Acute respiratory infection, diarrhoea and fever in young children at-risk of intellectual disability in 24 low- and middle-income countries

•Children with infectious diseases have higher prevalence of symptoms of diarrhoea and pneumonia.•However, they are less likely to receive treatment.•They face inequities in the treatment of three major infectious diseases.

ObjectivesThis study aims to (1) estimate the prevalence of acute respiratory infection (ARI) symptoms, diarrhoea and fever in the previous two weeks among 3-4 year old children who are/are not at-risk of intellectual disability in 24 low- and middle-income countries and (2) to investigate possible inequities in access to treatment among affected children.Study designCross-sectional survey.MethodsSecondary analysis of Rounds 4 and 5 UNICEF Multiple Indicator Cluster Surveys (MICS) from 24 low- and middle-income countries (n = 99,934 children).ResultsPooled estimates indicated that young children at-risk of intellectual disability in low-income countries were significantly more likely than their peers to have reported symptoms of ARI and diarrhoea in the previous 2 weeks, and significantly less likely to have received appropriate treatment. Pooled estimates indicated that in middle-income countries children at-risk of intellectual disability were significantly more likely than their peers to have reported symptoms of ARI, diarrhoea and fever during the previous 2 weeks. Symptomatic children at-risk of intellectual disability were significantly less likely than their peers to have received antibiotics/antimotility medication for diarrhoea or antibiotics for ARI symptoms, but significantly more likely to be prescribed anti-malarials for fever.ConclusionsThese results indicate the existence of significant inequalities and possible inequities in the exposure to and the treatment of three major infectious diseases among children who are/are not considered at-risk of intellectual disabilities in low- and middle-income countries.