dc.contributor.author | North, Crystal M | |
dc.contributor.author | MacNaughton, Piers | |
dc.contributor.author | Lai, Peggy S | |
dc.contributor.author | Vallarino, Jose | |
dc.contributor.author | Okello, Samson | |
dc.contributor.author | Kakuhikire, Bernard | |
dc.contributor.author | Tsai, Alexander C | |
dc.contributor.author | Castro, Marcia C | |
dc.contributor.author | Siedner, Mark J | |
dc.contributor.author | Allen, Joseph G | |
dc.contributor.author | Christiani, David C | |
dc.date.accessioned | 2022-02-17T13:05:42Z | |
dc.date.available | 2022-02-17T13:05:42Z | |
dc.date.issued | 2019-08-20 | |
dc.identifier.citation | North, C. M., MacNaughton, P., Lai, P. S., Vallarino, J., Okello, S., Kakuhikire, B., ... & Christiani, D. C. (2019). Personal carbon monoxide exposure, respiratory symptoms, and the potentially modifying roles of sex and HIV infection in rural Uganda: a cohort study. Environmental Health, 18(1), 1-12. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1491 | |
dc.description.abstract | Background: Most of the global burden of pollution-related morbidity and mortality is believed to occur in resource-limited settings, where HIV serostatus and sex may influence the relationship between air pollution exposure and respiratory morbidity. The lack of air quality monitoring networks in these settings limits progress in measuring global disparities in pollution-related health. Personal carbon monoxide monitoring may identify subpopulations at heightened risk for air pollution-associated respiratory morbidity in regions of the world where the financial cost of air quality monitoring networks is prohibitive.
Methods: From September 2015 through May 2017, we measured 48-h ambulatory carbon monoxide (CO) exposure in a longitudinal cohort of HIV-infected and uninfected adults in rural southwestern Uganda. We fit generalized mixed effects models to identify correlates of CO exposure exceeding international air quality
thresholds, quantify the relationship between CO exposure and respiratory symptoms, and explore potential effect modification by sex and HIV serostatus.
Results: Two hundred and sixty study participants completed 419 sampling periods. Personal CO exposure exceeded international thresholds for 50 (19%) participants. In covariate-adjusted models, living in a home where charcoal was the main cooking fuel was associated with CO exposure exceeding international thresholds (adjusted odds ratio [AOR] 11.3, 95% confidence interval [95%CI] 4.7–27.4). In sex-stratified models, higher CO exposure was associated with increased odds of respiratory symptoms among women (AOR 3.3, 95%CI 1.1–10.0) but not men (AOR 1.3, 95%CI 0.4–4.4). In HIV-stratified models, higher CO exposure was associated with increased odds of respiratory symptoms among HIV-infected (AOR 2.5, 95%CI 1.01–6.0) but not HIV-uninfected (AOR 1.4, 95%CI 0.1–14.4) participants.
Conclusions: In a cohort in rural Uganda, personal CO exposure frequently exceeded international thresholds,
correlated with biomass exposure, and was associated with respiratory symptoms among women and people
living with HIV. Our results provide support for the use of ambulatory CO monitoring as a low-cost, feasible method
to identify subgroups with heightened vulnerability to pollution-related respiratory morbidity in resource-limited
settings and identify subgroups that may have increased susceptibility to pollution-associated respiratory morbidity. | en_US |
dc.description.sponsorship | The results reported herein correspond to specific aims of NIH grant awards
R25TW009337 (CMN), P30ES000002 (CMN), and R21HL124712 (MJS). This
work was also supported by NIH grant awards P30AI060354, R24AG044325,
R01MH113494, T32HL116275, K23MH099916, K43TW010715, and
K23ES023700. Biostatistical consultation was provided with support from
Harvard Catalyst | The Harvard Clinical and Translational Science Center
(National Center for Research Resources and the National Center for
Advancing Translational Sciences, National Institutes of Health Award
UL1TR001102) and financial contributions from Harvard University and its
affiliated academic healthcare centers. The content is solely the responsibility
of the authors and does not necessarily represent the official views of the
Harvard Catalyst, Harvard University and its affiliated academic healthcare
centers, or the National Institutes of Health. The funding bodies named
above had no role in the design of the study, in the collection, analysis or
interpretation of the data, or in the writing of the manuscript. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Environmental Health | en_US |
dc.subject | Africa | en_US |
dc.subject | Biomass | en_US |
dc.subject | Pulmonary | en_US |
dc.subject | Air pollution | en_US |
dc.subject | Global health | en_US |
dc.title | Personal carbon monoxide exposure, respiratory symptoms, and the potentially modifying roles of sex and HIV infection in rural Uganda | en_US |
dc.title.alternative | a cohort study | en_US |
dc.type | Article | en_US |