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. 2023 Mar 29;7(2):e247.
doi: 10.1097/EE9.0000000000000247. eCollection 2023 Apr.

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

Adekunle Gregory Fakunle  1   2 , Nkosana Jafta  2 , Akinkunmi Paul Okekunle  3 , Lidwien A M Smit  4 , Rajen N Naidoo  2
Affiliations

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

Adekunle Gregory Fakunle et al. Environ Epidemiol. .

Abstract

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

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Conflict of interest statement

The authors declare that they have no conflict of interest with regard to the content of this report.

Figures

Figure 1.
Figure 1.
Adjusted odds ratios of having LRTI by exposure variables. A, Overall children under the age of 5 years; (B). among children under-five <6 months of age; (C) among children ≥6 months of age; D. Male; E. Female. Models were adjusted for age, sex, geographical location, number of siblings under-five, history of LRTI, breastfeeding status, housing tenure, season, occupant density, keeping pets, and environmental tobacco smoking
Figure 2.
Figure 2.
Shape of the exposure-response association between Lower Respiratory Tract Infections (LRTIs) among under-five children and (A) dampness/moisture damage; (B) Mold damage; (C) Damp-Mold Index. The graphs show a restricted cubic spline and 95% CI of the pooled odds ratio (OR) of LRTI by the predictor. The green lines denote the OR, and the grey shades represent the 95% confidence interval. Notes: Model adjusted for age, sex, geographical location, history of LRTI, breastfeeding status, number of siblings U5, season, housing tenure, pet ownership, environmental tobacco smoking, and occupant density.
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References

    1. Troeger C, Forouzanfar M, Rao PC, et al. . Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17:1133–1161. - PMC - PubMed
    1. Kyu HH, Vongpradith A, Sirota SB, et al. . Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis. 2022;22:1626–1647. - PMC - PubMed
    1. Liu L, Johnson HL, Cousens S, et al. ; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151–2161. - PubMed
    1. Walker CLF, Rudan I, Liu L, et al. . Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381:1405–1416. - PMC - PubMed
    1. Chao F, You D, Pedersen J, Hug L, Alkema L. National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment. Lancet Glob Health. 2018;6:e535–e547. - PMC - PubMed