Transition from traditional biomass/kerosene fuel to ethanol reduced adverse pregnancy outcomes. However, the difference in birthweight was statistically significant only after covariate adjustment and the other significant differences were in tertiary endpoints. Our results are suggestive of a beneficial effect of ethanol use. Larger trials are required to validate these findings.
Background
Low birthweight, intrauterine growth restriction (IUGR) and perinatal mortality have been associated with air pollution. However, intervention studies that use ultrasound measurements to assess the effects of household air pollution (HAP) on fetal biometric parameters (FBP) are rare. We investigated the effect of a cookstove intervention on FBP and IUGR in a randomized controlled trial (RCT) cohort of HAP-exposed pregnant Nigerian women.
Methods
We recruited 324 women early in the second trimester of pregnancy. Between 16 and 18 weeks, we randomized them to either continue cooking with firewood/kerosene (control group) or receive a CleanCook stove and ethanol fuel (intervention group). We measured fetal biparietal diameter (BPD), head circumference (HC), femur length (FL), abdominal circumference (AC) and ultrasound-estimated fetal weight (U-EFW) in the second and third trimesters. The women were clinically followed up at six regular time points during their pregnancies. Once during the women’s second trimester and once during the third, we made 72-h continuous measurements of their personal exposures to particulate matter having aerodynamic diameter < 2.5 μm (PM2.5). We adopted a modified intent-to-treat approach for the analysis. Differences between the intervention and control groups on impact of HAP on fetal growth trajectories were analyzed using mixed effects regression models.
Results
There were no significant differences in fetal growth trajectories between the intervention and control groups.
Conclusions
Larger studies in a setting of low ambient air pollution are required to further investigate the effect of transitioning to a cleaner fuel such as ethanol on intrauterine growth.
Trial registration
ClinicalTrials.gov NCT02394574; September 2012
This study reports the status of onchocerciasis and lymphatic filariasis (LF) in communities with low endemicity in Ogun-State, Nigeria. The Ov16/Wb123 biplex Rapid Diagnostic Test was used to screen 1,836 participants aged 5 years and above from 8 Local Government Areas (LGAs) from October to December, 2016. Skin snips and night blood were also used for microscopic detection of microfilariae (MF). A cumulative seroprevalence of 9.4% and 0.42% was recorded for onchocerciasis and LF respectively with a co-infection rate of 0.4%. Among the LGAs screened, Ijebu North-East recorded the highest seroprevalence of onchocerciasis (26.4%) and LF (0.9%) while Remo North, Sagamu and Obafemi-Owode LGAs recorded low prevalences ranging from 0.7 - 2.7% for both diseases. No positive result of MF was observed in all the communities screened, even in Ijebu North-East where seroprevalence was high, suggesting historic exposure to onchocerciasis and LF infection which may have occurred over time due to human migration during farming and fishing seasons. Extension of ongoing mass treatment in endemic LGAs is recommended for Ijebu North-East to ensure inclusion in the drive towards the elimination of the diseases in Ogun State.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.