Greenspace and burden of infectious illnesses among children in 49 low- and middle-income countries

Greenspace is projected to decrease the burden of infectious illnesses. Here, we examine the association between greenspace (measured using normalized difference vegetation index and percentages of greenspaces) and the prevalence of three infectious illnesses: acute respiratory infection (ARI), fever, and diarrhea among children under 5 years old, obtained from Demographic and Health Surveys in 49 low- and middle-income countries. Among 699,904 children from 49 countries, greenspace is associated with decreased odds of having ARI, fever, and diarrhea among children under 5 years old. These associations are stronger among children from poorer families and those living in rural areas. The air temperature, drought levels, and particulate matter ≤ 2.5 μm mediate 0.20%–18.45% of the associations between greenspaces and infectious illnesses. Our findings indicate that children living in greener areas may have lower odds of having infectious illnesses, and the underlying pathways may include lowering air temperature, drought, and air pollutants levels.