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Indoor microbiome and risk of lower respiratory tract infections among children under-five years: A meta-analysis

Adekunle G Fakunle1,2, Nkosana Jafta1, Akinkunmi P Okekunle3,4

  • 1Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa.

Indoor Air
|May 29, 2020
PubMed

Insights

Exposure to indoor microbiome (IM) increases the risk of lower respiratory tract infections (LRTI) in young children. Higher fungal concentrations pose a greater risk, suggesting interventions for IM exposure are crucial for managing LRTI.

Area of Science:

  • Environmental Health
  • Pediatric Infectious Diseases
  • Microbiology

Background:

  • Indoor environments harbor diverse microbiomes.
  • Exposure to indoor microbiome (IM) is a potential risk factor for respiratory illnesses in children.
  • Lower respiratory tract infections (LRTI) are a significant cause of morbidity in children under five.

Purpose of the Study:

  • To investigate the association between indoor microbiome exposure and the risk of LRTI in children under five.
  • To conduct a meta-analysis of existing studies quantifying this relationship.

Main Methods:

  • A systematic literature search was performed across multiple electronic databases (PubMed, Scopus, Web of Science, GreenFILE, EMBASE, Cochrane Library) up to July 2019.
  • Eligible studies reported adjusted risk measures (RR or OR with CI) for LRTI associated with IM exposure.
  • A meta-analysis pooled the odds ratios (OR) using the inverse of variance method, with sensitivity and heterogeneity analyses.

Main Results:

  • Seven studies were included in the meta-analysis.
  • Higher concentrations of indoor microbiome were significantly associated with an increased risk of LRTI (OR: 1.20, P < .0001).
  • Exposure to total fungal concentration showed a stronger association with LRTI risk (OR: 1.27, P < .0001) compared to visible molds (OR: 1.20, P = .001).

Conclusions:

  • Children under five exposed to higher indoor microbiome concentrations are at increased risk of developing LRTI.
  • Interventions aimed at reducing indoor microbiome exposure should be considered in the prevention and management of LRTI in young children.

Keywords:
effect estimateshome environmentindoor microbiomelower respiratory tract infectionsmeta-analysis.under-five children

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