Household Air Quality Risk Factors Associated with Childhood Pneumonia in Urban Dhaka, Bangladesh

Pavani K. Ram University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Dhiman Dutt University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Benjamin J. Silk University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Saumil Doshi University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Carole B. Rudra University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Jaynal Abedin University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Doli Goswami University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Alicia M. Fry University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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W. Abdullah Brooks University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Stephen P. Luby University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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Adam L. Cohen University at Buffalo, Buffalo, New York; International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh; Centers for Disease Control and Prevention, Atlanta, Georgia

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To inform interventions to reduce the high burden of pneumonia in urban settings such as Kamalapur, Bangladesh, we evaluated household air quality risk factors for radiographically confirmed pneumonia in children. In 2009–2010, we recruited children < 5 years of age with pneumonia and controls from a population-based surveillance for respiratory and febrile illnesses. Piped natural gas was used by 85% of 331 case and 91% of 663 control households. Crowding, a tin roof in the living space, low socioeconomic status, and male sex of the child were risk factors for pneumonia. The living space in case households was 28% less likely than in control households to be cross-ventilated. Particulate matter concentrations were not significantly associated with pneumonia. With increasing urbanization and supply of improved cooking fuels to urban areas, the high burden of respiratory illnesses in urban populations such as Kamalapur may be reduced by decreasing crowding and improving ventilation in living spaces.

Author Notes

* Address correspondence to Pavani K. Ram, Rm 270 Farber Hall, 3435 Main Street, Buffalo, NY 14214. E-mail: pkram@buffalo.edu

Authors' addresses: Pavani K. Ram, University at Buffalo, Department of Epidemiology and Environmental Health, Buffalo, NY, E-mail: pkram@buffalo.edu. Dhiman Dutt, icddr,b - Centre for Communicable Diseases, Dhaka, Bangladesh, E-mail: dhiman@icddrb.org. Benjamin J. Silk, Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, GA, E-mail: ekg3@cdc.gov. Saumil Doshi and Alicia M. Fry, Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, E-mails: hgj3@cdc.gov and agf1@cdc.gov. Carole Rudra, University at Buffalo - School of Public Health and Health Professions, Buffalo, NY, E-mail: cbrudra@buffalo.edu. Jaynal Abedin, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Centre for Communicable Diseases, Dhaka, Bangladesh, E-mail: jaynal@icddrb.org. Doli Goswami, ICDDR,B - Health Systems and Infectious Diseases, Dhaka, Bangladesh, E-mail: drdolly@icddrb.org. Abdullah Brooks, icddr,b - Centre for Communicable Diseases Dhaka, Bangladesh, E-mail: abrooks@icddrb.org, and Johns Hopkins University, Bloomberg School of Public Health - International Health, Baltimore, MD, E-mail: abrooks@jhsph.edu. Stephen Luby, Stanford University - Medicine, Stanford, CA, and icddr,b - Centre for Communicable Diseases, Dhaka, Bangladesh, E-mail: sluby@stanford.edu. Adam Cohen, Centers for Disease Control and Prevention - National Center for Immunization and Respiratory Diseases, Atlanta, GA, E-mail: acohen@sa.cdc.gov.

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