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EXPOSURE TO INDOOR FUNGAL AEROSOLS AND LOWER RESPIRATORY TRACT INFECTIONS AMONG HOSPITALIZED UNDER-FIVE CHILDREN IN IBADAN, NIGERIA
Previous epidemiological studies have documented the household factors associated with childhood lower respiratory tract infections (LRTI), but only very few studies have explored the dose-response relationship between residential microbial diversity and childhood LRTI.
This study aimed to investigate the association between exposure to diverse indoor fungal aerosols and LRTI among under-five children in Ibadan, Nigeria.
In-home visits were conducted among 178 under-five children with LRTI matched by age (±3months), sex, and geographical location with 180 community-based under-five children without LRTI in Ibadan, Nigeria. Trained study staff sampled the indoor environment for fungal exposures using active sampling approach. Indoor total fungal count (TFC) was estimated and dichotomized into high (>median) and low (≤median) exposures. Alpha diversity measures including richness (R), Shannon (H), and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor fungal aerosols and LRTI risk among under-five children.
The mean (SD) age of participants was 7.3 (1.35) months with a male preponderance (61.0%). Median TFC was higher in homes of cases (66 cfu/m3) than controls (49cfu/m3). Higher fungal diversities were found in homes of cases (R=2.56; H=0.82; D=2.33) than controls (R=1.89; H=0.55; D=1.88). In the multivariate models, higher categories of exposure to indoor TFC (OR=2.75, 95%CI=1.54–4.89), fungal richness (OR=3.17, 95%CI=1.65–6.07), and fungal diversity (OR=3.00, 95%CI=1.55–5.79) were independently associated with childhood LRTI risk.
Our study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor fungal aerosols.