Respiratory Tract Infections among

Infant and Children Under 5 years:

Assessment of Risk Factor,
Prevalence and Maternal
Knowledge and Attitude

Under the guidance and supervision of/

Dr. Amal Ahmed Elbilgahy
Ms. Deepa Jothirajan
Created by:

Mohammed Alhameed 202103138

Hamad Mtrak 202100352

Rakan Mutab 202103066

Farouq Fouad 202100807

 Introduction
Respiratory infections represent a significant public health concern,
particularly among children under 5 years of age. These infections
encompass a wide range of conditions, including pneumonia,
bronchiolitis, and influenza, and are a leading cause of morbidity and
mortality in this vulnerable population. The prevalence of RTIs in this
age group necessitates careful attention to preventive measures,
accurate diagnosis, and appropriate management to minimize
adverse health outcomes (Williams et al., 2018).

Several factors contribute to the heightened susceptibility of young

children to respiratory tract infections. Environmental influences,
such as overcrowded living conditions, exposure to indoor air
pollutants, and inadequate ventilation, can create a fertile ground for
the transmission of respiratory pathogens. Additionally, the close
interactions in daycare settings and schools facilitate the rapid spread
of infections among children, posing challenges for containment and
prevention efforts.
 Respiratory tract infections
among young children often
manifest with a spectrum of
symptoms that can range from
mild to severe. The initial stages
may involve non-specific
symptoms such as nasal
congestion, cough, and low-grade
fever, resembling common colds.
However, the progression of the
infection can lead to more severe
respiratory distress, characterized
by rapid breathing, wheezing,
and, in extreme cases cyanosis.
 The role of maternal knowledge in the prevention,
early recognition, and management of respiratory
infections in children cannot be overstated. Mothers
serve as primary caregivers and play a pivotal role in
shaping the health-seeking behavior for their
children. Understanding the level of awareness,
knowledge, and practices related to respiratory
infections is integral to developing targeted
educational programs. Maternal knowledge
influences preventive measures such as vaccination
adherence, optimal breastfeeding practices, and the
prompt recognition of warning signs, leading to
timely medical intervention. An in-depth assessment
of maternal knowledge provides valuable insights
into potential gaps in information dissemination and
can guide the development of culturally sensitive and
accessible health education initiatives.
 Significance of the Study:
Respiratory infections, such as pneumonia, bronchiolitis, and influenza, are a leading cause of morbidity
and mortality in young children globally. The significance of this problem stems from its widespread
prevalence, the associated risk factors, and the impact of maternal knowledge on prevention and
management. Respiratory infections are a major public health concern among children under 5 years of
age. They are a leading cause of hospital admissions and mortality in this age group, particularly in low-
and middle income countries. Understanding the prevalence of these infections is crucial for identifying
the burden of the disease and for developing effective intervention strategies.
 Aim of the Study:

The aim of the current study was to assess the prevelance, risk factors and mothers’ knowledge and
attitude about respiratory tract infections among infant and children under 5 years. Subjects and
Method Research design The current study utilized a cross-sectional exploratory research design.

❑ Research questions:
o What is the prevalence of respiratory tract infections among infant &children under 5 years of
age?

o What are the most common risk factors of respiratory tract infections among infant &children
under 5 years of age?

o What is the level of knowledge among mothers or primary caregivers regarding respiratory
infections in children under 5 years of age and their prevention?

o What is the mothers’ attitude regarding respiratory tract infection and antibiotic use?
 Study setting:

The study was conducted in pediatric ward and

pediatric outpatient department (OPD) at
Maternity & Children’s Hospital affiliated to
Ministry of Health, Arar, Saudi Arabia. The female
pediatric medical ward is a specialized unit within
the hospital. The pediatric ward consists of 30
patient rooms divided into ward A and B, each
designed to create a comforting and child-friendly
environment. With an average of 20 beds, the
ward maintains a nurse-to-patient ratio of 1:3 to
ensure that each child receives personalized
attention and care.
 Subjects: The current study includes two groups infant and children under 5 years and
their mothers as follows:

According to sample size equation listed below a convenience sampling of 383 mother
and their infants and children fulfilling the following inclusion criteria form.

Inclusion criteria: Exclusion criteria:

✓ All infant and children from birth till 5 years
✓ Diagnosed with respiratory tract infection
✓ Mothers willing to participate
❖ Children older than 5 years
❖ children with immunosuppressive diseases
❖ Children taking immunosuppressive drugs
❖ Children with congenital or developmental
abnormalities affecting the respiratory system.
Tools of Data Collection:

One tool was used for data collection:

Tool 1 : Prevalence, risk factors and mothers knowledge and

attitude about respiratory tract infection among infant and children
under 5 years structured interview.

The tool collection divided into 4 segments:

Part I: Demographic characteristics of mothers.

Part II: Demographic characteristics and health status of the child.

Part III: Mothers knowledge about respiratory tract infection and

their prevention.

Part IV: Mothers attitude about respiratory tract infection and

antibiotics use
 Validity and Reliability
The validity of the developed tool was done. Five
faculty members from faculty of nursing from pediatric
nursing departments from Northern Border &
Mansoura University verified the content validity of the
instruments. The reliability of scale was done using
Alpha Cronbach's coefficient test. The alpha reliability
for the survey was (0.83).
Ethical Considerations
The study in process for getting ethical approval from
Research Ethics Committee at the Faculty of Nursing -
Northern Border University. Written permission was
acquired from mothers to conduct the study after
explaining and clarifying the aim of the study. Secrecy
of information was assured that the data will be
confidential and the participants have the right to leave
the study whenever they need.
 Pilot study
A pilot study was carried out on 38 mother
and their children (10%) to ascertain the
feasibility, applicability and clarity of the
tool and minor modification was done.
Statistical Analysis
Data were verified prior to computerized
entry. The Statistical Package for Social
Science (SPSS), version 21.0 was used for
that purpose followed by data analysis and
tabulation. Descriptive statistics were
applied (e.g., frequency, percentage, mean
and standard deviation,).
 Analysis &
Interpretation of
Results
 Variables n %
Table 1: Age in years
demographic < 25
25 -≤ 30
6
13
13.3
28.9
characteristics 30 -≤ 35 7 15.6
> 35 19 42.2
of the studied Nationality
mothers Saudi
Non-Saudi
45 100

Education Level
Basic education 6 13
Intermediate qualification 3 6.5
Higher qualification - university degree 35 76.1
Marital Status
Married 41 89.1
Widow 1 2.2
Divorced 4 8.7
Number of children
1-2 16 35.6
3-4 12 26.7
5-6 10 22.2
7 & more
Occupation
Housewife 25 55.6
Student 2 4.4
Employed in the government or private sector 18 40
 Variables n %
Child's Age (months) Mean ±SD
Gender Table 2:
Male 13 30.2
Female 30 69.8 Demographic
Diagnosis characteristic
Pneumonia
Bronchitis s and health
Bronchiolitis status of
Otaitis media
children
Order of birth
First 11 29.7
Second 2 5.4
Third 6 16.2
Fourth 5 13.5
Fifth 8 21.6
Six and more
Child's Condition at Birth
Full-term 32 80
Premature 3 7.5
Post-term 5 12.5
Child receive all vaccinations according to the schedule
Yes 32 82.1
No 7 17.9
Child suffer from any other illnesses or chronic conditions
Yes 3 7.7
No 36 92.3
Child undergone any surgeries before
Yes 3 7.5
No 37 92.5
Figure 4:
Hospitalization
of children.
Figure 2:

Figure 1:
Figure 5:
Figure 3:

Figure 7:
 Conclusion:

In conclusion, the study provided valuable insights into the health status of children, risk factors for
respiratory tract infections, mothers' knowledge about respiratory infections, and their attitudes towards the
use of antibiotics. The findings revealed that a significant proportion of mothers had a basic education level
and were married. Additionally, a considerable number of children had been diagnosed with pneumonia,
bronchitis and bronchiolitis. The study highlighted the importance of breastfeeding and the potential
protective role it plays in preventing respiratory infections.

However, there were areas of concern identified in mothers' knowledge and attitudes towards the use of
antibiotics. A proportion of mothers held misconceptions about the appropriate use of antibiotics, with some
believing that antibiotics should be given for all respiratory infections or that they have no side effects.
 Recommendation:
❑ Develop educational programs targeted to mothers
about respiratory tract infections and their prevention,
the appropriate use of antibiotics as well as address
misconceptions

❑ Conduct further research to explore other potential risk

factors for respiratory tract infections and assess the long-
term effects of inappropriate antibiotic use on antibiotic
resistance and children's health outcomes.

❑ Develop educational program to improve mothers

awareness about importance of breast feeding and
influenza vaccine in reducing respiratory infection

❑ Public health campaigns should focus on raising

awareness about the importance of hand hygiene,
breastfeeding, and the potential harms of unnecessary
antibiotic use
 Implications to nursing practice
Based on the findings of the study, several implications for
nursing practice can be suggested:

1- Nurses should take an active role in educating mothers

about respiratory infections, their prevention, and the
appropriate use of antibiotics. This can be done through
individual counseling sessions, group education programs, or
the development of educational materials.

2- Nurses can play a vital role in promoting healthy behaviors

and lifestyle modifications that reduce the risk of respiratory
infections. This includes educating parents about the benefits
of breastfeeding, the importance of maintaining a smoke-free
environment, and encouraging regular vaccinations. Nurses
should also provide guidance on proper nutrition, adequate
rest, and physical activity to support children's overall health
and immune function
 References:
➢ Shtayyat, K. F., & Abu-Baker, N. N. (2023). Knowledge, Attitude, and Practice toward Antibiotic use
with Acute Respiratory Infection among Parents of Children under Five Years. The Open Nursing
Journal, 17(1).
https://opennursingjournal.com/VOLUME/17/ELOCATOR/e187443462305100/FULLTEXT/
➢ Al-Noban, M. S., & Elnimeiri, M. K. (2022). Mothers knowledge, attitude and practices regarding
acute respiratory infection in children under five years/urban and rural Areas-Al Mukalla city-2022.
Electronic Journal of University of Aden for Basic and Applied Sciences, 3(2), 93-100.
https://ejua.net/index.php/EJUA-BA/article/view/157

➢ El-Koofy, N. M., El-Shabrawi, M. H., Abd El-alim, B. A., Zein, M. M., & Badawi, N. E. (2022). Patterns
of respiratory tract infections in children under 5 years of age in a low–middle-income country.
Journal of the Egyptian Public Health Association, 97(1), 22.
 Respiratory Tract Infections Among Infant and
Children Under 5 Years: Assessment of Risk
Factor, Prevalence and Maternal Knowledge
and Attitude

Under the guidance and supervision of/

Dr. Amal Ahmed Elbilgahy

Ms. Deepa Jothirajan

Introduction:
Respiratory tract infections (RTIs) pose a significant public health concern, particularly among
infants and children under 5 years of age. These infections encompass a range of conditions,
including pneumonia, bronchiolitis, and influenza, and are a leading cause of morbidity and
mortality in this vulnerable population. Therefore, the aim of the current study was to assess the
risk factors, prevalence, and maternal knowledge and attitude regarding respiratory tract
infections among infant and children under 5 years.

Methods: Results:
The current study utilized a cross-sectional
exploratory research design on a The majority of children diagnosed with
convivence sample of 371mother and their respiratory infection were female, not
children based on the sample size suffering from chronic illness and not
calculation formula and fulfilling the receiving influnza vaccine (69.8%, 92.3% &
following inclusion criteria: all infant and 85% respectively). Moreover, the minority
children from birth till 5 years, Diagnosed of child (18.6%) had previous
with respiratory tract infection. Children hospitalization with respiratory infection
with immunosuppressive diseases or taking and 44.7 % had at least one attack of
immunosuppressive drugs were excluded respiratory infection per year.
from the study. One tool was used for data
collection and the data was collected from
pediatric ward and pediatric outpatient
department (OPD) at Maternity &
Children’s Hospital affiliated to Ministry
of Health, Arar, Saudi Arabia.

CONCLUSION
SUBHEADING
There is a need for widespread public
health education programs targeting
parents and caregivers on the prevention
and management of RTIs in children.
This should include information on
proper hygiene practices, vaccinations,
and recognizing early signs and
symptoms of respiratory infections.

RECOMMENDATION :

There is a need for widespread public

health education programs targeting
parents and caregivers on the prevention
and management of RTIs in children.
This should include information on
proper hygiene practices, vaccinations,
and recognizing early signs and symptoms
of respiratory infections.

REFERENCES:
Shtayyat, K. F., & Abu-Baker, N. N. (2023). Knowledge, Attitude, and Practice toward Antibiotic use with Acute
Respiratory Infection among Parents of Children under Five Years. The Open Nursing Journal, 17(1).
https://opennursingjournal.com/VOLUME/17/ELOCATOR/e187443462305100/FULLTEXT/
Al-Noban, M. S., & Elnimeiri, M. K. (2022). Mothers knowledge, attitude and practices regarding acute respiratory
infection in children under five years/urban and rural Areas-Al Mukalla city-2022. Electronic Journal of University of
Aden for Basic and Applied Sciences, 3(2), 93-100.‫‏‬https://ejua.net/index.php/EJUA-BA/article/view/157

El-Koofy, N. M., El-Shabrawi, M. H., Abd El-alim, B. A., Zein, M. M., & Badawi, N. E. (2022). Patterns of
respiratory tract infections in children under 5 years of age in a low–middle-income country. Journal of the Egyptian
Public Health Association, 97(1), 22.‫‏‬

Submitted/presented by:
Mohammed Alhameed - Hamad Mtrak- Rakan Mutab - Under the guidance and
Farouq Fouad supervision of/ Dr. Amal Ahmed
Elbilgahy