Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.
Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK.
Int J Environ Res Public Health. 2021 Sep 15;18(18):9729. doi: 10.3390/ijerph18189729.
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 (PM) 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 PM 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 PM ranged from 8.9 to 64.6 μg/m. 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/m higher of PM. This explorative study found no associations between short-term ambient PM and respiratory health among young SSA children, necessitating future analyses using better-defined exposure and health metrics to study this important link.
大气污染预计将成为撒哈拉以南非洲（SSA）的主要环境风险。由于数据有限，对其健康影响的研究受到阻碍。我们旨在研究 SSA 五岁以下儿童中直径≤2.5μm 的颗粒物（PM）与咳嗽或急性下呼吸道感染（ALRI）患病率之间的横断面关系。数据来自 SSA 21 个国家的 31 次人口与健康调查（DHS），时间为 2005-2018 年。根据卫星测量和化学传输模型，评估了调查日期前一个月的平均 PM。咳嗽和 ALRI 在过去两周内从问卷中得出。在每个调查群内，使用条件逻辑回归分析关联，调整了儿童的年龄、性别、出生大小、家庭财富、母亲教育、母亲年龄和访谈月份。使用随机效应荟萃分析汇总了特定调查的比值比（OR）。纳入了 368366 名儿童用于咳嗽分析，109664 名儿童用于 ALRI 分析。平均而言，20.5%的儿童报告咳嗽，6.4%的儿童报告 ALRI，32%的儿童生活在城市地区。前一个月的平均 PM 范围从 8.9 到 64.6μg/m。在所有调查中，总体人群中没有观察到任何与咳嗽或 ALRI 相关的结果。在中高人类发展指数国家中，与 PM 每增加 1μg/m，咳嗽（汇总 OR：1.022，95%CI：0.982-1.064）和 ALRI（汇总 OR：1.018，95%CI：0.975-1.064）呈正相关。这项探索性研究没有发现短期环境 PM 与 SSA 年轻儿童呼吸健康之间的关联，需要进一步使用更好定义的暴露和健康指标进行分析，以研究这一重要联系。
