Understanding the effect of indoor air pollution on pneumonia in children under 5 in low- and middle-income countries: a systematic review of evidence

Adaji, Enemona Emmanuel; Ekezie, Winifred; Clifford, M.J.; Phalkey, Revati

doi:10.1007/s11356-018-3769-1

Cited by 58 publications

(44 citation statements)

References 56 publications

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“…Higher odds of pneumonia were observed in under-five children whose family uses wood as a source of fuel. This result was in line with studies conducted in India (52), and Sri Lanka (53); and with systematic reviews conducted in Low and Middle income countries (54), and Africa, China and Latin America (55). It was also consistent with a global review conducted by Jackson et al (56).…”

Section: Non-exclusive Breast Feedingsupporting

confidence: 91%

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Beletew¹,

Bimrew²,

Kasie³

et al. 2020

Preprint

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Section: Non-exclusive Breast Feedingsupporting

confidence: 91%

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Beletew¹,

Bimrew²,

Kasie³

et al. 2020

Preprint

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“…Higher odds of pneumonia were observed in under-ve children whose family uses wood as a source of fuel. This result was in line with studies conducted in India (52), and Sri Lanka (53); and with systematic reviews conducted in Low and Middle income countries (54), and Africa, China and Latin America (55). It was also consistent with a global review conducted by Jackson et al (56).…”

Section: Non-exclusive Breast Feedingsupporting

confidence: 91%

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Beletew

Bimrew

Kasie

et al. 2020

Preprint

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Background: Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa.Objective: The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa.Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies.Result: A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I2= 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I2= 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I2= 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I2= 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I2= 11.7% ;P=0.337) were identified factors of pneumonia.Conclusions: The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

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“…Previous studies have measured single pollutants or used proxies measurements in the absence of observed primary data (Broor et al, 2001;Mahalanabis et al, 2002;Dherani et al, 2008;Bassani et al, 2010;Dhimal et al, 2010;Dionisio et al, 2012;Bruce et al, 2013;Jackson et al, 2013;Karki et al, 2014;Ram et al, 2014;Shibata et al, 2014;Zar & Ferkol, 2014;Buchner & Rehfuess, 2015;Kelly et al, 2015;Sonego et al, 2015;Howie et al, 2016;PrayGod et al, 2016;Mortimer et al, 2017a). We have previously reported that when directly measuring pollutants, there was no association with pneumonia incidence, but when using biomass fuel as a proxy, there was (Adaji EE et al, 2019). This highlights the need for targeted approaches for measuring indoor pollutant levels.…”

Section: Discussionmentioning

confidence: 79%

Association Between Specific Indoor Air Pollutants and Pneumonia Episodes in Children Under Five in Abuja, Nigeria: A Case-control Study

Adaji

Clifford

Gibson

et al. 2020

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Background: Pneumonia causes most death in children under five globally. Indoor air pollution has been reported to increase the risk of children to pneumonia. ObjectiveTo investigate the association between specific indoor air pollutants and pneumonia episodes in children under five.MethodsUsing a case-control study design, we compared exposure of cases and controls to specific pollutants (PM2.5, CO, BC and PM1), using battery operated aerosol monitors. Data was analysed using Wilcoxon signed-rank test.ResultsThe mean PM2.5 was higher in controls compared to cases. PM2.5 highest mean recorded for controls was 177 µg/m3. There was a significant difference between cases and controls for 10 hours (p-value 0.0147), 15 hours (p-value 0.0111) and 20-24 hours (p-value 0.0296) for PM2.5. No significant difference in CO concentration between cases and controls, the highest CO mean concentration recorded being 2930 µg/m3. Similarly, PM1 was consistently higher in controls compared to cases. However, this difference was not significant from exposure to PM1 between cases and controls (P-value>0.05), with the highest PM1 mean concentration recorded being 91 µg/m3. There was a significant difference (p-value 0.0260) in exposure to Black Carbon between cases and controls. BC was higher in households of cases compared to controls, with the mean average of BC for cases 4350 µg/m3 and controls 4126 µg/m3. In this study, BC is positively associated with a pneumonia episode. We also report the importance of unmodifiable and behaviourally modifiable factors on pneumonia episode in children.Discussion: In conclusion, we show that children present during cooking, number of available windows and MUAC increased the likelihood of a pneumonia episode. We recommend household level behaviour changes and targeted IMCI including early effective detection and treatment of childhood pneumonia particularly in high pollution areas in Nigeria.

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Understanding the effect of indoor air pollution on pneumonia in children under 5 in low- and middle-income countries: a systematic review of evidence

Cited by 58 publications

References 56 publications

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Association Between Specific Indoor Air Pollutants and Pneumonia Episodes in Children Under Five in Abuja, Nigeria: A Case-control Study

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