Determinants of early-life lung function in African infants

Background Low lung function in early life is associated with later respiratory illness. There is limited data on lung function in African infants despite a high prevalence of respiratory disease. Aim To assess the determinants of early lung function in African infants. Method Infants enrolled in a...

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Main Authors: Gray, D., Willemse, L., Visagie, A., Czövek, D., Nduru, P., Vanker, A., Stein, D., Koen, N., Sly, P., Hantos, Z., Hall, Graham, Zar, H.
Format: Journal Article
Published: BMJ Group 2016
Online Access:http://hdl.handle.net/20.500.11937/54336
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author Gray, D.
Willemse, L.
Visagie, A.
Czövek, D.
Nduru, P.
Vanker, A.
Stein, D.
Koen, N.
Sly, P.
Hantos, Z.
Hall, Graham
Zar, H.
author_facet Gray, D.
Willemse, L.
Visagie, A.
Czövek, D.
Nduru, P.
Vanker, A.
Stein, D.
Koen, N.
Sly, P.
Hantos, Z.
Hall, Graham
Zar, H.
author_sort Gray, D.
building Curtin Institutional Repository
collection Online Access
description Background Low lung function in early life is associated with later respiratory illness. There is limited data on lung function in African infants despite a high prevalence of respiratory disease. Aim To assess the determinants of early lung function in African infants. Method Infants enrolled in a South African birth cohort, the Drakenstein child health study, had lung function measured at 6-10 weeks of age. Measurements, made with the infant breathing via a facemask during natural sleep, included tidal breathing, sulfur hexafluoride multiple breath washout and the forced oscillation technique. Information on antenatal and early postnatal exposures was collected using questionnaires and urine cotinine. Household benzene exposure was measured antenatally. Results Successful tests were obtained in 645/675 (95%) infants, median (IQR) age of 51 (46-58) days. Infant size, age and male gender were associated with larger tidal volume. Infants whose mothers smoked had lower tidal volumes (-1.6 mL (95% CI -3.0 to -0.1), p=0.04) and higher lung clearance index (0.1 turnovers (95% CI 0.01 to 0.3), p=0.03) compared with infants unexposed to tobacco smoke. Infants exposed to alcohol in utero or household benzene had lower time to peak tidal expiratory flow over total expiratory time ratios, 10% (95% CI -15.4% to -3.7%), p=0.002) and 3.0% (95% CI -5.2% to -0.7%, p=0.01) lower respectively compared with unexposed infants. HIVexposed infants had higher tidal volumes (1.7 mL (95% CI 0.06 to 3.3) p=0.04) compared with infants whose mothers were HIV negative. Conclusion We identified several factors including infant size, sex, maternal smoking, maternal alcohol, maternal HIV and household benzene associated with altered early lung function, many of which are factors amenable to public health interventions. Long-term study of lung function and respiratory disease in these children is a priority to develop strategies to strengthen child health.
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spelling curtin-20.500.11937-543362017-09-13T15:50:48Z Determinants of early-life lung function in African infants Gray, D. Willemse, L. Visagie, A. Czövek, D. Nduru, P. Vanker, A. Stein, D. Koen, N. Sly, P. Hantos, Z. Hall, Graham Zar, H. Background Low lung function in early life is associated with later respiratory illness. There is limited data on lung function in African infants despite a high prevalence of respiratory disease. Aim To assess the determinants of early lung function in African infants. Method Infants enrolled in a South African birth cohort, the Drakenstein child health study, had lung function measured at 6-10 weeks of age. Measurements, made with the infant breathing via a facemask during natural sleep, included tidal breathing, sulfur hexafluoride multiple breath washout and the forced oscillation technique. Information on antenatal and early postnatal exposures was collected using questionnaires and urine cotinine. Household benzene exposure was measured antenatally. Results Successful tests were obtained in 645/675 (95%) infants, median (IQR) age of 51 (46-58) days. Infant size, age and male gender were associated with larger tidal volume. Infants whose mothers smoked had lower tidal volumes (-1.6 mL (95% CI -3.0 to -0.1), p=0.04) and higher lung clearance index (0.1 turnovers (95% CI 0.01 to 0.3), p=0.03) compared with infants unexposed to tobacco smoke. Infants exposed to alcohol in utero or household benzene had lower time to peak tidal expiratory flow over total expiratory time ratios, 10% (95% CI -15.4% to -3.7%), p=0.002) and 3.0% (95% CI -5.2% to -0.7%, p=0.01) lower respectively compared with unexposed infants. HIVexposed infants had higher tidal volumes (1.7 mL (95% CI 0.06 to 3.3) p=0.04) compared with infants whose mothers were HIV negative. Conclusion We identified several factors including infant size, sex, maternal smoking, maternal alcohol, maternal HIV and household benzene associated with altered early lung function, many of which are factors amenable to public health interventions. Long-term study of lung function and respiratory disease in these children is a priority to develop strategies to strengthen child health. 2016 Journal Article http://hdl.handle.net/20.500.11937/54336 10.1136/thoraxjnl-2015-207401 BMJ Group unknown
spellingShingle Gray, D.
Willemse, L.
Visagie, A.
Czövek, D.
Nduru, P.
Vanker, A.
Stein, D.
Koen, N.
Sly, P.
Hantos, Z.
Hall, Graham
Zar, H.
Determinants of early-life lung function in African infants
title Determinants of early-life lung function in African infants
title_full Determinants of early-life lung function in African infants
title_fullStr Determinants of early-life lung function in African infants
title_full_unstemmed Determinants of early-life lung function in African infants
title_short Determinants of early-life lung function in African infants
title_sort determinants of early-life lung function in african infants
url http://hdl.handle.net/20.500.11937/54336