Research Article: Noncommunicable Respiratory Disease and Air Pollution Exposure in Malawi (CAPS). A Cross-Sectional Study

Date Published: March 1, 2019

Publisher: American Thoracic Society

Author(s): Rebecca Nightingale, Maia Lesosky, Graham Flitz, Sarah J. Rylance, Jamilah Meghji, Peter Burney, John Balmes, Kevin Mortimer.


Rationale: Noncommunicable respiratory diseases and exposure to air pollution are thought to be important contributors to morbidity and mortality in sub-Saharan African adults.

Partial Text

Between August 2014 and July 2015, we attempted to contact the 3,000 adults sampled to invite them to participate, of whom 1,481 (49.4%) consented and completed BOLD study questionnaires. Of these, 950 (64.6%) went on to do spirometry; the remaining 520 (35.3%) were unable to do spirometry because they could not physically cooperate with the procedure (n = 258; 48.9%), had a fieldworker-determined contraindication (n = 193; 37%), or refused (n = 69; 13.3%). Of the 1,481 participants, 1,144 (77.2%) underwent personal air pollution exposure monitoring. There were 424 (28.6%) participants from CAPS intervention or control households (Figure 1).

The main findings of this cross-sectional study of the burden and determinants of noncommunicable respiratory disease in adults living in Chikhwawa, rural Malawi, were that: 13.6% of participants had chronic respiratory symptoms (mainly cough); >40% had abnormal spirometry (mainly spirometric restriction); day-to-day air pollution exposures were approximately three times the WHO upper safety limit; and there was no association between CAPS trial arm and any of the secondary trial outcomes in the subset of adults included both in this study and the trial.




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