The Effect of Household Air Pollution on Lung Function Growth in Infants With Pneumonia in Sub-Saharan Africa (PLUS2)

The Effect of Household Air Pollution on Lung Function Growth in Infants With Pneumonia in Sub-Saharan Africa

The Effect of Household Air Pollution on Lung Function Growth in Infants With Pneumonia in Sub-Saharan Africa

This study will evaluate the feasibility and acceptability of a household-based clean air intervention

A clean air intervention will be implemented in each household, including HEPA- based air filtration, solar lighting, and education. The air filtration system will be cycled monthly, with active filtration alternating with no filtration for one month on/one month off. To determine the effect of the clean air intervention within the household, PM2.5 concentration during each cycle and lung function will be measured among household members.

Pneumonia, Pollution; Exposure, Lung Function Decreased, Chronic Respiratory Disease, Pediatric Respiratory Diseases, Lungs; Developmental Disorder

The air filtration system will be cycled monthly, with active filtration alternating with no filtration for one month on/one month off.

Based on findings from preliminary focus groups/in-depth interviews, staff will introduce various components of established clean air interventions to each household. Each household will receive interventions, depending on their known risk factors, exposures, and willingness to trial the intervention. Study staff will ask the primary cook to complete a time-activity diary during the intervention period that includes cooking episodes, duration of cooking, stove(s) used, type of food cooked, and number of people for whom the meal was cooked. Staff will continuously monitor use of the LPG/pellet stove and any other stoves owned by the household with the Berkeley Stove Use Monitoring System, a temperature logger attached to the stove to quantify the number of stove uses / time of use . Study staff will use similar loggers to monitor use of other devices installed including the air purifiers, lighting etc.

Inclusion Criteria: Age < 12 months • First episode of WHO-defined severe pneumonia22: cough or difficulty breathing with Oxygen saturation < 90% or central cyanosis, Severe respiratory distress, or Signs of pneumonia with a general danger sign Be willing to commit to entire 2 years of follow up visits. (Controls) Matched to each case on age (+/-1 month), sex, and community Exclusion Criteria: Craniofacial, cardiac or other major malformation Neuromuscular condition that affects respiration Outside Smart Discharges Project catchment area Prior hospitalizations or known episodes of respiratory illness or episodes of pneumonia before index admission,