scholarly journals Exposure to landscape fire smoke extremely reduced birthweight in low- and middle-income countries

2021 ◽  
Author(s):  
jiajianghui li ◽  
Tianjia Guan ◽  
Qian Guo ◽  
Guannan Geng ◽  
Huiyu Wang ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Low Birthweight ◽  
Fine Particulate Matter ◽  
Binary Outcomes ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Exposure ◽  
Fire Smoke ◽  
Fixed Effects Regression ◽  
Low And Middle Income

Landscape fire smoke (LFS) has been associated with reduced birthweight, but evidence from low and middle income countries (LMICs) is rare. Here, we present a sibling matched case control study of 227,948 newborns to identify an association between fire sourced fine particulate matter (PM2.5) and birthweight in 54 LMICs from 2000 to 2014. We selected mothers from the geocoded Demographic and Health Survey with at least two children and valid birthweight records. Newborns affiliated with the same mother were defined as a family group. Gestational exposure to LFS was assessed in each newborn using the concentration of fire sourced PM2.5. We determined the associations of the within group variations in LFS exposure with birthweight differences between matched siblings using a fixed effects regression model. Additionally, we analyzed the binary outcomes of low birthweight (LBW) or very low birthweight (VLBW). According to fully adjusted models, a 1 ug/m3 increase in the concentration of fire sourced PM2.5 was significantly associated with a 2.17 g (95% confidence interval [CI]: 0.56, 3.77) reduction in birthweight, a 2.80% (95% CI: 0.97, 4.66) increase in LBW risk, and an 11.68% (95% CI: 3.59, 20.40) increase in VLBW risk. Our findings indicate that gestational exposure to LFS harms maternal health.

scholarly journals Exposure to landscape fire smoke reduced birthweight in low- and middle-income countries: findings from a siblings-matched case-control study

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Jiajianghui Li ◽  
Tianjia Guan ◽  
Qian Guo ◽  
Guannan Geng ◽  
Huiyu Wang ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Case Control Study ◽  
Case Control ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Exposure ◽  
Fire Smoke ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Landscape fire smoke (LFS) has been associated with reduced birthweight, but evidence from low- and middle-income countries (LMICs) is rare. Here, we present a sibling-matched case-control study of 227,948 newborns to identify an association between fire-sourced fine particulate matter (PM2.5) and birthweight in 54 LMICs from 2000 to 2014. We selected mothers from the geocoded Demographic and Health Survey with at least two children and valid birthweight records. Newborns affiliated with the same mother were defined as a family group. Gestational exposure to LFS was assessed in each newborn using the concentration of fire-sourced PM2.5. We determined the associations of the within-group variations in LFS exposure with birthweight differences between matched siblings using a fixed-effects regression model. Additionally, we analyzed the binary outcomes of low birthweight (LBW) or very low birthweight (VLBW). According to fully adjusted models, a 1 µg/m3 increase in the concentration of fire-sourced PM2.5 was significantly associated with a 2.17 g (95% confidence interval [CI]: 0.56-3.77) reduction in birthweight, a 2.80% (95% CI: 0.97-4.66) increase in LBW risk, and an 11.68% (95% CI: 3.59-20.40) increase in VLBW risk. Our findings indicate that gestational exposure to LFS harms fetal health.

scholarly journals Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 491 ◽  
Author(s):  
Christina Oh ◽  
Emily C. Keats ◽  
Zulfiqar A. Bhutta
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Child Health ◽  
Low Birthweight ◽  
Grey Literature ◽  
Micronutrient Supplementation ◽  
Maternal Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.

scholarly journals Infant Mortality in Low- and Middle-income Countries: Does Government Health Spending Matter?

2020 ◽  
Vol 5 (1) ◽  
pp. 54-73
Author(s):  
Micheal Kofi Boachie ◽  
Tatjana Põlajeva ◽  
Albert Opoku Frimpong
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Health Sector ◽  
Health Spending ◽  
Middle Income ◽  
Government Health ◽  
Middle Income Countries ◽  
Low And Middle Income

The issue of whether government health spending improves health outcomes has been a matter of contention over the years. There have been calls for governments to reduce their financing role in the health sector since such funding do not produce better health. This article examines the effect of public (i.e., government) health expenditure on infant mortality, a proxy of health outcomes, in low- and middle-income countries. We use data from the World Bank’s World Development Indicators database and employ fixed effects estimation technique, with three-stage least squares as a robustness check. The data cover the period 1995–2014. We find that public health expenditure improves health outcomes significantly, as it reduces infant mortality. The results further show that rising income and access to safe water are some of the reasons for improved health outcomes in low- and middle-income countries. Based on these results and the expected redistributive impact of government spending, governments in low- and middle-income countries may consider increasing health spending for better healthcare systems and improved health.

scholarly journals Diurnal variability of fine-particulate pollution concentrations: data from 14 low- and middle-income countries

2021 ◽  
Vol 25 (3) ◽  
pp. 206-214
Author(s):  
R. Dobson ◽  
K. Siddiqi ◽  
T. Ferdous ◽  
R. Huque ◽  
M. Lesosky ◽  
...  
Keyword(s):  
New York ◽  
Air Pollution ◽  
Indoor Air Pollution ◽  
Fine Particulate Matter ◽  
Second Hand Smoke ◽  
Middle Income ◽  
Diurnal Variability ◽  
Middle Income Countries ◽  
Fine Particulate ◽  
Low And Middle Income

BACKGROUND: Scientific understanding of indoor air pollution is predominately based on research carried out in cities in high‐income countries (HICs). Less is known about how pollutant concentrations change over the course of a typical day in cities in low‐ and middle‐income countries (LMICs).OBJECTIVE: To understand how concentrations of fine particulate matter smaller than 2.5 microns in diameter (PM2.5) change over the course of the day outdoors (across a range of countries) and indoors (using measurements from Dhaka, Bangladesh).DESIGN: Data on PM2.5 concentrations were gathered from 779 households in Dhaka as part of the MCLASS II (Muslim Communities Learning About Second‐hand Smoke in Bangladesh) project, and compared to outdoor PM2.5 concentrations to determine the temporal variation in exposure to air pollution. Hourly PM2.5 data from 23 cities in 14 LMICs, as well as London (UK), Paris (France) and New York (NY, USA), were extracted from publicly available sources for comparison.RESULTS: PM2.5 in homes in Dhaka demonstrated a similar temporal pattern to outdoor measurements, with greater concentrations at night than in the afternoon. This pattern was also evident in 19 of 23 LMIC cities.CONCLUSION: PM2.5 concentrations are greater at night than during the afternoon in homes in Dhaka. Diurnal variations in PM2.5 in LMICs is substantial and greater than in London, Paris or New York. This has implications for public health community approaches to health effects of air pollution in LMICs.

scholarly journals How many low birthweight babies in low- and middle-income countries are preterm?

2011 ◽  
Vol 45 (3) ◽  
pp. 607-616 ◽  
Author(s):  
Fernando C Barros ◽  
Aluísio J D Barros ◽  
José Villar ◽  
Alicia Matijasevich ◽  
Marlos R Domingues ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Exposure to air pollution and tobacco smoking and their combined effects on depression in six low- and middle-income countries

2017 ◽  
Vol 211 (3) ◽  
pp. 157-162 ◽  
Author(s):  
Hualiang Lin ◽  
Yanfei Guo ◽  
Paul Kowal ◽  
Collins O. Airhihenbuwa ◽  
Qian Di ◽  
...  
Keyword(s):  
Air Pollution ◽  
Logistic Regression ◽  
Tobacco Smoking ◽  
Smoking Status ◽  
Fine Particulate Matter ◽  
Additive Model ◽  
Interactive Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundLittle is known about the joint mental health effects of air pollution and tobacco smoking in low- and middle-income countries.AimsTo investigate the effects of exposure to ambient fine particulate matter pollution (PM2.5) and smoking and their combined (interactive) effects on depression.MethodMultilevel logistic regression analysis of baseline data of a prospective cohort study (n=41785). The 3-year average concentrations of PM2.5 were estimated using US National Aeronautics and Space Administration satellite data, and depression was diagnosed using a standardised questionnaire. Three-level logistic regression models were applied to examine the associations with depression.ResultsThe odds ratio (OR) for depression was 1.09 (95% CI 1.01–1.17) per 10 μg/m3 increase in ambient PM2.5, and the association remained after adjusting for potential confounding factors (adjusted OR = 1.10, 95% CI 1.02–1.19). Tobacco smoking (smoking status, frequency, duration and amount) was also significantly associated with depression. There appeared to be a synergistic interaction between ambient PM2.5 and smoking on depression in the additive model, but the interaction was not statistically significant in the multiplicative model.ConclusionsOur study suggests that exposure to ambient PM2.5 may increase the risk of depression, and smoking may enhance this effect.

scholarly journals Does government expenditure reduce inequalities in infant mortality rates in low- and middle-income countries?: A time-series, ecological analysis of 48 countries from 1993 to 2013

2018 ◽  
Vol 14 (2) ◽  
pp. 249-273 ◽  
Author(s):  
Peter Baker ◽  
Thomas Hone ◽  
Aaron Reeves ◽  
Mauricio Avendano ◽  
Christopher Millett
Keyword(s):  
Infant Mortality ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Government Expenditure ◽  
Health Expenditures ◽  
Mortality Rates ◽  
Demographic And Health Surveys ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractInequalities in infant mortality rates (IMRs) are rising in some low- and middle-income countries (LMICs) and decreasing in others, but the explanation for these divergent trends is unclear. We investigate whether government expenditures and redistribution are associated with reductions in inequalities in IMRs. We estimated country-level fixed-effects panel regressions for 48 LMICs (142 country observations). Slope and Relative Indices of Inequality in IMRs (SII and RII) were calculated from Demographic and Health Surveys between 1993 and 2013. RII and SII were regressed on government expenditure (total, health and non-health) and redistribution, controlling for gross domestic product (GDP), private health expenditures, a democracy indicator, country fixed effects and time. Mean SII and RII was 39.12 and 0.69, respectively. In multivariate models, a 1 percentage point increase in total government expenditure (% of GDP) was associated with a decrease in SII of −2.468 [95% confidence intervals (CIs): −4.190, −0.746] and RII of −0.026 (95% CIs: −0.048, −0.004). Lower inequalities were associated with higher non-health government expenditure, but not higher government health expenditure. Associations with inequalities were non-significant for GDP, government redistribution, and private health expenditure. Understanding how non-health government expenditure reduces inequalities in IMR, and why health expenditures may not, will accelerate progress towards the Sustainable Development Goals.

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