Background: Household air pollution from solid fuels increases the risk of childhood pneumonia. Nasopharyngeal carriage of Streptococcus pneumoniae is a necessary step in the development of pneumococcal pneumonia. We aimed to assess the association between exposure to household air pollution and the prevalence and density of S pneumoniae carriage among children.
Methods: The Malawi Streptococcus pneumoniae Carriage and Air Pollution Exposure study was a nested, prospective, observational study of children participating in the cluster randomised controlled Cooking and Pneumonia Study (CAPS) in the Karonga Health and Demographic Surveillance System (HDSS) area in northern Malawi. CAPS compared the effects of a cleaner burning biomass-fuelled cookstove (intervention group) with traditional open-fire cooking (control group) on the incidence of pneumonia in children. Eligible children aged 6 weeks or 6 months (those recruited a 6 weeks were also followed up at age 6 months) were identified by the Karonga HDSS centre. Nasopharyngeal swabs were taken to detect S pneumoniae, and infant exposure to particulate matter with a diameter of ≤2·5 μm (PM) exposure was assessed by use of a MicroPEM device. The primary outcome was the prevalence of nasopharyngeal S pneumoniae carriage in all children aged 6 months, assessed in all children with valid data on PM. The effects of the intervention stoves (intention-to-treat analysis) and PM (adjusted exposure-response analysis) on the prevalence of S pneumoniae carriage were also assessed in the study children.
Findings: Between Nov 15, 2015, and Nov 2, 2017, 485 children were recruited (240 from the intervention group and 245 from the control group). Of all 450 children with available data at age 6 months, 387 (86% [95% CI 82-89]) were positive for S pneumoniae. Geometric mean PM exposure was 60·3 μg/m (95% CI 55·8-65·3) in S pneumoniae-positive children and 47·0 μg/m (38·3-57·7) in S pneumoniae-negative children (p=0·044). In the intention-to-treat analysis, a non-significant increase in the risk of S pneumoniae carriage was observed in intervention group children compared with control group children (odds ratio 1·36 [95% CI 0·95-1·94]; p=0·093). In the exposure-response analysis, a significant association between PM exposure and S pneumoniae carriage was observed; a one unit increase in decile of PM was found to significantly increase the risk of S pneumoniae carriage by 10% (1·10 [1·01-1·20]; p=0·035), after adjustment for age, sex, 13-valent pneumococcal conjugate vaccination status, season, current use of antibiotics, and MicroPEM run-time.
Interpretation: Despite the absence of effect from the intervention cookstove, household air pollution exposure was significantly associated with the prevalence of nasopharyngeal S pneumoniae carriage. These results provide empirical evidence for the potential mechanistic association between exposure to household air pollution and childhood pneumonia.
Funding: Bill & Melinda Gates Foundation.
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http://dx.doi.org/10.1016/S2214-109X(21)00405-8 | DOI Listing |
Lancet Digit Health
December 2024
Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address:
Microbiology reference laboratories perform a crucial role within public health systems. This role was especially evident during the COVID-19 pandemic. In this Viewpoint, we emphasise the importance of microbiology reference laboratories and highlight the types of digital data and expertise they provide, which benefit national and international public health.
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December 2024
Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Accra, Ghana.
Background: The nasopharynx is characterised by a rich microbial diversity, making it an important endogenous reservoir for respiratory infections. People living with diabetes (PLWD) have a high risk for acquisition of respiratory tract infections, but their nasopharyngeal bacterial flora have rarely been investigated.
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PLoS One
December 2024
School of General Medicine-2, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
This study aims to examine the prevalence of nasopharyngeal Streptococcus pneumoniae carriage (NSPC) in infants during their first two years of life and to compare the carriage rates among different vaccine groups and country income-levels. This will be achieved through a systematic review of the published literature, specifically focusing on data from cohort studies and randomized controlled trials. A comprehensive search was conducted in four electronic databases: PubMed, Web of Science, ScienceDirect, and Scopus, using a predefined search strategy.
View Article and Find Full Text PDFFront Cell Infect Microbiol
December 2024
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "P. Giaccone", University of Palermo, Palermo, Italy.
Introduction: is a prevalent and virulent global pathogen, with colonization being considered a precondition for pneumococcal disease. Understanding colonization is critical for gaining insights into transmission dynamics and developing effective interventions. This study aimed to determine the prevalence of nasopharyngeal colonization and serotype distribution in the Sicilian population.
View Article and Find Full Text PDFActa Trop
December 2024
One Health Research Group. Universidad de Las Américas. Quito. Ecuador. Electronic address:
In the Andean region of South America, guinea pigs (Cavia porcellus) are raised as livestock in close contact with other domestic animals and humans. Although the susceptibility of guinea pigs to being affected by a wide range of diseases is well known as a laboratory animal model, there are a few reports about the potential role of zoonotic pathogens in livestock guinea pigs. In this work, we analyzed the nasopharyngeal carriage of respiratory pathogenic viruses and bacteria in guinea pigs from farms in Ecuador.
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