Intervening to Improve Birth Weight and Infant Respiratory Health in Rural Ghana

采取干预措施改善加纳农村地区的出生体重和婴儿呼吸系统健康

基本信息

批准号：
8240440
负责人：
Patrick Lott Kinney
金额：
$ 64.37万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-10 至 2015-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8240440
关键词：
Acute Africa Africa South of the Sahara Age Age-Months Beds Biomass Birth Birth Weight Carbon Monoxide Cause of Death Cessation of life Child Childhood Clinic Clinical Collaborations Communities Cross-Sectional Studies Developing Countries Early treatment Effectiveness Enrollment Exposure to Family Fetus Field Workers Gestational Age Ghana Goals Guidelines Health Health Insurance Heating Home environment Household Infant Infant Health Insecticides Insurance Intervention Intervention Trial Lead Life Malaria Measures Monitor Mothers Neonatal New York City Newborn Infant Outcome Pneumonia Pregnancy Pregnant Women Prenatal care Randomized Research Research Infrastructure Residual state Respiratory Tract Infections Risk Rural Smoke Testing Third Pregnancy Trimester Time Ultrasonography Universities Variant Woman base burden of illness cooking cost critical period effective intervention follow-up group intervention improved informant particle exposure postnatal programs public health relevance respiratory response

项目摘要

DESCRIPTION (provided by applicant): Smoke from biomass combustion leads to approximately 1.6 million excess annual deaths and a substantial share of the global burden of disease, due in large part to increased risk of acute lower respiratory infections (ALRI) in children under age five. Recent evidence also suggests that exposures to cook smoke during pregnancy may be associated with reduced birth weight. This issue is particularly relevant in sub-Saharan Africa, where cooking with biomass fuels is widespread. The overall goal of the proposed research is to test the effectiveness of commercially available, low cost improved cook stoves in improving infant health outcomes from birth through six months of age. Two hypotheses will be tested: Hypothesis 1. Use of improved cook stoves starting by the third trimester pregnancy will lead to a significant increase in average birth weight in newborns. Hypothesis 2: Use of improved cook stoves will lead to a significant reduction in the rate of severe ALRI during the first six months of life. These hypotheses will be tested in a randomized intervention trial among 800 maternal- infant pairs in the Kintampo district of rural Ghana in West Africa. Pregnant women who are primary cooks in their families will be identified before the third trimester of pregnancy. We will randomly assign villages, matched on average assets, to early or late intervention groups. Within the early intervention villages, improved cook stoves will be distributed to enrolled pregnant women, along with health insurance and an insecticide-treated bed net. The late intervention group will receive insurance and a bed net at enrollment, and the full intervention at the completion of the postnatal follow-up. Gestational age will be determined by sonogram upon enrollment and provide confirmation that potential subjects are carrying live singleton fetuses. We will assess real-time personal exposure to carbon monoxide (CO) among all subjects during pregnancy and during the neonatal period. At birth we will measure birthweight and collect a placental smear for malaria assessment. Field workers will monitor for severe pneumonia at weekly intervals in the home for the first six months of the life of a child based on the Integrated Management of Childhood Illness (IMCI) guidelines, with clinical referral of cases. The proposed research builds on an established collaboration between Columbia University and the Kintampo Health Research Center in central Ghana. PUBLIC HEALTH RELEVANCE: Smoke from cooking with biomass fuels leads to almost one million deaths in children under age five around the world. However, we lack sufficient understanding of exposure-response, and of critical periods of exposure, to develop effective interventions for reducing these impacts. The proposed research will carefully examine the benefits of an intervention to improve infant birth weight and respiratory health in rural Ghana.

描述（由申请人提供）：生物质燃烧中的烟雾可导致大约160万例全年疾病负担，这很大程度上是由于五岁以下儿童急性下呼吸道感染（ALRI）的风险增加。最近的证据还表明，怀孕期间烹饪烟雾的暴露可能与出生体重减轻有关。这个问题在撒哈拉以南非洲尤其重要，那里的生物质燃料很普遍。拟议的研究的总体目标是测试市售，低成本改善库克炉的有效性，从而改善了从出生到六个月大的婴儿健康结果。将检验两个假设：假设1。在三个月怀孕开始时使用改进的库克炉将导致新生儿平均出生体重的显着增加。假设2：使用改进的库克炉将导致在生命的头六个月中严重的ALRI率显着降低。这些假设将在西非乡村的Kintampo区的800个母婴对中进行随机干预试验进行检验。在怀孕三个月之前，将确定自己是家人的主要厨师的孕妇。我们将随机分配平均资产，早期或晚期干预组的村庄。在早期的干预村中，改善的库克炉将分发给入学的孕妇，以及健康保险和经过杀虫剂治疗的床网。晚期干预小组将在入学时获得保险和床网，并在产后随访完成时进行全面干预。胎龄将在入学时通过超声检查确定，并确认潜在的受试者正在携带活胎胎胎儿。我们将评估怀孕期间和新生儿期间所有受试者中对一氧化碳（CO）的实时接触。出生时，我们将衡量出生体重并收集胎盘涂片以进行疟疾评估。野外工作人员将根据儿童疾病综合管理（IMCI）指南，在儿童生命的头六个月内每周在家庭中监测严重的肺炎，并通过病例转诊。拟议的研究基于哥伦比亚大学与加纳中部的Kintampo Health Research Center之间建立的合作。公共卫生相关性：用生物质燃料烹饪的烟雾会导致全球五岁以下儿童死亡近100万人死亡。但是，我们对暴露响应和关键暴露时期缺乏足够的了解，无法制定有效的干预措施来减少这些影响。拟议的研究将仔细研究干预措施的好处，以改善加纳农村地区的婴儿出生体重和呼吸健康。