) technology. Anthropometric, address and disease prevalence data were collected through the SEEM (Study of Environmental Enteropathy and Malnutrition) study in Matiari, Pakistan. Publicly available map data were used to compile coordinates of healthcare facilities. A Pearson correlation coefficient ( r ) was used to calculate the correlation between distance from healthcare facilities and participant growth and morbidity. Other continuous variables influencing these outcomes were analyzed using a random forest regression model. In this study of 416 children, we found that participants living closer to secondary hospitals had a lower prevalence of ARI ( r = 0.154, p < 0.010) and diarrhea (r = 0.228, p < 0.001) as well as participants living closer to Maternal Health Centers (MHCs): ARI ( r = 0.185, p < 0.002) and diarrhea ( r = 0.223, p < 0.001) compared to those living near primary facilities. Our random forest model showed that distance has high variable importance in the context of disease prevalence. Our results indicated that participants closer to more basic healthcare facilities reported a higher prevalence of both diarrhea and ARI than those near more urban facilities, highlighting potential public policy gaps in ameliorating rural health.

Keywords: nutrition; pediatrics; geographic information systems; acute respiratory infections; diarrhea; growth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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