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Household air pollution, chronic respiratory disease and pneumonia in Malawian adults: A case-control study

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Jary, Hannah, Aston, Stephen, Ho, Antonia, Giorgi, Emanuele, Kalata, Newton, Nyirenda, Mulinda, Mallewa, Jane, Peterson, Ingrid, Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116 and Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871 (2017) 'Household air pollution, chronic respiratory disease and pneumonia in Malawian adults: A case-control study'. Wellcome Open Research, Vol 2, p. 103.

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Abstract

Background: Four million people die each year from diseases caused by exposure to household air pollution. There is an association between exposure to household air pollution and pneumonia in children (half a million attributable deaths a year); however, whether this is true in adults is unknown. We conducted a case-control study in urban Malawi to examine the association between exposure to household air pollution and pneumonia in adults.
Methods: Hospitalized patients with radiologically confirmed pneumonia (cases) and healthy community controls underwent 48 hours of ambulatory and household particulate matter (µg/m3) and carbon monoxide (ppm) exposure monitoring. Multivariate logistic regression, stratified by HIV status, explored associations between these and other potential risk factors with pneumonia.
Results: 145 (117 HIV-positive; 28 HIV-negative) cases and 253 (169 HIV-positive; 84 HIV-negative) controls completed follow up. We found no evidence of association between household air pollution exposure and pneumonia in HIV-positive (e.g. ambulatory particulate matter adjusted odds ratio [aOR] 1.00 [95% CI 1.00–1.01, p=0.141]) or HIV-negative (e.g. ambulatory particulate matter aOR 1.00 [95% CI 0.99–1.01, p=0.872]) participants. Chronic respiratory disease was associated with pneumonia in both HIV-positive (aOR 28.07 [95% CI 9.29–84.83, p<0.001]) and HIV-negative (aOR 104.27 [95% CI 12.86–852.35, p<0.001]) participants.
Conclusions: We found no evidence that exposure to household air pollution is associated with pneumonia in Malawian adults. In contrast, chronic respiratory disease was strongly associated with pneumonia.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Sanitation. Environmental Control > General Sanitation and Environmental Control > WA 670 General works
WA Public Health > Air pollution > WA 750 Air sanitation and hygiene
WA Public Health > Air pollution > WA 754 Pollution and pollutants (incl. tobacco pollution; passive smoking)
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
WF Respiratory System > WF 140 Diseases of the respiratory system (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.12688/wellcomeopenres.12621.1
Related URLs:
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 28 Nov 2017 16:14
Last Modified: 28 Nov 2017 16:14
URI: http://archive.lstmed.ac.uk/id/eprint/7866

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