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

Wellcome Open Research

article

Hannah R. Jary¹  Stephen Aston¹  Antonia Ho¹  Emanuele Giorgi⁵  Newton Kalata¹  Mulinda Nyirenda⁶  Jane Mallewa⁶  Ingrid Peterson¹  Stephen B. Gordon¹  Kevin Mortimer¹ 

[1] Malawi-Liverpool-Wellcome Trust Clinical Research Programme;Liverpool School of Tropical of Medicine;Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital;Institute of Infection and Global Health, University of Liverpool;Lancaster Medical School, Lancaster University;College of Medicine, University of Malawi;Queen Elizabeth Central Hospital

关键词: Household air pollution;    Pneumonia;    Chronic respiratory disease;    Particulate matter;    Carbon monoxide;    Malawi;    Sub-Saharan Africa;   

DOI  :  10.12688/wellcomeopenres.12621.1

学科分类：内科医学

来源: Wellcome

【 摘 要 】

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.

【 授权许可】

CC BY