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Rainfall, household crowding, and acute respiratory infections in the tropics
E L Murray1, M Klein, L Brondi
1Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, GA, USA. emurray24@gmail.com
Insights
Rainfall increases the risk of acute respiratory infections (ARI) in young children by promoting indoor crowding. This study in Bangladesh highlights the link between weather, household density, and childhood illness, informing prevention strategies.
Area of Science:
- Environmental Health
- Epidemiology
- Pediatrics
Background:
- Acute respiratory infections (ARI) are a primary cause of mortality in children under five globally.
- Understanding ARI seasonality is crucial for effective prevention strategies, particularly in tropical regions where infections peak during rainy seasons.
Purpose of the Study:
- To investigate the hypothesis that rainfall increases ARI risk in young children by promoting indoor crowding.
- To evaluate the association between rainfall, household crowding, and ARI incidence in Bangladeshi children.
Main Methods:
- A case-crossover study design was employed.
- Data were collected from 718 Bangladeshi children under five years old over a 3-month period with variable rainfall.
- Statistical analysis assessed the association between rainfall, household density (people per room), and ARI risk.
Main Results:
- Rainfall was significantly associated with an increased risk of ARI (OR 2.97, 95% CI 1.87-4.70).
- A stronger association was observed with increased household crowding (≥3 people/room, OR 3.31, 95% CI 2.03-5.38).
- However, the association weakened in the most crowded households (≥5 to <6 people/room, OR 1.55, 95% CI 0.54-4.47), suggesting other factors may be involved.
Conclusions:
- Rainfall appears to elevate ARI risk in young children, likely by increasing exposure within crowded indoor environments.
- While household crowding is a significant factor, other unmeasured variables may also influence the relationship between rainfall and ARI.
- Findings underscore the importance of considering environmental and social factors in pediatric respiratory health interventions.
Abstract:
SUMMARYAcute respiratory infections (ARI) are the leading cause of death worldwide in children aged <5 years, and understanding contributing factors to their seasonality is important for targeting and implementing prevention strategies. In tropical climates, ARI typically peak during the pre-rainy and rainy seasons. One hypothesis is that rainfall leads to more time spent indoors, thus increasing exposure to other people and in turn increasing the risk of ARI. A case-crossover study design in 718 Bangladeshi children aged <5 years was used to evaluate this hypothesis. During a 3-month period with variable rainfall, rainfall was associated with ARI [odds ratio (OR) 2·97, 95% confidence interval (CI) 1·87-4·70]; some evidence of an increased strength of association as household crowding increased was found (≥3 people/room, OR 3·31, 95% CI 2·03-5·38), but there was a lack of association in some of the most crowded households (≥5 to <6 people/room, OR 1·55, 95% CI 0·54-4·47). These findings suggest that rainfall may be increasing exposure to crowded conditions, thus leading to an increased risk of ARI, but that additional factors not captured by this analysis may also play a role.
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