CAREGIVERS’ LEVEL OF KNOWLEDGE ON INDOOR AIR POLLUTION AND ACUTE RESPIRATORY INFECTIONS AMONG UNDER-FIVES IN INFORMAL SETTLEMENT: MAKADARA, NAIROBI COUNTY
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Keywords:
Air Pollution, Respiratory Infections, Risk FactorsAbstract
Purpose: The aim of this study was to determine the caregivers’ level of knowledge on indoor air pollution and risk of ARIs among 393 children below five years who live at Makadara Sub-County, Nairobi City County.
Methodology: Descriptive, cross-sectional study design was employed in this study. Semi-Structured questionnaires were used to collect data from the caregivers of children suffering from ARIs. The questionnaires contained both closed and open-ended questions, which helped participants to provide explanations about the infection, and the perceived risk factors. Closed ended questions were utilized to gather data such as income levels, age ranges, and religion. Quantitative data was cleaned, coded and analysed using the SSPS version 22. Descriptive statistics was used to describe the caregivers’ socio-economic and demographic characteristics, knowledge and practices. Chi-square and ordered logistic regression was used to determine relationships and associations between the dependent variable (ARIs) and independent variables (socio-economic and demographic factors, knowledge level, and IAP).
Findings:The findings of the study will be used in the improvement of the caregivers’ level of knowledge on IAP and the risk of ARIs among children below five years. There was significant statistical differences between ARIs among children below five years and cigarette smoke exposure (P=0.005), use of charcoal in cooking (P=0.002), room occupancy P=0.013), lack of ventilation (P=0.001). The mean for particulate matter in the households was 50.1556 while the S.D for those who use charcoal was 13.372, kerosene, 16.860 and gas was 10.388. The mean knowledge level was 5.39, 95% CI; 5.07-5.72. Therefore, a mean of 5.39 out of 14 represent lower knowledge level on IAP and the risk of ARIs. There was significant statistical difference between availability of windows in the house and caregivers’ level of knowledge on risk factors of IAP, χ2 (2) = 11.09, P= 0.004.
Unique contribution to theory, practice and policy:The study recommended that there is need to ensure implementation and compliance of the existing government policies on environmental pollution especially on indoor air pollution that can lead to reduction of risk factors of acute respiratory infections. This can be achieved through regular awareness creation through trainings and counselling of caregivers on the sources of indoor air pollution and risk factors associated with acute respiratory infections among children below five years.
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References
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Bowling, A. (2014). Research methods in health: investigating health and health services. McGraw-Hill Education (UK).
Bruce, N., Pope, D., Rehfuess, E., Balakrishnan, K., Adair-Rohani, H., & Dora, C. (2015). WHO indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure–risk functions. Atmospheric Environment, 106, 451-457.
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Darrow, L. A., Klein, M., Flanders, W. D., Mulholland, J. A., Tolbert, P. E., & Strickland, M. J. (2014). Air pollution and acute respiratory infections among children 0–4 years of age: an 18-year time-series study. American Journal of Epidemiology, 180(10), 968-977.
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acute lower respiratory infections among children: a birth cohort study in urban Bangladesh. Indoor air, 23(5), 379-386.
Hajat, S., Anderson, H. R., Atkinson, R. W., & Haines, A. (2002).Effects of air pollution on general practitioner consultations for upper respiratory diseases in London. Occupational and environmental medicine, 59(5), 294-299.
Honicky RE, Osborne JSD (1991). Respiratory eVects of wood heat: clinical observations and epidemiologic assessment. Environ Health Perspect, 95:105–9.
Hox, J. J., Moerbeek, M., & van de Schoot, R. (2017). Multilevel analysis: Techniques and applications. Routledge.
Jackson, S., Mathews, K. H., Pulanić, D., Falconer, R., Rudan, I., Campbell, H., & Nair, H. (2013).Risk factors for severe acute lower respiratory infections in children–a systematic review and meta-analysis. Croatian medical journal, 54(2), 110-121.
Jedrychowski WA, Perera FP, Spengler JD, Mroz E, Stigter L, Flak E, et al. (2013), Intrauterine exposure to fine particulate matter as a risk factor for increased susceptibility to acute broncho-pulmonary infections in early childhood. Int J Hyg Environ Health 2164) 395–401.
Kreuter, M.W.; De Rosa, C.; Howze, E.H.; Baldwin, G.T. Understanding wicked problems: A key to advancing environmental health promotion. Health Educ. Behav. 2004, 31, 441–454.
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Larson TV, Koenig JQ. (1994) Wood smoke: emissions and noncancer respiratory eVects. Annu Rev Public Health; 15:133–56
Lin M, Stieb DM, Chen Y. (2005), Coarse particulate matter and hospitalization for respiratory infections in children younger than 15 years in Toronto: a case-crossover analysis. Pediatrics; 116(2).
MacIntyre EA, Karr CJ, Koehoorn M, Demers PA, Tamburic L, Lencar C, et al.(2011) Residential air pollution and otitis media during the first two years of life. Epidemiology. 22(1):81–89.
MacIntyre, E. A., Gehring, U., Mölter, A., Fuertes, E., Klümper, C., Krämer, U.,&Koppelman, G. H. (2014). Air pollution and respiratory infections during early childhood: an analysis of 10 European birth cohorts within the ESCAPE Project. Environmental health perspectives, 122(1), 107.
Mahalanabis D, Gupta S, Paul D, Gupta A, Lahiri M, Khaled MA.(2002), Risk factors for pneumonia in infants and young children and the role of solid fuel for cooking: a case-control study. Epidemiol Infect.; 129(1):65–71.
Martínez-Mesa J, González-Chica DA, Bastos JL, Bonamigo RR, Duquia RP (2014). Sample size: how many participants do I need in my research? A Bras Dermatol.; 89:609–615.
Matu, M. N. (2015). Risk factors and cost of illness for acute respiratory infections in children under five years of age attending selected health facilities in Nakuru County, Kenya (Doctoral dissertation).
Matu, M., Kikuvi, G., Wanzala, P., Karama, M., &Symekher, S. (2014). Aetiology of acute respiratory infections in children under five years in Nakuru, Kenya. J MicrobiolExp, 1(4), 00021.
McConnochie, KM., C.B. Hall, and W.H. Barker., (1988). Lower respiratory tract illness in the first two years of life: epidemiologic patterns and costs in a suburban pediatric practice." American Journal of Public Health,v. L8, no. 1, pp 34-39.
Mehta, S., Shin, H., Burnett, R., North, T., & Cohen, A. J. (2013). Ambient particulate air pollution and acute lower respiratory infections: a systematic review and implications for estimating the global burden of disease. Air Quality, Atmosphere & Health, 6(1), 69-83.
Mishra, V. (2003).Indoor air pollution from biomass combustion and acute respiratory illness in preschool age children in Zimbabwe. International journal of epidemiology, 32(5), 847-853.
Muindi, K. (2017). Air pollution in Nairobi slums: sources, levels and lay perceptions (Doctoral dissertation, Umeå University).
Murray DM, Burmaster DE (1995). Residential air exchange rates in the United States: empirical and estimated parametric distributions by season and climatic region. Risk Analysis;15:459–65.
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Sanbata, H., Asfaw, A., & Kumie, A. (2014). Association of biomass fuel use with acute respiratory infections among under-five children in a slum urban of Addis Ababa, Ethiopia. BMC public health, 14(1), 1122.
Selvaraj, K., Chinnakali, P., Majumdar, A., & Krishnan, I. S. (2014). Acute respiratory infections among under-5 children in India: A situational analysis. Journal of natural science, biology, and medicine, 5(1), 15.
Shi, T., Balsells, E., Wastnedge, E., Singleton, R., Rasmussen, Z. A., Zar, H. J., .&Bulkow, L. R. (2015). Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: Systematic review and meta–analysis. Journal of global health, 5(2).
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Zar, H. J., & Ferkol, T. W. (2014).The global burden of respiratory disease—impact on child health. Pediatric pulmonology, 49(5), 430-434.
Alim, A.M.; Nurunnabi, A.S.M; Ahmad, S.; Khan, M.A.; Ahmad, S.A. Knowledge of health hazards and perception of prevention amongst females exposed to biomass fuel and gas/electricity fuel in a district in Bangladesh. AKMMC J. 2013, 4, 20–24.
Al-Khamees, N. A. (2018). Knowledge of, Attitudes toward, and Practices regarding Indoor Pollution at Kuwait University. Journal of Geoscience and Environment Protection, 6(12), 146-157.
Armstrong, J.R.M.; Campbell, H. Indoor air pollution exposure and lower respiratory infections in young Gambian children. Int. J. Epidemiol. 1991, 20, 424–429.
Barnes, B. R. (2014). Behavioural change, indoor air pollution and child respiratory health in developing countries: A review. International journal of environmental research and public health, 11(5), 4607-4618.
Bates, M. N., Chandyo, R. K., Valentiner-Branth, P., Pokhrel, A. K., Mathisen, M., Basnet, S. ...& Smith, K. R. (2013). Acute lower respiratory infection in childhood and household fuel use in Bhaktapur, Nepal. Environmental health perspectives, 121(5), 637.
Bhat, R. Y., &Manjunath, N. (2013).Correlates of acute lower respiratory tract infections in children under 5 years of age in India. The international journal of tuberculosis and lung disease, 17(3), 418-422.
Bowling, A. (2014). Research methods in health: investigating health and health services. McGraw-Hill Education (UK).
Bruce, N., Pope, D., Rehfuess, E., Balakrishnan, K., Adair-Rohani, H., & Dora, C. (2015). WHO indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure–risk functions. Atmospheric Environment, 106, 451-457.
Bryman, A. (2015). Social research methods. Oxford university press.
Bulla, A. and K.L. Hitze.(1978) "Acute respiratory infections: a review." Bulletin of the World Health Organization, v. 56, 1112 481-498.
Crofton, J. and A Douglas. Resperniratory Diseases. Oxford and Edinburgh: Blackwell, 1975.
Da Costa JL, Navarro A, Neves JB (2004), Martin M. Household wood and charcoal smoke increases risk of otitis media in childhood in Maputo. Int J Epidemiololy; 33(3):573–578.
Darrow, L. A., Klein, M., Flanders, W. D., Mulholland, J. A., Tolbert, P. E., & Strickland, M. J. (2014). Air pollution and acute respiratory infections among children 0–4 years of age: an 18-year time-series study. American Journal of Epidemiology, 180(10), 968-977.
Egondi, T.; Kyobutungi, C.; Ng, N.; Muindi, K.; Oti, S.; van de Vijver, S.; Ettarh, R.; Rocklöv, J. Community perceptions of air pollution and related health risks in Nairobi slums. Int. J. Environ. Res. Public Health 2013, 10, 4851–4868.
Esplugues A, Ballester F, Estarlich M, Llop S, Fuentes-Leonarte V, Mantilla E, et al. (2011) Outdoor, but not indoor, nitrogen dioxide exposure is associated with persistent cough during the first year of life. Sci Total Environ. 409(22):4667–4673.
Flick, U. (2015). Introducing research methodology: A beginner's guide to doing a research project. Sage.
Gauderman, W. J., Urman, R., Avol, E., Berhane, K., McConnell, R., Rappaport, E.,. & Gilliland, F. (2015). Association of improved air quality with lung development in children. New England Journal of Medicine, 372(10), 905-913.
Ghana Health Project Assessment Team. (981)"A quantitative method of assessing the health impact of different diseases in less developed countries." International Journal of Epidemiolga,v. 10, pp. 73-80.
Gordon, S. B., Bruce, N. G., Grigg, J., Hibberd, P. L., Kurmi, O. P., Lam, K. B. H., ... & Bar-Zeev, N. (2014). Respiratory risks from household air pollution in low and middle income countries. The Lancet Respiratory Medicine, 2(10), 823-860.
Guest, G. (2013). Describing mixed methods research: An alternative to typologies. Journal of Mixed Methods Research, 7(2), 141-151.
Gurley, E. S., Homaira, N., Salje, H., Ram, P. K., Haque, R., Petri, W., &Azziz‐Baumgartner, E. (2013). Indoor exposure to particulate matter and the incidence of
acute lower respiratory infections among children: a birth cohort study in urban Bangladesh. Indoor air, 23(5), 379-386.
Hajat, S., Anderson, H. R., Atkinson, R. W., & Haines, A. (2002).Effects of air pollution on general practitioner consultations for upper respiratory diseases in London. Occupational and environmental medicine, 59(5), 294-299.
Honicky RE, Osborne JSD (1991). Respiratory eVects of wood heat: clinical observations and epidemiologic assessment. Environ Health Perspect, 95:105–9.
Hox, J. J., Moerbeek, M., & van de Schoot, R. (2017). Multilevel analysis: Techniques and applications. Routledge.
Jackson, S., Mathews, K. H., Pulanić, D., Falconer, R., Rudan, I., Campbell, H., & Nair, H. (2013).Risk factors for severe acute lower respiratory infections in children–a systematic review and meta-analysis. Croatian medical journal, 54(2), 110-121.
Jedrychowski WA, Perera FP, Spengler JD, Mroz E, Stigter L, Flak E, et al. (2013), Intrauterine exposure to fine particulate matter as a risk factor for increased susceptibility to acute broncho-pulmonary infections in early childhood. Int J Hyg Environ Health 2164) 395–401.
Kreuter, M.W.; De Rosa, C.; Howze, E.H.; Baldwin, G.T. Understanding wicked problems: A key to advancing environmental health promotion. Health Educ. Behav. 2004, 31, 441–454.
Lakey, P. S., Berkemeier, T., Tong, H., Arangio, A. M., Lucas, K., Pöschl, U., &Shiraiwa, M. (2016).Chemical exposure-response relationship between air pollutants and reactive oxygen species in the human respiratory tract. Scientific reports, 6, 32916.
Larson TV, Koenig JQ. (1994) Wood smoke: emissions and noncancer respiratory eVects. Annu Rev Public Health; 15:133–56
Lin M, Stieb DM, Chen Y. (2005), Coarse particulate matter and hospitalization for respiratory infections in children younger than 15 years in Toronto: a case-crossover analysis. Pediatrics; 116(2).
MacIntyre EA, Karr CJ, Koehoorn M, Demers PA, Tamburic L, Lencar C, et al.(2011) Residential air pollution and otitis media during the first two years of life. Epidemiology. 22(1):81–89.
MacIntyre, E. A., Gehring, U., Mölter, A., Fuertes, E., Klümper, C., Krämer, U.,&Koppelman, G. H. (2014). Air pollution and respiratory infections during early childhood: an analysis of 10 European birth cohorts within the ESCAPE Project. Environmental health perspectives, 122(1), 107.
Mahalanabis D, Gupta S, Paul D, Gupta A, Lahiri M, Khaled MA.(2002), Risk factors for pneumonia in infants and young children and the role of solid fuel for cooking: a case-control study. Epidemiol Infect.; 129(1):65–71.
Martínez-Mesa J, González-Chica DA, Bastos JL, Bonamigo RR, Duquia RP (2014). Sample size: how many participants do I need in my research? A Bras Dermatol.; 89:609–615.
Matu, M. N. (2015). Risk factors and cost of illness for acute respiratory infections in children under five years of age attending selected health facilities in Nakuru County, Kenya (Doctoral dissertation).
Matu, M., Kikuvi, G., Wanzala, P., Karama, M., &Symekher, S. (2014). Aetiology of acute respiratory infections in children under five years in Nakuru, Kenya. J MicrobiolExp, 1(4), 00021.
McConnochie, KM., C.B. Hall, and W.H. Barker., (1988). Lower respiratory tract illness in the first two years of life: epidemiologic patterns and costs in a suburban pediatric practice." American Journal of Public Health,v. L8, no. 1, pp 34-39.
Mehta, S., Shin, H., Burnett, R., North, T., & Cohen, A. J. (2013). Ambient particulate air pollution and acute lower respiratory infections: a systematic review and implications for estimating the global burden of disease. Air Quality, Atmosphere & Health, 6(1), 69-83.
Mishra, V. (2003).Indoor air pollution from biomass combustion and acute respiratory illness in preschool age children in Zimbabwe. International journal of epidemiology, 32(5), 847-853.
Muindi, K. (2017). Air pollution in Nairobi slums: sources, levels and lay perceptions (Doctoral dissertation, Umeå University).
Murray DM, Burmaster DE (1995). Residential air exchange rates in the United States: empirical and estimated parametric distributions by season and climatic region. Risk Analysis;15:459–65.
Newby, P. (2014). Research methods for education; Routledge.
Punch, K. F. (2013). Introduction to social research: Quantitative and qualitative approaches. sage.
Punch, K. F., &Oancea, A. (2014). Introduction to research methods in education.Sage.
Sanbata, H., Asfaw, A., & Kumie, A. (2014). Association of biomass fuel use with acute respiratory infections among under-five children in a slum urban of Addis Ababa, Ethiopia. BMC public health, 14(1), 1122.
Selvaraj, K., Chinnakali, P., Majumdar, A., & Krishnan, I. S. (2014). Acute respiratory infections among under-5 children in India: A situational analysis. Journal of natural science, biology, and medicine, 5(1), 15.
Shi, T., Balsells, E., Wastnedge, E., Singleton, R., Rasmussen, Z. A., Zar, H. J., .&Bulkow, L. R. (2015). Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: Systematic review and meta–analysis. Journal of global health, 5(2).
Sikolia DN, Mwololo M, Cherop H, Hussein A, Juma M, Kurui J, Bwika A, Seki I, Osaki Y., (2002). The prevalence of acute respiratory infections and the associated risk factors: a study of children under five years of age in KiberaLindi village, Nairobi, Kenya. J. Natl. Inst. Public Health, 51, 1.
Smith, K. R., Bruce, N., Balakrishnan, K., Adair-Rohani, H., Balmes, J., Chafe, Z., .&Rehfuess, E. (2014). Millions dead: how do we know and what does it mean? Methods used in the comparative risk assessment of household air pollution. Annual review of public health, 35, 185-206.
Solomon, O. O., Odu, O. O., Amu, E. O., Solomon, O. A., Bamidele, J. O., Emmanuel, E., ... & Parakoyi, B. D. (2018). Prevalence and risk factors of acute respiratory infection among under fives in rural communities of Ekiti State Nigeria. Global Journal of Medicine and Public Health, 7(1), 12.
Sonego, M., Pellegrin, M. C., Becker, G., & Lazzerini, M. (2015). Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies. PloS one, 10(1), e0116380.
Ujunwa, F. A., & Ezeonu, C. T. (2014). Risk Factors for Acute Respiratory Tract Infections in Under five Children in Enugu Southeast Nigeria. Annals of medical and health sciences research, 4(1), 95-99.
Ujunwa, F. A., &Ezeonu, C. T. (2014).Risk Factors for Acute Respiratory Tract Infections in Under five Children in Enugu Southeast Nigeria. Annals of medical and health sciences research, 4(1), 95.
World Health Organization, (2013); World Health Statistics 2013, Geneva, Switzerland; World Health Organization Press.
Zar, H. J., & Ferkol, T. W. (2014).The global burden of respiratory disease—impact on child health. Pediatric pulmonology, 49(5), 430-434.
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2020-08-02
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Muro, M. B., Njogu, E., & Orinda, G. (2020). CAREGIVERS’ LEVEL OF KNOWLEDGE ON INDOOR AIR POLLUTION AND ACUTE RESPIRATORY INFECTIONS AMONG UNDER-FIVES IN INFORMAL SETTLEMENT: MAKADARA, NAIROBI COUNTY. Journal of Health, Medicine and Nursing, 5(3), 1 – 23. Retrieved from https://www.iprjb.org/journals/index.php/JHMN/article/view/1106
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