The effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana
Identifieur interne : 001F27 ( Pmc/Curation ); précédent : 001F26; suivant : 001F28The effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana
Auteurs : Matthew S. Kelly [Botswana, États-Unis] ; Kathleen E. Wirth [États-Unis] ; Jaime Madrigano [États-Unis] ; Kristen A. Feemster [États-Unis] ; Coleen K. Cunningham [États-Unis] ; Tonya Arscott-Mills [Botswana, États-Unis] ; Sefelani Boiditswe [Botswana] ; Samir S. Shah [États-Unis] ; Rodney Finalle [États-Unis] ; Andrew P. Steenhoff [Botswana, États-Unis]Source :
- The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease [ 1027-3719 ] ; 2015.
Abstract
Tertiary hospital in Gaborone, Botswana.
To examine whether exposure to wood smoke worsens outcomes of childhood pneumonia.
Prospective cohort study of children 1-23 months of age meeting clinical criteria for pneumonia. Household use of wood as a cooking fuel was assessed during a face-to-face questionnaire with caregivers. We estimated crude and adjusted risk ratios (RR) and 95% confidence intervals (CI) for treatment failure at 48 hours by household use of wood as a cooking fuel. We assessed for effect modification by age (1-5 vs. 6-23 months) and malnutrition (none vs. moderate vs. severe).
Median age of the 284 enrolled children was 5.9 months and 17% had moderate or severe malnutrition. Ninety-nine (35%) children failed treatment at 48 hours and 17 (6%) died. In multivariable analyses, household use of wood as a cooking fuel increased the risk of treatment failure at 48 hours (RR: 1.44, 95% CI: 1.09-1.92,
Exposure to wood smoke worsens outcomes from childhood pneumonia. Efforts to prevent exposure to smoke from unprocessed fuels may improve pneumonia outcomes among children.
Url:
DOI: 10.5588/ijtld.14.0557
PubMed: 25686146
PubMed Central: 4352146
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Kelly</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A4">Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Wirth, Kathleen E" sort="Wirth, Kathleen E" uniqKey="Wirth K" first="Kathleen E." last="Wirth">Kathleen E. 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Cunningham</name><affiliation wicri:level="1"><nlm:aff id="A4">Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Arscott Mills, Tonya" sort="Arscott Mills, Tonya" uniqKey="Arscott Mills T" first="Tonya" last="Arscott-Mills">Tonya Arscott-Mills</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Boiditswe, Sefelani" sort="Boiditswe, Sefelani" uniqKey="Boiditswe S" first="Sefelani" last="Boiditswe">Sefelani Boiditswe</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Shah, Samir S" sort="Shah, Samir S" uniqKey="Shah S" first="Samir S." last="Shah">Samir S. Shah</name><affiliation wicri:level="1"><nlm:aff id="A8">Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</wicri:regionArea></affiliation></author><author><name sortKey="Finalle, Rodney" sort="Finalle, Rodney" uniqKey="Finalle R" first="Rodney" last="Finalle">Rodney Finalle</name><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Steenhoff, Andrew P" sort="Steenhoff, Andrew P" uniqKey="Steenhoff A" first="Andrew P." last="Steenhoff">Andrew P. 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Kelly</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A4">Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Wirth, Kathleen E" sort="Wirth, Kathleen E" uniqKey="Wirth K" first="Kathleen E." last="Wirth">Kathleen E. Wirth</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Madrigano, Jaime" sort="Madrigano, Jaime" uniqKey="Madrigano J" first="Jaime" last="Madrigano">Jaime Madrigano</name><affiliation wicri:level="1"><nlm:aff id="A6">Department of Environmental and Occupational Health, Rutgers School of Public Health, Piscataway, New Jersey, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Environmental and Occupational Health, Rutgers School of Public Health, Piscataway, New Jersey</wicri:regionArea></affiliation></author><author><name sortKey="Feemster, Kristen A" sort="Feemster, Kristen A" uniqKey="Feemster K" first="Kristen A." last="Feemster">Kristen A. Feemster</name><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Cunningham, Coleen K" sort="Cunningham, Coleen K" uniqKey="Cunningham C" first="Coleen K." last="Cunningham">Coleen K. Cunningham</name><affiliation wicri:level="1"><nlm:aff id="A4">Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Arscott Mills, Tonya" sort="Arscott Mills, Tonya" uniqKey="Arscott Mills T" first="Tonya" last="Arscott-Mills">Tonya Arscott-Mills</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Boiditswe, Sefelani" sort="Boiditswe, Sefelani" uniqKey="Boiditswe S" first="Sefelani" last="Boiditswe">Sefelani Boiditswe</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Shah, Samir S" sort="Shah, Samir S" uniqKey="Shah S" first="Samir S." last="Shah">Samir S. Shah</name><affiliation wicri:level="1"><nlm:aff id="A8">Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</wicri:regionArea></affiliation></author><author><name sortKey="Finalle, Rodney" sort="Finalle, Rodney" uniqKey="Finalle R" first="Rodney" last="Finalle">Rodney Finalle</name><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Steenhoff, Andrew P" sort="Steenhoff, Andrew P" uniqKey="Steenhoff A" first="Andrew P." last="Steenhoff">Andrew P. Steenhoff</name><affiliation wicri:level="1"><nlm:aff id="A1">Botswana-UPenn Partnership, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Botswana-UPenn Partnership, Gaborone</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A7">Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author></analytic><series><title level="j">The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease</title><idno type="ISSN">1027-3719</idno><idno type="eISSN">1815-7920</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Setting</title><p id="P1">Tertiary hospital in Gaborone, Botswana.</p></sec><sec id="S2"><title>Objective</title><p id="P2">To examine whether exposure to wood smoke worsens outcomes of childhood pneumonia.</p></sec><sec id="S3"><title>Design</title><p id="P3">Prospective cohort study of children 1-23 months of age meeting clinical criteria for pneumonia. Household use of wood as a cooking fuel was assessed during a face-to-face questionnaire with caregivers. We estimated crude and adjusted risk ratios (RR) and 95% confidence intervals (CI) for treatment failure at 48 hours by household use of wood as a cooking fuel. We assessed for effect modification by age (1-5 vs. 6-23 months) and malnutrition (none vs. moderate vs. severe).</p></sec><sec id="S4"><title>Results</title><p id="P4">Median age of the 284 enrolled children was 5.9 months and 17% had moderate or severe malnutrition. Ninety-nine (35%) children failed treatment at 48 hours and 17 (6%) died. In multivariable analyses, household use of wood as a cooking fuel increased the risk of treatment failure at 48 hours (RR: 1.44, 95% CI: 1.09-1.92, <italic>P</italic>=0.01). This association differed by child nutritional status (<italic>P</italic>=0.02), with a detrimental effect observed only among children with no or moderate malnutrition.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Exposure to wood smoke worsens outcomes from childhood pneumonia. Efforts to prevent exposure to smoke from unprocessed fuels may improve pneumonia outcomes among children.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9706389</journal-id><journal-id journal-id-type="pubmed-jr-id">20773</journal-id><journal-id journal-id-type="nlm-ta">Int J Tuberc Lung Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Tuberc. Lung Dis.</journal-id><journal-title-group><journal-title>The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease</journal-title></journal-title-group><issn pub-type="ppub">1027-3719</issn><issn pub-type="epub">1815-7920</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25686146</article-id><article-id pub-id-type="pmc">4352146</article-id><article-id pub-id-type="doi">10.5588/ijtld.14.0557</article-id><article-id pub-id-type="manuscript">NIHMS665256</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kelly</surname><given-names>Matthew S.</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Wirth</surname><given-names>Kathleen E.</given-names></name><degrees>ScD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Madrigano</surname><given-names>Jaime</given-names></name><degrees>ScD, MPH</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Feemster</surname><given-names>Kristen A.</given-names></name><degrees>MD, MPH, MSHPR</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Cunningham</surname><given-names>Coleen K.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Arscott-Mills</surname><given-names>Tonya</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Boiditswe</surname><given-names>Sefelani</given-names></name><degrees>BNSc</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Shah</surname><given-names>Samir S.</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Finalle</surname><given-names>Rodney</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Steenhoff</surname><given-names>Andrew P.</given-names></name><degrees>MBBCh, DCH</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A7">7</xref></contrib></contrib-group><aff id="A1"><label>1</label>Botswana-UPenn Partnership, Gaborone, Botswana</aff><aff id="A2"><label>2</label>Global Health Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</aff><aff id="A3"><label>3</label>Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA</aff><aff id="A4"><label>4</label>Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA</aff><aff id="A5"><label>5</label>Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA</aff><aff id="A6"><label>6</label>Department of Environmental and Occupational Health, Rutgers School of Public Health, Piscataway, New Jersey, USA</aff><aff id="A7"><label>7</label>Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA</aff><aff id="A8"><label>8</label>Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA</aff><author-notes><corresp id="CR1">Corresponding Author: Matthew S. Kelly, MD Box 3499, Duke University Medical Center, Durham, NC 27710 Phone: 1-(919) 530-0712 <email>matthew.kelly@duke.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>21</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>3</month><year>2016</year></pub-date><volume>19</volume><issue>3</issue><fpage>349</fpage><lpage>355</lpage><pmc-comment>elocation-id from pubmed: 10.5588/ijtld.14.0557</pmc-comment>
<abstract><sec id="S1"><title>Setting</title><p id="P1">Tertiary hospital in Gaborone, Botswana.</p></sec><sec id="S2"><title>Objective</title><p id="P2">To examine whether exposure to wood smoke worsens outcomes of childhood pneumonia.</p></sec><sec id="S3"><title>Design</title><p id="P3">Prospective cohort study of children 1-23 months of age meeting clinical criteria for pneumonia. Household use of wood as a cooking fuel was assessed during a face-to-face questionnaire with caregivers. We estimated crude and adjusted risk ratios (RR) and 95% confidence intervals (CI) for treatment failure at 48 hours by household use of wood as a cooking fuel. We assessed for effect modification by age (1-5 vs. 6-23 months) and malnutrition (none vs. moderate vs. severe).</p></sec><sec id="S4"><title>Results</title><p id="P4">Median age of the 284 enrolled children was 5.9 months and 17% had moderate or severe malnutrition. Ninety-nine (35%) children failed treatment at 48 hours and 17 (6%) died. In multivariable analyses, household use of wood as a cooking fuel increased the risk of treatment failure at 48 hours (RR: 1.44, 95% CI: 1.09-1.92, <italic>P</italic>=0.01). This association differed by child nutritional status (<italic>P</italic>=0.02), with a detrimental effect observed only among children with no or moderate malnutrition.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Exposure to wood smoke worsens outcomes from childhood pneumonia. Efforts to prevent exposure to smoke from unprocessed fuels may improve pneumonia outcomes among children.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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