ArticleThorax2019
Lung health and exposure to air pollution in Malawian children (CAPS): a cross-sectional study.
Article in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Impact of prenatal and postnatal household air pollution exposure on respiratory morbidity and lung function in sub-Saharan African children: a systematic review and meta-analysis.Environmental health : a global access science source · 2025Pooled it
- A Systematic Review and Meta-Analysis Assessing the Impact of Improved Cookstove Technology Trials (ICTs) on Household Air Pollution and Human Health in Sub-Saharan Africa.Current environmental health reports · 2025Pooled it
- Trial
- A randomised clinical trial to evaluate the safety, fit, comfort of a novel N95 mask in children.Scientific reports · 2019Trial
- Lung function across the life course in Kenya: a series of cross-sectional surveys.ERJ open research · 2026Article
- Leveraging Stakeholder Engagement for Adolescent School Journeys in Malawi: An Exploration of Road Safety and Air Pollution Interventions.International journal of environmental research and public health · 2025Article
- Diagnosis of carbon monoxide exposure in clinical research and practice: A scoping review.PloS one · 2025Article
- Air pollution exposure, respiratory consequences, and perceptions among urban African children living in poor conditions - A case study in Abidjan, Côte d'Ivoire.PLOS global public health · 2025Article
- Expanding access to NCD services via community retail pharmacies in LMICs: a systematic review of the literature.Journal of pharmaceutical policy and practice · 2025Review
- Household Air Pollution Interventions to Improve Health in Low- and Middle-Income Countries: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2024Article
- Impact of higher-income countries on child health in lower-income countries from a climate change perspective. A case study of the UK and Malawi.PLOS global public health · 2024Article
- Physico-chemical characterization of indoor settled dust in Children's microenvironments in Ikeja and Ota, Nigeria.Heliyon · 2023Article
- Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa.BMJ open respiratory research · 2023Article
- Article
- Cough hypersensitivity and chronic cough.Nature reviews. Disease primers · 2022Review
- Respiratory symptoms and lung function among inmates in a Nigerian prison: a cross sectional study.BMC pulmonary medicine · 2022Article
- Household air pollution and COPD: cause and effect or confounding by other aspects of poverty?The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Review
- Factors predisposing women and children to indoor air pollution in rural villages, Western Kenya.Archives of public health = Archives belges de sante publique · 2022Article
- Exploring smoke: an ethnographic study of air pollution in rural Malawi.BMJ global health · 2021Article
- Revamping of Chronic Respiratory Diseases in Low- and Middle-Income Countries.Frontiers in public health · 2021Review
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundNon-communicable lung disease and exposure to air pollution are major problems in sub-Saharan Africa. A high burden of chronic respiratory symptoms, spirometric abnormalities and air pollution exposures has been found in Malawian adults; whether the same would be true in children is unknown.
methodsThis cross-sectional study of children aged 6-8 years, in rural Malawi, included households from communities participating in the Cooking and Pneumonia Study (CAPS), a trial of cleaner-burning biomass-fuelled cookstoves. We assessed; chronic respiratory symptoms, anthropometry, spirometric abnormalities (using Global Lung Initiative equations) and personal carbon monoxide (CO) exposure. Prevalence estimates were calculated, and multivariable analyses were done.
resultsWe recruited 804 children (mean age 7.1 years, 51.9% female), including 476 (260 intervention; 216 control) from CAPS households. Chronic respiratory symptoms (mainly cough (8.0%) and wheeze (7.1%)) were reported by 16.6% of children. Average height-for-age and weight-for-age z-scores were -1.04 and -1.10, respectively. Spirometric abnormalities (7.1% low forced vital capacity (FVC); 6.3% obstruction) were seen in 13.0% of children. Maximum CO exposure and carboxyhaemoglobin levels (COHb) exceeded WHO guidelines in 50.1% and 68.5% of children, respectively. Children from CAPS intervention households had lower COHb (median 3.50% vs 4.85%, p=0.006) and higher FVC z-scores (-0.22 vs -0.44, p=0.05) than controls.
conclusionThe substantial burden of chronic respiratory symptoms, abnormal spirometry and air pollution exposures in children in rural Malawi is concerning; effective prevention and control strategies are needed. Our finding of potential benefit in CAPS intervention households calls for further research into clean-air interventions to maximise healthy lung development in children.
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