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Table 5 Incidence rate ratio from multilevel Poisson models showing the multivariate association between morbidity incidence and the child-level, parent-related, household-level and community-level characteristics

From: Determinants of multimorbidity of infectious diseases among under-five children in Bangladesh: role of community context

Fixed-effects characteristics

Morbidity statuse

Model-If

Model-IIf

IRRa

95% CIb

IRRa

95% CIb

Age of child (in years)

 Four

Ref

 

Ref

 

 Three

1.08*

(0.99—1.17)

1.08*

(0.99—1.17)

 Two

1.28***

(1.18—1.38)

1.28***

(1.18—1.38)

 One

1.55***

(1.44—1.67)

1.55***

(1.44—1.67)

 Less than one year

1.41***

(1.30—1.52)

1.41***

(1.30—1.52)

Gender of child

 Female

Ref

 

Ref

 

 Male

1.12***

(1.07—1.17)

1.11***

(1.06—1.17)

Number of children under mother

 One

Ref

 

Ref

 

 Two

0.90***

(0.85—0.96)

0.91***

(0.85—0.96)

 Three or more

0.75***

(0.60—0.93)

0.74***

(0.60—0.92)

Mother’s level of education

 Secondary and above

Ref

 

Ref

 

 Upto primary

1.00

(0.94—1.06)

1.01

(0.95—1.07)

 No formal education

0.92

(0.83—1.03)

0.94

(0.84—1.04)

Father’s level of education

 Secondary and above

Ref

 

Ref

 

 Upto primary

1.01

(0.96—1.08)

1.02

(0.96—1.08)

 No formal education

0.98

(0.90—1.06)

0.97

(0.90—1.06)

Household sanitation condition

 Poor

Ref

 

Ref

 

 Average

1.10**

(1.01—1.20)

1.11**

(1.02—1.21)

 Good

1.07

(0.98—1.17)

1.07

(0.98—1.17)

Water treated before drinking

 Yes

Ref

 

Ref

 

 No

1.11**

(1.01—1.22)

1.03

(0.93—1.14)

Type of handwashing place

 Private space

Ref

 

Ref

 

 Public space

0.92***

(0.87—0.98)

0.92**

(0.87—0.98)

 No handwashing place

1.05

(0.92—1.21)

1.05

(0.91—1.20)

Shares Toilet with other households

 Not shared

Ref

 

Ref

 

 Shared by two HH

1.05

(0.99—1.13)

1.06

(0.99—1.13)

 Shared by three HH

1.08*

(0.99—1.18)

1.08*

(0.99—1.18)

 Shared by four and more HH

0.96

(0.87—1.05)

1.00

(0.91—1.09)

Household wealth quintile

 Richest

Ref

 

Ref

 

 Rich

1.18***

(1.08—1.28)

1.14***

(1.05—1.25)

 Middle

1.15***

(1.05—1.26)

1.11**

(1.00—1.22)

 Poor

1.15***

(1.04—1.27)

1.09*

(0.98—1.22)

 Poorest

1.22***

(1.11—1.34)

1.16***

(1.04—1.29)

Religion of household

 Islam

Ref

 

Ref

 

 Hinduism

0.92*

(0.83—1.02)

0.91*

(0.83—1.01)

 Others

0.48***

(0.29—0.77)

0.47***

(0.29—0.76)

Type of season

 Summer

Ref

 

Ref

 

 Winter

1.12*

(0.99—1.27)

1.05

(0.92—1.20)

 Monsoon

1.21**

(1.02—1.45)

1.31***

(1.07—1.60)

Type of community

 

 City corporation

  

Ref

 

 Other urban areas

  

1.28***

(1.11—1.47)

 Rural areas

  

1.29***

(1.11—1.51)

Altitude level of community

 Low

  

Ref

 

 Medium

  

1.11**

(1.01—1.22)

 High

  

1.16**

(1.03—1.30)

Socioeconomic status of community

 Low

  

Ref

 

 Medium

  

1.00

(0.92—1.09)

 High

  

1.05

(0.93—1.18)

Level of maternal education in community

 Low

  

Ref

 

 Medium

  

0.98

(0.90—1.07)

 High

  

0.98

(0.89—1.08)

Administrative division of community

 Dhaka

  

Ref

 

 Chittagong

  

1.21**

(1.04—1.40)

 Barisal

  

1.32***

(1.12—1.56)

 Khulna

  

1.16*

(0.99—1.36)

 Mymensingh

  

1.13

(0.96—1.32)

 Rajshahi

  

1.23**

(1.04—1.45)

 Rangpur

  

1.15

(0.96—1.38)

 Sylhet

  

1.16*

(0.99—1.36)

Degrees of freedom

29

 

44

 

Akaike’s information criterion (AIC)

21,631.59

 

21,620.15

 

Bayesian information criterion (BIC)

21,835.63

 

21,929.72

 

Likelihood-ratio test between Model I and II

  

41.44***

 

Number of communities

672

 

672

 

Number of children

8,398

 

8,398

 
  1. a IRR incidence rate ratio; b 95% Confidence Interval (CI) is given in brackets; c Statistical significance is denoted by asterisks where *** p-value < 0.01, ** p-value < 0.05, * p-value < 0.1; d Ref. denotes reference category; e Multimorbidity status is a count variable of the number of conditions a child suffered from in two weeks preceding the survey; f Model-I includes all covariates excluding the community-level characteristics, Model-II includes all covariates