TY - JOUR
T1 - Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria
AU - Fakunle, Adekunle Gregory
AU - Jafta, Nkosana
AU - Okekunle, Akinkunmi Paul
AU - Smit, Lidwien A M
AU - Naidoo, Rajen N
N1 - Funding Information:
This work was supported by the College of Health (CHS) PhD Scholarship of the University of KwaZulu-Natal to facilitate field activities.
Funding Information:
We acknowledge the support received from the College of Health (CHS) PhD Scholarship of the University of KwaZulu-Natal to facilitate field activities. We would like to thank Prof. Regina Oladokun of the Department of Paediatrics, University College Hospital.
Publisher Copyright:
Copyright © 2023 The Author(s).
PY - 2023/4/29
Y1 - 2023/4/29
N2 - Background: Previous epidemiological studies demonstrated an increased risk of respiratory health effects in children and adults exposed to dampness or mold. This study investigated associations of quantitative indicators of indoor dampness and mold exposure with severe lower respiratory tract infections (LRTI) among children aged 1-59 months in Ibadan, Nigeria. Methods: In-home visits were conducted among 178 children hospitalized with LRTI matched by age (±3 months), sex, and geographical location with 180 community-based children without LRTI. Trained study staff evaluated the indoor environment using a standardized home walkthrough checklist and measured visible dampness and mold damage. Damp-moldy Index (DMI) was also estimated to quantify the level of exposure. Exposure-response relationships of dampness and mold exposure with severe LRTI were assessed using multivariable restricted cubic spline regression models adjusting for relevant child, housing, and environmental characteristics. Results: Severe LRTI cases were more often male than female (61.8%), and the overall mean (SD) age was 7.3 (1.35) months. Children exposed to dampness <0.3 m2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.05, 4.36), and between 0.3 and 1.0 m2 (OR = 2.34; 95% CI = 1.01, 7.32), had a higher odds of severe LRTI compared with children not exposed to dampness. The restricted cubic spline showed a linear exposure-response association between severe LRTI and residential dampness (P < 0.001) but a nonlinear relationship with DMI (P = 0.01). Conclusions: Residential dampness and DMI were exposure-dependently associated with higher odds of severe LRTI among under-five children. If observed relationships were causal, public health intervention strategies targeted at reducing residential dampness are critically important to mitigate the burden of severe LRTI among under-five children.
AB - Background: Previous epidemiological studies demonstrated an increased risk of respiratory health effects in children and adults exposed to dampness or mold. This study investigated associations of quantitative indicators of indoor dampness and mold exposure with severe lower respiratory tract infections (LRTI) among children aged 1-59 months in Ibadan, Nigeria. Methods: In-home visits were conducted among 178 children hospitalized with LRTI matched by age (±3 months), sex, and geographical location with 180 community-based children without LRTI. Trained study staff evaluated the indoor environment using a standardized home walkthrough checklist and measured visible dampness and mold damage. Damp-moldy Index (DMI) was also estimated to quantify the level of exposure. Exposure-response relationships of dampness and mold exposure with severe LRTI were assessed using multivariable restricted cubic spline regression models adjusting for relevant child, housing, and environmental characteristics. Results: Severe LRTI cases were more often male than female (61.8%), and the overall mean (SD) age was 7.3 (1.35) months. Children exposed to dampness <0.3 m2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.05, 4.36), and between 0.3 and 1.0 m2 (OR = 2.34; 95% CI = 1.01, 7.32), had a higher odds of severe LRTI compared with children not exposed to dampness. The restricted cubic spline showed a linear exposure-response association between severe LRTI and residential dampness (P < 0.001) but a nonlinear relationship with DMI (P = 0.01). Conclusions: Residential dampness and DMI were exposure-dependently associated with higher odds of severe LRTI among under-five children. If observed relationships were causal, public health intervention strategies targeted at reducing residential dampness are critically important to mitigate the burden of severe LRTI among under-five children.
KW - Dampness
KW - mold exposure
KW - lower respiratory tract infections
KW - under-five children
KW - Nigeria
KW - epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85151330464&partnerID=8YFLogxK
U2 - 10.1097/EE9.0000000000000247
DO - 10.1097/EE9.0000000000000247
M3 - Article
C2 - 37064421
SN - 2474-7882
VL - 7
SP - 1
EP - 7
JO - Environmental Epidemiology
JF - Environmental Epidemiology
IS - 2
M1 - e247
ER -