Pneumonia case-finding in the RESPIRE Guatemala indoor air pollution trial: standardizing methods for resource-poor settings

Bruce, Nigel; Weber, Martin; Arana, Byron; Díaz, Anaité; Jenny, Alisa; Thompson, Lisa; McCracken, John P.; Dherani, Mukesh; Juarez, Damaris; Ordóñez, Sergio; Klein, Robert E.; Smith, Kirk R.

doi:10.2471/blt.06.035832

Cited by 112 publications

(118 citation statements)

References 16 publications

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“…More research, both from animal and human studies, is needed to establish the causal association between these health effects and exposure to biomass smoke. Some of the health effects associated with solid-fuel smoke exposure are acute, and include oxygen desaturation [52] and acute lower respiratory infection (ALRI)/pneumonia [53].…”

Section: Health Effects From Exposure To Solid Fuel Smokementioning

confidence: 99%

Indoor air pollution and the lung in low- and medium-income countries

2012

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Over half the world's population, mostly from developing countries, use solid fuel for domestic purposes and are exposed to very high concentrations of harmful air pollutants with potential health effects such as respiratory problems, cardiovascular problems, infant mortality and ocular problems. The evidence also suggests that, although the total percentage of people using solid fuel is decreasing, the absolute number is currently increasing. Exposure to smoke from solid fuel burning increases the risk of chronic obstructive pulmonary disease (COPD) and lung cancer in adults, and acute lower respiratory tract infection/pneumonia in children. Despite the heterogeneity among studies, the association between COPD and exposure to smoke produced by burning different types of solid fuel is consistent. However, there is strong evidence that while coal burning is a risk factor for lung cancer, exposure to other biomass fuel smoke is less so. There is some evidence that reduction of smoke exposure using improved cooking stoves reduces the risk of COPD and, possibly, acute lower respiratory infection in children, so approaches to reduce biomass smoke exposure are likely to result in reductions in the global burden of respiratory disease.

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Section: Health Effects From Exposure To Solid Fuel Smokementioning

confidence: 99%

Indoor air pollution and the lung in low- and medium-income countries

2012

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“…Many studies have reported that the general population employs a broader language to describe health and illness than the medical community, which limits definitions to specific, proscribed terms (Cane, Pao, & McKenzie, 2001). Agreement among rural, coastal Guatemalans about specific symptoms caused by asthma has been found to be lower than for other Latino groups in Mexico and immigrant Latino populations in the U.S., and many of the reported "asthma" symptoms overlapped with symptoms commonly seen in upper respiratory infections (Pachter, Weller, Baer, de Alba Garcia, Trotter, Glazer et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…During the second part of the focus group session, we showed a minute-long video clip created by the ISAAC study investigators (http://isaac.auckland.ac.nz/Phasethr/Video.html) of children and adults with active wheeze (nocturnal and exercise-induced). Participants were then asked questions shown in Table 2 that were modified from a previous study (Cane, Pao, & McKenzie, 2001). The goal of using the video was to allow participants to view the symptoms, free of any descriptive terms for "asthma" or "wheeze" from the researchers, and then permit them to supply their own terms, thus reducing bias imposed by the researchers ) (see Figure 3).…”

Section: Phase Ii: Focus Groups With Participantsmentioning

confidence: 99%

“…Using focus groups with parents of children without asthma, Cane and coworkers (Cane, Pao, & McKenzie, 2001) explored how parents describe terms such as "wheeze" and "breathlessness". After dividing 66 mothers of Bangladeshi, European and Afro-Caribbean descent residing in East London into ethnic-specific focus groups, the mothers were asked to view a video of a boy with audible wheeze and cough without being told that the child had asthma.…”

Section: Introductionmentioning

confidence: 99%

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Nxwisen, ntzarrin or ntzo’lin? Mapping children's respiratory symptoms among indigenous populations in Guatemala

Thompson

Dı́az

Jenny

et al. 2007

Social Science & Medicine

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Estimating the prevalence of asthma is an epidemiologic challenge, particularly in rural areas of lesser-developed countries characterized by low literacy and poor access to health care. To avoid under-or over-reporting of symptoms, questionnaires must use terminology familiar to participants and that accurately describes the triad of cough, wheeze and breathlessness characteristic of asthma. In preparation for a large longitudinal cohort study entitled Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (CRECER) that will examine the effects of variable early lifetime woodsmoke exposure on the respiratory health of Mam-speaking children residing in communities in the western highlands of Guatemala, we conducted individual interviews (n=18) and five focus groups (n=46) with indigenous women from 17 of these communities to elicit and define local Mam and Spanish terms for common respiratory symptoms used to describe their own and their children's respiratory symptoms. Focus group participants were also shown an International Study of Asthma and Allergies in Childhood (ISAAC) video of wheezing children and adults. We developed a conceptual framework that can be used as an efficient model for future studies investigating health and/or disease terminology in isolated communities, an integral step in the development of standardized questionnaires. Among this Mam-speaking population, wheeze was best described as: nxwisen or ntzarrin, "breathing sounds that are heard in the neck but come from the chest." The variation in understanding of terms between women with and without children with a history of wheeze (such that for those without wheezing children some terms were virtually unrecognized), has important implications for large-scale populations surveys within countries and comparative surveys such as ISAAC. It is important to use linguistically and culturally appropriate

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“…(91) However, there was a significant reduction in severe pneumonia, and a 50% reduction in exposure was significantly associated with a lower rate of diagnosis of pneumonia. Other randomized controlled trials of improved stoves are underway, but results are yet to be published (Bruce 2007). (92) …”

Section: Pollution Intervention Studies Beijing Olympics Interventionmentioning

confidence: 99%

Respiratory health effects of air pollution: Update on biomass smoke and traffic pollution

2012

Journal of Allergy and Clinical Immunology

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Mounting evidence suggests that air pollution contributes to the large global burden of respiratory and allergic diseases including asthma, chronic obstructive pulmonary disease, pneumonia and possibly tuberculosis. Although associations between air pollution and respiratory disease are complex, recent epidemiologic studies have led to an increased recognition of the emerging importance of traffic-related air pollution in both developed and less-developed countries, as well as the continued importance of emissions from domestic fires burning biomass fuels primarily in the less-developed world. Emissions from these sources lead to personal exposures to complex mixtures of air pollutants that change rapidly in space and time due to varying emission rates, distances from source, ventilation rates, and other factors. Although the high degree of variability in personal exposure to pollutants from these sources remains a challenge, newer methods for measuring and modeling these exposures are beginning to unravel complex associations with asthma and other respiratory disease. These studies indicate that air pollution from these sources is a major preventable cause of increased incidence and exacerbation of respiratory disease. Physicians can help to reduce the risk of adverse respiratory effects of exposure to biomass and traffic air pollutants by promoting awareness and supporting individual and community-level interventions.

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Pneumonia case-finding in the RESPIRE Guatemala indoor air pollution trial: standardizing methods for resource-poor settings

Cited by 112 publications

References 16 publications

Indoor air pollution and the lung in low- and medium-income countries

Indoor air pollution and the lung in low- and medium-income countries

Nxwisen, ntzarrin or ntzo’lin? Mapping children's respiratory symptoms among indigenous populations in Guatemala

Respiratory health effects of air pollution: Update on biomass smoke and traffic pollution

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