Browsing by Subject "Childhood asthma"

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    A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol
    (2017) Olaniyan, Toyib; Jeebhay, Mohamed; Röösli, Martin; Naidoo, Rajen; Baatjies, Roslynn; KYnzil, Nino; Tsai, Ming; Davey, Mark; de Hoogh, Kees; Berman, Dilys; Parker, Bhawoodien; Leaner, Joy; Dalvie, Mohamed Aqiel
    Abstract Background There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements. Methods/design A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop). Discussion This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature.
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    A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol
    (BioMed Central, 2017-09-16) Olaniyan, Toyib; Jeebhay, Mohamed; Röösli, Martin; Naidoo, Rajen; Baatjies, Roslynn; Künzil, Nino; Tsai, Ming; Davey, Mark; de Hoogh, Kees; Berman, Dilys; Parker, Bhawoodien; Leaner, Joy; Dalvie, Mohamed A
    Background: There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements. Methods/design: A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop). Discussion: This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature.
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    Assessing the role of temperature and air pollution in exacerbating childhood asthma in Cape Town, South Africa
    (2022) Phakisi, Tshepo Kingsley; Rother, Hanna-Andrea; Godsmark, Christie Nicole; Weimann, Edda
    Childhood asthma is one of the most common chronic diseases worldwide, including in South Africa. There has been substantial evidence on the role of air pollution in asthma exacerbation but limited research on the role of climate change and how the interaction between climate change and air pollution is affecting childhood asthma, specifically in low and middle-income countries (LMICs). Temperature changes can be used as an effect of climate change to investigate the association between climate change, air pollution and childhood asthma. This study, therefore, used a case study approach aimed at examining the interaction between air pollution and temperature in exacerbating childhood asthma focusing on clinical data obtained from Red Cross War Memorial Children's Hospital, air quality data (City of Cape Town) and temperature data (South African Weather Services) for Cape Town, South Africa for three study years (2009, 2014 and 2019). The protocol (Part A) of the mini dissertation describes childhood asthma literature globally and in LMICs and specifically in South Africa. It also discusses the increasing incidences and prevalence of the disease and possible causes such as air pollution and climate change. Furthermore, it discusses the vulnerability of children to the exposure of interest, being air pollution (PM2.5, PM10, NO2 and O3) and climate change (i.e., temperature). Subsequently, the development of air quality standards is discussed, specifically concerning whether they consider the specific children's vulnerability to exposures. The protocol then describes the study population and methodologies for conducting this study. The journal ready article (Part B) presents the findings of the study. Spearman's correlation was used to measure the degree of association between temperature variables and air pollutants. The results indicated that diurnal temperature was associated with PM2.5 (r=0.579: p< 0.01) and PM10 (r=0.505: p< 0.01). A Poisson regression analysis was applied to evaluate the relationship between asthma exacerbation with air pollutants and temperature variables. In a univariate analysis there was a statistically significant relationship between asthma exacerbation and diurnal temperature for 2019, IRR=0.98 (95% CI,0.97 – 0.99) p< 0.05, maximum temperature 2014, IRR=0.99(95% CI, 0.98 - 1.00) p< 0.05 and for 2019, IRR=0.98(95% CI, 0.97 - 0.99) p< 0.01, average temperature 2014, IRR=0.99(95% CI, 0.98 - 1.00) p< 0.05 and for 2019, IRR=0.98(95% CI, 0.97 - 0.99) p< 0.01. Using a multivariate analysis there v of 110 was no significant relationship between childhood asthma exacerbation and air pollutants (PM10, NO2 and O3) except for PM2.5 IRR=0.12(95% CI, 0.01 - 0.81) p< 0.05. Diurnal temperature statistically significant childhood asthma predictor for 2009, IRR=1.02(95% CI, 1.00 - 1.05) p< 0.05 and for 2014, IRR=0.97(95% CI, 0.96 - 0.99) p< 0.01. Temperature increase, therefore, seems to be related to asthma exacerbation. More research is needed on the relationship between diurnal temperature, childhood asthma, and air pollutants to inform adaptation strategies. The findings of this study are important for the development of climate change and health adaptation and prevention strategies in South Africa, particularly in relation to heat adaptation. These findings are also relevant for the development of air quality guidelines and guidelines to address children, as the most vulnerable population to environmental health exposures. The appendices (Part C) present the analyses that were not included in the protocol (Part A) and article (Part B). These also include documents relating to the study such as ethics approval and permission to conduct research by different entities.