The effect of household air pollution on the health outcomes of infants in Botswana
Sweta Patel, MD
BACKGROUND: Household air pollution (HAP) from the burning of solid biomass fuels is a risk factor for pneumonia, the leading infectious cause of death in children. Accurate screening tools are urgently needed to reduce child mortality. GAP: Little is known about the health effects of HAP during infancy, due in part to the lack of accurate tools to quantify these exposures in infants. Questionnaires are often used but may be inaccurate given the many factors that may affect individual exposures. Levels of malondialdehyde (MDA), a biomarker of oxidative stress, are elevated in older children and adults with exposure to HAP, but its utility in the infant population is unknown. HYPOTHESIS: Our hypotheses are: 1) maternal-reported use of solid fuels will be only weakly associated with the incidence of respiratory infections among infants during the first 12 months of life; and 2) higher serum MDA levels will be associated with a higher incidence of respiratory infections during the first 12 months of life. METHODS: This project will be conducted within the context of an ongoing prospective cohort study of 300 mother-infant pairs recruited within 72 hours of birth in Gaborone, Botswana. Detailed information on household use of biomass fuels and serum samples are collected at enrollment; we will use high performance liquid chromatography to measure serum MDA levels at birth. RESULTS: Pending IMPACT: An accurate screening tool to identify infants who are at high risk of respiratory infections because of HAP exposure could facilitate targeting of public health interventions to reduce HAP exposure in children, which could in turn lead to reduced pneumonia-related mortality within the next 5 years.