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Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya

Meme, Hellen, Amukoye, Evans, Bowyer, Cressida, Chakaya, Jeremiah, Das, Darpan, Dobson, Ruaraidh, Dragosits, Ulrike, Fuld, Jonathan, Gray, Cindy, Hahn, Matthew, Kiplimo, Richard, Lesosky, Maia ORCID: https://orcid.org/0000-0002-2026-958X, Loh, Miranda, McKendree, Jean, Mortimer, Kevin, Ndombi, Amos, Netter, Louis, Obasi, Angela ORCID: https://orcid.org/0000-0001-6801-8889, Orina, Fred, Pearson, Clare, Price, Heather, Quint, Jennier, Semple, Sean, Twigg, Marsaididh, Waelde, Charlotte, Walnycki, Anna, Warwick, Melaneia, Wendler, Jana, West, Sarah, Wilson, Michael, Zurba, Lindsey and Devereux, Graham ORCID: https://orcid.org/0000-0002-0024-4887 (2023) 'Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya'. Thorax, Vol 78, pp. 1118-1125.

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Abstract

Background:
Although one billion people live in informal (slum) settlements, the consequences for respiratory health of living in these settlements remain largely unknown. This study investigated whether children living in an informal settlement in Nairobi, Kenya are at increased risk of asthma symptoms.

Methods:
Children attending schools in Mukuru (an informal settlement in Nairobi) and a more affluent area (Buruburu) were compared. Questionnaires quantified respiratory symptoms and environmental exposures; spirometry was performed; personal exposure to particulate matter (PM2.5) was estimated.

Results:
2373 children participated, 1277 in Mukuru (median age, interquartile range, 11, 9-13 years, 53% girls), and 1096 in Buruburu (10, 8-12 years, 52% girls). Mukuru schoolchildren were from less affluent homes, had greater exposure to pollution sources and PM2.5. When compared with Buruburu schoolchildren, Mukuru schoolchildren had a greater prevalence of symptoms, ‘current wheeze’ (9.5% vs 6.4%, p=0.007) and ‘trouble breathing’ (16.3% vs 12.6%, p=0.01), and these symptoms were more severe and problematic. Diagnosed asthma was more common in Buruburu (2.8% vs 1.2%, p=0.004). Spirometry did not differ between Mukuru and Buruburu. Regardless of community, significant adverse associations were observed with self-reported exposure to ‘vapours, dusts, gases, fumes’, mosquito coil burning, adult smoker(s) in the home, refuse burning near homes, and residential proximity to roads.

Conclusion:
Children living in informal settlements are more likely to develop wheezing symptoms consistent with asthma that are more severe but less likely to be diagnosed as asthma. Self-reported but not objectively measured air pollution exposure was associated with increased risk of asthma symptoms.

Item Type: Article
Subjects: WA Public Health > Air pollution > WA 750 Air sanitation and hygiene
WF Respiratory System > Lungs > WF 600 Lungs
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Repository link:
Item titleItem URI
Dataset for the article: Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenyahttps://archive.lstmed.ac.uk/21509/
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1136/thorax-2023-220057
Depositing User: Mary Creegan
Date Deposited: 20 Jun 2023 10:00
Last Modified: 07 Mar 2024 15:42
URI: https://archive.lstmed.ac.uk/id/eprint/22469

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