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 m 2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1. 05, 4.36), and between 0.3 and 1.0 m 2 (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.

Childhood lower respiratory tract infections linked to residential airborne bacterial and fungal microbiota

“…Notably, the presence of visible dampness (21.4% vs 2.0%), visible molds (11.2% vs 2.0%) and pets in the house (38.8% vs 20.2%) in homes of cases versus controls differed significantly. Our previous report also showed an exposure-response relationship between residential dampness and severe LRTI among children under the age of five years (Fakunle et al, 2023). interquartile range; dampness was defined as the presence/absence of moisture/ mold growth on the walls or roof in the child's sleeping area; pets was defined as presence/absence of any pets in the house.…”