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Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort.
Environ Int 2019; 133(Pt A):105150EI

Abstract

BACKGROUND

Pneumonia, a leading cause of childhood mortality, is associated with household air pollution (HAP) exposure. Mechanisms between HAP and pneumonia are poorly understood, but studies suggest that HAP may increase the likelihood of bacterial, instead of viral, pneumonia. We assessed the relationship between HAP and infant microbial nasal carriage among 260 infants participating in the Ghana Randomized Air Pollution and Health Study (GRAPHS).

METHODS

Data are from GRAPHS, a cluster-randomized controlled trial of cookstove interventions (improved biomass or LPG) versus the 3-stone (baseline) cookstove. Infants were surveyed for pneumonia during the first year of life and had routine personal exposure assessments. Nasopharyngeal swabs collected from pneumonia cases (n = 130) and healthy controls (n = 130) were analyzed for presence of 22 common respiratory microbes by MassTag polymerase chain reaction. Data analyses included intention-to-treat (ITT) comparisons of microbial species presence by study arm, and exposure-response relationships.

RESULTS

In ITT analyses, 3-stone arm participants had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p < 0.0001, n = 260). This difference was driven by increased bacterial (p < 0.0001) rather than viral species presence (non-significant). Results were pronounced in pneumonia cases and attenuated in healthy controls. Higher prevalence bacterial species were Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Exposure-response relationships did not yield significant associations between measured CO and nasal microbial carriage.

CONCLUSIONS

Our intention-to-treat findings are consistent with a link between HAP and bacterial nasal carriage. No relationships were found for viral carriage. Given the null results in exposure-response analysis, it is likely that a pollutant besides CO is driving these differences.

Authors+Show Affiliations

Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: daniel.carrion@mssm.edu.Kintampo Health Research Centre, Kintampo, Ghana.Department of Environmental Health, Boston University, Boston, USA.University of Health and Allied Sciences, Ho, Ghana.Lamont-Doherty Earth Observatory, Columbia University, New York, USA.Kintampo Health Research Centre, Kintampo, Ghana.Fogarty International Center, National Institutes of Health, Bethesda, USA.Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA.Kintampo Health Research Centre, Kintampo, Ghana.Icahn School of Medicine at Mount Sinai, New York, USA.Center for Infection and Immunity, Columbia University, New York, USA.Kintampo Health Research Centre, Kintampo, Ghana.Department of Environmental Health Sciences, Columbia University, New York, USA. Electronic address: daniel.dj2183@columbia.edu.Kintampo Health Research Centre, Kintampo, Ghana.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31518936

Citation

Carrión, Daniel, et al. "Examining the Relationship Between Household Air Pollution and Infant Microbial Nasal Carriage in a Ghanaian Cohort." Environment International, vol. 133, no. Pt A, 2019, p. 105150.
Carrión D, Kaali S, Kinney PL, et al. Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort. Environ Int. 2019;133(Pt A):105150.
Carrión, D., Kaali, S., Kinney, P. L., Owusu-Agyei, S., Chillrud, S., Yawson, A. K., ... Asante, K. P. (2019). Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort. Environment International, 133(Pt A), p. 105150. doi:10.1016/j.envint.2019.105150.
Carrión D, et al. Examining the Relationship Between Household Air Pollution and Infant Microbial Nasal Carriage in a Ghanaian Cohort. Environ Int. 2019 Sep 10;133(Pt A):105150. PubMed PMID: 31518936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort. AU - Carrión,Daniel, AU - Kaali,Seyram, AU - Kinney,Patrick L, AU - Owusu-Agyei,Seth, AU - Chillrud,Steven, AU - Yawson,Abena K, AU - Quinn,Ashlinn, AU - Wylie,Blair, AU - Ae-Ngibise,Kenneth, AU - Lee,Alison G, AU - Tokarz,Rafal, AU - Iddrisu,Luisa, AU - Jack,Darby W, AU - Asante,Kwaku Poku, Y1 - 2019/09/10/ PY - 2019/04/15/received PY - 2019/08/19/revised PY - 2019/09/02/accepted PY - 2019/9/14/pubmed PY - 2019/9/14/medline PY - 2019/9/14/entrez KW - Biomass fuels KW - Childhood pneumonia KW - Household air pollution KW - Lower respiratory infections KW - Microbial carriage SP - 105150 EP - 105150 JF - Environment international JO - Environ Int VL - 133 IS - Pt A N2 - BACKGROUND: Pneumonia, a leading cause of childhood mortality, is associated with household air pollution (HAP) exposure. Mechanisms between HAP and pneumonia are poorly understood, but studies suggest that HAP may increase the likelihood of bacterial, instead of viral, pneumonia. We assessed the relationship between HAP and infant microbial nasal carriage among 260 infants participating in the Ghana Randomized Air Pollution and Health Study (GRAPHS). METHODS: Data are from GRAPHS, a cluster-randomized controlled trial of cookstove interventions (improved biomass or LPG) versus the 3-stone (baseline) cookstove. Infants were surveyed for pneumonia during the first year of life and had routine personal exposure assessments. Nasopharyngeal swabs collected from pneumonia cases (n = 130) and healthy controls (n = 130) were analyzed for presence of 22 common respiratory microbes by MassTag polymerase chain reaction. Data analyses included intention-to-treat (ITT) comparisons of microbial species presence by study arm, and exposure-response relationships. RESULTS: In ITT analyses, 3-stone arm participants had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p < 0.0001, n = 260). This difference was driven by increased bacterial (p < 0.0001) rather than viral species presence (non-significant). Results were pronounced in pneumonia cases and attenuated in healthy controls. Higher prevalence bacterial species were Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Exposure-response relationships did not yield significant associations between measured CO and nasal microbial carriage. CONCLUSIONS: Our intention-to-treat findings are consistent with a link between HAP and bacterial nasal carriage. No relationships were found for viral carriage. Given the null results in exposure-response analysis, it is likely that a pollutant besides CO is driving these differences. SN - 1873-6750 UR - https://www.unboundmedicine.com/medline/citation/31518936/Examining_the_relationship_between_household_air_pollution_and_infant_microbial_nasal_carriage_in_a_Ghanaian_cohort L2 - https://linkinghub.elsevier.com/retrieve/pii/S0160-4120(19)31272-3 DB - PRIME DP - Unbound Medicine ER -