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    Determinants of early-life lung function in African infants

    Access Status
    Open access via publisher
    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.
    Date
    2016
    Type
    Journal Article
    
    Metadata
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    Citation
    Gray, D. and Willemse, L. and Visagie, A. and Czövek, D. and Nduru, P. and Vanker, A. and Stein, D. et al. 2016. Determinants of early-life lung function in African infants. Thorax. 72 (5): pp. 445-450.
    Source Title
    Thorax
    DOI
    10.1136/thoraxjnl-2015-207401
    ISSN
    0040-6376
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/54336
    Collection
    • Curtin Research Publications
    Abstract

    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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      Rationale: Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness ...
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