Late Breaking Abstract - Ambient air pollution and respiratory health in sub-Saharan African children: a cross-sectional analysis

Abstract

Introduction: Ambient air pollution is projected to become a major environmental risk in sub-Saharan Africa (SSA). Yet, research into its health impacts is hindered by limited data.

Aims: We aimed to investigate the cross-sectional relationship between particulate matter with a diameter<=2.5μm (PM2.5) and prevalence of cough or acute lower respiratory infection (ALRI) among under-5 children in SSA.

Methods: Data were collected from 31 Demographic and Health Surveys (DHS) in 21 SSA countries between 2005-2018. Prior-month average PM2.5 preceding the survey date was assessed based on satellite measurements and chemical transport model. Cough and ALRI symptoms in the past two weeks were reported by mothers. Associations were analysed using conditional logistic regression within each survey, adjusting for child’s age, sex, birth size, household wealth, maternal education, maternal age and month of the interview. Individual survey odds ratios (ORs) were pooled using random-effect meta-analysis.

Results: 368,366 and 109,664 children were included for the analysis of cough and ALRI respectively. On average, 20.5% children had reported cough; 6.4% reported ALRI; and 32% of children lived in urban areas. Prior-month average PM2.5 ranged from 8.9 to 64.6 μg/m3. Across surveys, no associations were observed with either outcome in total populations. Sub-group analyses revealed positive associations with both cough (pooled OR: 1.013, 95%CI: 0.996-1.029) and ALRI (pooled OR: 1.037, 95%CI: 1.002-1.075) for every 1 μg/m3 higher of PM2.5.

Conclusions: Short-term higher exposure to PM2.5 was associated with higher odds of maternally-reported cough or ALRI among SSA urban children.