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撒哈拉以南非洲五岁以下儿童的生命早期环境暴露与贫血:来自人口与健康调查的新视角。

Early-life environmental exposures and anaemia among children under age five in Sub-Saharan Africa: An insight from the Demographic & Health Surveys.

机构信息

Big Data Centre for Environment and Health (BERTHA), Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.

出版信息

Sci Total Environ. 2022 Aug 1;832:154957. doi: 10.1016/j.scitotenv.2022.154957. Epub 2022 Mar 31.

Abstract

BACKGROUND

Reports show that the majority (60%) of children under age five years in Sub-Saharan Africa are anaemic. Studies in the region have mainly focused on the effect of individual, maternal and household socioeconomic status on the prevalence of anaemia. Currently, there is limited understanding of the association between early-life environmental exposures and anaemia among children in Sub-Saharan Africa.

OBJECTIVE

The study examines the association between early-life environmental exposures and anaemia among children under five in Sub-Saharan Africa.

METHODS

The study used health and demographic data from the Demographic and Health Survey (DHS) program and environmental data from NASA's Geospatial Interactive Online Visualization ANd aNalysis Infrastructure (GIOVANNI) and Atmospheric Composition Analysis Group. Three exposure periods were defined for the study, namely: in-utero, post-utero and cumulative life exposures. Multilevel mixed-effect models were used to assess the associations between environmental exposures and anaemia in each exposure period.

RESULTS

The findings show that 63% of children in the study were anaemic. It also reveals that mean PM 2.5 exposure for in-utero (34.93 μgm), post-utero (35.23 μgm) and cumulative exposure (35.08 μgm) were seven times higher than the new air quality guideline WHO recommended. A 10 μgm increase in in-utero, post-utero and cumulative PM 2.5 exposures was associated with 4% to 5% increase in the prevalence of anaemia among children. A 10ppbv increase in in-utero, post-utero and cumulative carbon monoxide exposures was associated with 1% increase in the prevalence of anaemia among children. The spatial risk distribution maps show that socioeconomic factors modify the spatial risk distribution pattern.

CONCLUSION

The findings of the study suggest that early-life exposure to ambient air pollution is significantly associated with anaemia among children in Sub-Saharan Africa. Thus, policies aimed at addressing air quality should be incorporated into targeted interventions for anaemia among children in the region.

摘要

背景

报告显示,撒哈拉以南非洲地区 60%的五岁以下儿童患有贫血症。该地区的研究主要集中在个体、产妇和家庭社会经济地位对贫血症患病率的影响上。目前,人们对撒哈拉以南非洲地区儿童生命早期环境暴露与贫血症之间的关联知之甚少。

目的

本研究旨在探讨撒哈拉以南非洲地区五岁以下儿童生命早期环境暴露与贫血症之间的关系。

方法

本研究使用了来自人口与健康调查(DHS)项目的健康和人口统计数据以及来自美国宇航局的地球空间交互式在线可视化分析和分析基础设施(GIOVANNI)和大气成分分析组的环境数据。研究定义了三个暴露期,分别是:宫内、产后和终生暴露。多水平混合效应模型用于评估每个暴露期内环境暴露与贫血症之间的关系。

结果

研究结果显示,研究中的 63%的儿童患有贫血症。研究还表明,宫内(34.93μg/m³)、产后(35.23μg/m³)和终生(35.08μg/m³)PM2.5暴露的平均值比世界卫生组织推荐的新空气质量指南高 7 倍。宫内、产后和终生 PM2.5 暴露每增加 10μg/m³,儿童贫血症的患病率就会增加 4%至 5%。宫内、产后和终生 CO 暴露每增加 10ppbv,儿童贫血症的患病率就会增加 1%。空间风险分布地图显示,社会经济因素改变了空间风险分布模式。

结论

本研究结果表明,生命早期暴露于环境空气污染与撒哈拉以南非洲地区儿童贫血症显著相关。因此,应将旨在解决空气质量问题的政策纳入该地区儿童贫血症的针对性干预措施中。

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