Observational studyThe Lancet. Global health2022
Association between household air pollution and nasopharyngeal pneumococcal carriage in Malawian infants (MSCAPE): a nested, prospective, observational study.
Observational study in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pneumonia in Ghana: prevalence, mortality and antimicrobial resistance-a systematic review and meta-analysis.International health · 2026Pooled it
- Pooled it
- Impact of cooking with liquefied petroleum gas compared with traditional cooking practices on perinatal and early neonatal mortality: the Poriborton cluster randomised controlled trial.BMJ global health · 2026Trial
- Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia.The New England journal of medicine · 2024Trial
- Residential indoor air monitoring to assess long-term exposure to air pollution in susceptible populations for epidemiology: overview and early findings.Environmental health : a global access science source · 2026Article
- Pneumococcal population structure influences the effects of air pollution on invasive disease risk in South Africa.Nature microbiology · 2026Article
- Early Environments, Lasting Effects: Air Pollution, Microbes, and Respiratory Infection Risk in Children.Pediatric pulmonology · 2026Review
- Non-Vaccine Serotype Replacement and Subdominant Persistence of Vaccine Types in Nepalese Infants Following PCV10 Introduction.Vaccines · 2026Article
- Early-life carriage and antibiotic resistance ofFrontiers in microbiology · 2026Article
- Air Pollution and Global Pediatric Pneumococcal Disease.Open forum infectious diseases · 2025Review
- Improving Energy Access, Climate and Socio-Economic Outcomes Through Off-Grid Electrification Technologies: A Systematic Review.Campbell systematic reviews · 2025Review
- Effects of indoor air pollution on clinical outcomes in patients with interstitial lung disease: protocol of a multicentre prospective observational study.BMJ open respiratory research · 2024Article
- High frequencies of nonviral colds and respiratory bacteria colonization among children in rural Western Uganda.Frontiers in pediatrics · 2024Article
- Mechanistic Insights into the Impact of Air Pollution on Pneumococcal Pathogenesis and Transmission.American journal of respiratory and critical care medicine · 2022Review
- Household fuel use and its association with potential respiratory pathogens among healthy mothers and children in Ethiopia.PloS one · 2022Article
- Characterization and Quantification of Vehicular Emissions in Abuja Municipality-Implications for Public Health.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHousehold air pollution from solid fuels increases the risk of childhood pneumonia. Nasopharyngeal carriage of Streptococcus pneumoniae is a necessary step in the development of pneumococcal pneumonia. We aimed to assess the association between exposure to household air pollution and the prevalence and density of S pneumoniae carriage among children.
methodsThe Malawi Streptococcus pneumoniae Carriage and Air Pollution Exposure study was a nested, prospective, observational study of children participating in the cluster randomised controlled Cooking and Pneumonia Study (CAPS) in the Karonga Health and Demographic Surveillance System (HDSS) area in northern Malawi. CAPS compared the effects of a cleaner burning biomass-fuelled cookstove (intervention group) with traditional open-fire cooking (control group) on the incidence of pneumonia in children. Eligible children aged 6 weeks or 6 months (those recruited a 6 weeks were also followed up at age 6 months) were identified by the Karonga HDSS centre. Nasopharyngeal swabs were taken to detect S pneumoniae, and infant exposure to particulate matter with a diameter of ≤2·5 μm (PM
findingsBetween Nov 15, 2015, and Nov 2, 2017, 485 children were recruited (240 from the intervention group and 245 from the control group). Of all 450 children with available data at age 6 months, 387 (86% [95% CI 82-89]) were positive for S pneumoniae. Geometric mean PM
interpretationDespite the absence of effect from the intervention cookstove, household air pollution exposure was significantly associated with the prevalence of nasopharyngeal S pneumoniae carriage. These results provide empirical evidence for the potential mechanistic association between exposure to household air pollution and childhood pneumonia.
fundingBill & Melinda Gates Foundation.
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