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Risk factors for mortality from acute lower respiratory tract infections in young Gambian children
A de Francisco1, J Morris, A J Hall
1Medical Research Council Laboratories, Banjul, The Gambia.
Insights
Exposure to cooking smoke significantly increases the risk of death from acute lower respiratory tract infections (ALRI) in young children in The Gambia. Reducing smoke exposure could lower ALRI mortality rates.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Acute lower respiratory tract infections (ALRI) are a leading cause of mortality in young children globally.
- Identifying modifiable risk factors is crucial for developing effective prevention strategies.
Purpose of the Study:
- To evaluate risk factors associated with death from ALRI in children under two years old in rural The Gambia.
- To compare risk factors between ALRI deaths and other causes of death.
Main Methods:
- A case-control study design was employed.
- 129 children who died from ALRI were matched with controls who died from other causes and with live controls.
- Data collected through post-mortem interviews and control matching.
Main Results:
- Exposure to cooking smoke, parental smoking, and prolonged exclusive breastfeeding were associated with increased ALRI mortality.
- Bed sharing with siblings, antenatal care, and immunization were associated with reduced ALRI mortality.
- Exposure to cooking smoke emerged as the strongest identified risk factor.
Conclusions:
- Household air pollution from cooking smoke is a significant risk factor for childhood ALRI mortality in this setting.
- Interventions to reduce smoke exposure during cooking may decrease ALRI deaths.
- Maternal education, socioeconomic status, and maternal age were not associated with ALRI mortality.
Abstract:
A case-control study has been undertaken in a rural area of The Gambia to evaluate risk factors for death from acute lower respiratory tract infections (ALRI) in young children. On the basis of a post-mortem interview 129 children aged < 2 years were thought to have died from ALRI. These cases were each matched according to age, sex, ethnic group, time and place of death with a child who had died from a cause other than an ALRI and with two live control children. Cases and controls were well matched. Comparison of cases and live controls suggested that exposure to smoke during cooking, parental smoking and exclusive, prolonged breastfeeding were associated with an increased risk of death from ALRI whilst sharing a bed with siblings, use of antenatal and welfare clinics and immunization were associated with a reduced risk of death from ALRI. No associations were found between mortality from ALRI and maternal education and literacy, socioeconomic status or with the age of the mother. Comparison of children who died from causes other than ALRI with the live controls showed a similar pattern of associations and no significant differences were found in any of the risk factors studied between children whose deaths were attributed to ALRI and those whose death was attributed to another cause. Association of death with exposure to smoke during cooking was the strongest risk factor identified. This risk might be altered by reducing smoke exposure during cooking.