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Cai YS, Gibson H, Ramakrishnan R, Mamouei M, Rahimi K. Ambient Air Pollution and Respiratory Health in Sub-Saharan African Children: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189729. [PMID: 34574653 PMCID: PMC8467583 DOI: 10.3390/ijerph18189729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 02/03/2023]
Abstract
Ambient air pollution is projected to become a major environmental risk in sub-Saharan Africa (SSA). Research into its health impacts is hindered by limited data. We aimed to investigate the cross-sectional relationship between particulate matter with a diameter ≤ 2.5 μm (PM2.5) and prevalence of cough or acute lower respiratory infection (ALRI) among children under five in SSA. Data were collected from 31 Demographic and Health Surveys (DHS) in 21 SSA countries between 2005–2018. Prior-month average PM2.5 preceding the survey date was assessed based on satellite measurements and a chemical transport model. Cough and ALRI in the past two weeks were derived from questionnaires. Associations were analysed using conditional logistic regression within each survey cluster, adjusting for child’s age, sex, birth size, household wealth, maternal education, maternal age and month of the interview. Survey-specific odds ratios (ORs) were pooled using random-effect meta-analysis. Included were 368,366 and 109,664 children for the analysis of cough and ALRI, respectively. On average, 20.5% children had reported a cough, 6.4% reported ALRI, and 32% of children lived in urban areas. Prior-month average PM2.5 ranged from 8.9 to 64.6 μg/m3. Pooling all surveys, no associations were observed with either outcome in the overall populations. Among countries with medium-to-high Human Development Index, positive associations were observed with both cough (pooled OR: 1.022, 95%CI: 0.982–1.064) and ALRI (pooled OR: 1.018, 95%CI: 0.975–1.064) for 1 μg/m3 higher of PM2.5. This explorative study found no associations between short-term ambient PM2.5 and respiratory health among young SSA children, necessitating future analyses using better-defined exposure and health metrics to study this important link.
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Affiliation(s)
- Yutong Samuel Cai
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Correspondence:
| | - Harry Gibson
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
| | - Rema Ramakrishnan
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK;
| | - Mohammad Mamouei
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
| | - Kazem Rahimi
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
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Masekela R, Vanker A. Lung Health in Children in Sub-Saharan Africa: Addressing the Need for Cleaner Air. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6178. [PMID: 32858786 PMCID: PMC7504680 DOI: 10.3390/ijerph17176178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/17/2022]
Abstract
Air pollution is increasingly recognized as a global health emergency with its impacts being wide ranging, more so for low- and middle-income countries where both indoor and outdoor pollution levels are high. In Africa, more than 80% of children live in households which use unclean sources of energy. The effects of both indoor and outdoor pollution on lung health on children who are the most vulnerable to their effects range from acute lower respiratory tract infections to long-term chronic health effects. We reviewed the literature on the effects of air pollution in children in Sub-Saharan Africa from prenatal exposure, infancy and school-going children. Data from Sub-Saharan Africa on quantification of exposures both indoor and outdoor mainly utilizes modelling or self-reporting. Exposures to biomass not only increases the risk of acute respiratory tract infections in young children but also increases the risk of carriage of pathogenic bacteria in the upper respiratory tract. Although there is limited evidence of association between asthma and pollution in African children, airway hyper-responsiveness and lower lung function has been demonstrated in children with higher risk of exposure. Interventions at a policy level to both quantify the exposure levels at a population level are urgently needed to address the possible interventions to limit exposure and improve lung health in children in Sub-Saharan Africa.
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Affiliation(s)
- Refiloe Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4013, South Africa
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town 7700, South Africa;
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