Household air pollution, chronic respiratory disease and pneumonia in Malawian adults: A case-control study

Jary, H. R., Aston, S., Ho, A. , Giorgi, E., Kalata, N., Nyirenda, M., Mallewa, J., Peterson, I., Gordon, S. B. and Mortimer, K. (2017) Household air pollution, chronic respiratory disease and pneumonia in Malawian adults: A case-control study. Wellcome Open Research, 2, 103. (doi: 10.12688/wellcomeopenres.12621.1) (PMID:29387802) (PMCID:PMC5730861)

Abstract

Background: Four million people die each year from diseases caused by exposure to household air pollution. There is an association between exposure to household air pollution and pneumonia in children (half a million attributable deaths a year); however, whether this is true in adults is unknown. We conducted a case-control study in urban Malawi to examine the association between exposure to household air pollution and pneumonia in adults. Methods: Hospitalized patients with radiologically confirmed pneumonia (cases) and healthy community controls underwent 48 hours of ambulatory and household particulate matter (µg/m3) and carbon monoxide (ppm) exposure monitoring. Multivariate logistic regression, stratified by HIV status, explored associations between these and other potential risk factors with pneumonia. Results: 145 (117 HIV-positive; 28 HIV-negative) cases and 253 (169 HIV-positive; 84 HIV-negative) controls completed follow up. We found no evidence of association between household air pollution exposure and pneumonia in HIV-positive (e.g. ambulatory particulate matter adjusted odds ratio [aOR] 1.00 [95% CI 1.00–1.01, p=0.141]) or HIV-negative (e.g. ambulatory particulate matter aOR 1.00 [95% CI 0.99–1.01, p=0.872]) participants. Chronic respiratory disease was associated with pneumonia in both HIV-positive (aOR 28.07 [95% CI 9.29–84.83, p<0.001]) and HIV-negative (aOR 104.27 [95% CI 12.86–852.35, p<0.001]) participants. Conclusions: We found no evidence that exposure to household air pollution is associated with pneumonia in Malawian adults. In contrast, chronic respiratory disease was strongly associated with pneumonia.

• Item Type: Articles
• Additional Information: This work was supported by the Wellcome Trust [099929], Clinical PhD Fellow to HJ.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ho, Dr Antonia
• Authors: Jary, H. R., Aston, S., Ho, A., Giorgi, E., Kalata, N., Nyirenda, M., Mallewa, J., Peterson, I., Gordon, S. B., and Mortimer, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
• Journal Name: Wellcome Open Research
• Publisher: F1000Research
• ISSN: 2398-502X
• ISSN (Online): 2398-502X
• Copyright Holders: Copyright © 2017 The AuthorsJary HR et al
• First Published: First published in Wellcome Open Research 2:103
• Publisher Policy: Reproduced under a Creative Commons License