Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;78(11):1118-1125.
doi: 10.1136/thorax-2023-220057. Epub 2023 Jun 6.

Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya

Hellen Meme  1 , Evans Amukoye  1 , Cressida Bowyer  2 , Jeremiah Chakaya  1 , Darpan Das  3 , Ruaraidh Dobson  4 , Ulrike Dragosits  5 , Jonathan Fuld  6 , Cindy Gray  7 , Matthew Hahn  8 , Richard Kiplimo  1 , Maia Lesosky  9 , Miranda M Loh  3 , Jean McKendree  10 , Kevin Mortimer  11   12 , Amos Ndombi  1 , Louis Netter  2 , Angela Obasi  13   14 , Fred Orina  1 , Clare Pearson  5 , Heather Price  15 , Jennifer K Quint  16 , Sean Semple  4 , Marsailidh Twigg  5 , Charlotte Waelde  17 , Anna Walnycki  18 , Melaneia Warwick  19 , Jana Wendler  20 , Sarah E West  10 , Michael Wilson  19 , Lindsay Zurba  21 , Graham Devereux  22
Affiliations

Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya

Hellen Meme et al. Thorax. 2023 Nov.

Abstract

Background: Although 1 billion people live in informal (slum) settlements, the consequences for respiratory health of living in these settlements remain largely unknown. This study investigated whether children living in an informal settlement in Nairobi, Kenya are at increased risk of asthma symptoms.

Methods: Children attending schools in Mukuru (an informal settlement in Nairobi) and a more affluent area (Buruburu) were compared. Questionnaires quantified respiratory symptoms and environmental exposures; spirometry was performed; personal exposure to particulate matter (PM2.5) was estimated.

Results: 2373 children participated, 1277 in Mukuru (median age, IQR 11, 9-13 years, 53% girls), and 1096 in Buruburu (10, 8-12 years, 52% girls). Mukuru schoolchildren were from less affluent homes, had greater exposure to pollution sources and PM2.5. When compared with Buruburu schoolchildren, Mukuru schoolchildren had a greater prevalence of symptoms, 'current wheeze' (9.5% vs 6.4%, p=0.007) and 'trouble breathing' (16.3% vs 12.6%, p=0.01), and these symptoms were more severe and problematic. Diagnosed asthma was more common in Buruburu (2.8% vs 1.2%, p=0.004). Spirometry did not differ between Mukuru and Buruburu. Regardless of community, significant adverse associations were observed with self-reported exposure to 'vapours, dusts, gases, fumes', mosquito coil burning, adult smoker(s) in the home, refuse burning near homes and residential proximity to roads.

Conclusion: Children living in informal settlements are more likely to develop wheezing symptoms consistent with asthma that are more severe but less likely to be diagnosed as asthma. Self-reported but not objectively measured air pollution exposure was associated with increased risk of asthma symptoms.

Keywords: asthma; asthma epidemiology; paediatric asthma.

PubMed Disclaimer

Conflict of interest statement

Competing interests: RD has declared employment by the University of Stirling for the duration of the study. ML has declared employment by the Institute of Occupational Medicine and funding for the study from UKRI MRC/Kenya National Research Fund. JKQ has declared personal funding from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Chiesi, Teva, Insmed, Bayer and institutional funding from UKRI MRC, Health Data Research UK, GlaxoSmithKline, Bayer, Boehringer Ingelheim, Chiesi, AstraZeneca and Asthma and Lung UK. All other authors have declared they have nothing to disclose.

Comment in

References

    1. Ezeh A, Oyebode O, Satterthwaite D, et al. . The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet 2017;389:547–58.:S0140-6736(16)31650-6. 10.1016/S0140-6736(16)31650-6 - DOI - PubMed
    1. World Health Organisation . A billion voices: listening and responding to the health needs of slum dwellers and informal settlers in new urban settings. n.d.
    1. United Nations Population Fund . State of World population 2007. United Nations Population Fund; 2007.
    1. UN Department of Economics and Social Affairs . The 2018 revision of World urbanization prospects. 2018. Available: https://population.un.org/wup/ [Accessed Jan 2023].
    1. Rutstein SO, Staveteig S, Winter R, et al. . Urban Child Poverty, Health, and Survival in Low- and Middle-Income Countries DHS Comparative Reports 40. Rockville,Maryland, USA: ICF International, 2016.

Publication types