Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria

Adekunle Gregory Fakunle; Nkosana Jafta; Akinkunmi Paul Okekunle; Lidwien A M Smit; Rajen N Naidoo

doi:10.1097/EE9.0000000000000247

Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria

Adekunle Gregory Fakunle
, Nkosana Jafta
, Akinkunmi Paul Okekunle
, Lidwien A M Smit
, Rajen N Naidoo

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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.

Original language	English
Article number	e247
Pages (from-to)	1-7
Number of pages	7
Journal	Environmental Epidemiology
Volume	7
Issue number	2
Early online date	29 Mar 2023
DOIs	https://doi.org/10.1097/EE9.0000000000000247
Publication status	Published - 29 Apr 2023

Bibliographical note

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).

Keywords

Dampness
mold exposure
lower respiratory tract infections
under-five children
Nigeria
epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/EE9.0000000000000247Licence: CC BY-NC-ND

Exposure_response_relationship_of_residential.5Final published version, 1.2 MBLicence: CC BY-NC-ND

Cite this

@article{6a215573be454e16a5aa2f9acd30c853,

title = "Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria",

abstract = "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.",

keywords = "Dampness, mold exposure, lower respiratory tract infections, under-five children, Nigeria, epidemiology",

author = "Fakunle, \{Adekunle Gregory\} and Nkosana Jafta and Okekunle, \{Akinkunmi Paul\} and Smit, \{Lidwien A M\} and Naidoo, \{Rajen N\}",

note = "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 {\textcopyright} 2023 The Author(s).",

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doi = "10.1097/EE9.0000000000000247",

language = "English",

volume = "7",

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Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria. / Fakunle, Adekunle Gregory; Jafta, Nkosana; Okekunle, Akinkunmi Paul et al.
In: Environmental Epidemiology, Vol. 7, No. 2, e247, 29.04.2023, p. 1-7.

Research output: Contribution to journal › Article › Academic › peer-review

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 - https://www.scopus.com/pages/publications/85151330464

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 -

Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria

Abstract

Bibliographical note

Keywords

UN SDGs

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