Graduate Thesis Or Dissertation
 

Environmental and Community Exposures and Children’s Infectious Diseases in Bangladesh

Public Deposited

Downloadable Content

Download PDF
Request Accessible Version
https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/kh04dw71k

Descriptions

Attribute NameValues
Creator
Abstract
  • Under-5 mortality has decreased globally, but millions of children still die every year. In Bangladesh, respiratory infection and diarrheal disease remain leading causes of morbidity and mortality for children under-5, despite incredible progress in the past three decades. Immune system development begins in utero and continues into adulthood. Toxic environmental exposures can impair immune system development and have life-long and possibly inter-generational consequences on infectious disease risk. In-vitro and in-vivo studies have demonstrated the impact early-childhood arsenic exposure can have on infectious disease risk in the first year of life. Additional household exposures, such as indoor air pollution, nutrition, poverty, family income, and maternal education also influence infectious disease risk of children. In the first study presented here, we show that drinking water arsenic during pregnancy is associated with children’s acute respiratory infection (ARI) risk from ages 4-5 years in Bangladesh. However, drinking water arsenic exposure during toddlerhood and childhood were not associated with ARI. Furthermore, drinking water arsenic was not associated with fever in children aged 4-5 years at any of these three timepoints. These effect estimates did not differ by child sex. In the second study, we identified family income and maternal education as key predictors of ARI incidence in children aged 4-5 years. We expanded upon this in the third study to estimate the possible reduction in ARI burden if all families were intervened upon and brought above specific income and maternal education thresholds. We found that both household incomes above 3,000Taka per month (approximately $1.25/person/day) and mothers completing primary education would reduce infectious disease incidence in children 4-5 years old in Bangladesh. These effect sizes decreased at higher thresholds. These findings add to the growing body of evidence that environmental exposure to arsenic can modulate the human immune system. Furthermore, gestation is a critical window of development and immunologic insults during this vulnerable time can have long lasting repercussions on children’s health. These results also suggest that ongoing efforts by the Government of Bangladesh to increase girls’ education, and international efforts to expand universal child benefits in the form of cash transfers, can have the potential for wide-ranging positive impacts on children’s health, including reducing ARI burden. Finally, this study suggests that intervention efforts may be best targeted at the most impoverished households, i.e. families with the lowest income and least maternal education, rather than at specific exposure sources (e.g. clean-burning stoves).
License
Resource Type
Date Issued
Degree Level
Degree Name
Degree Field
Degree Grantor
Commencement Year
Advisor
Academic Affiliation
Rights Statement
Publisher
Peer Reviewed
Language
Embargo reason
  • Pending Publication
Embargo date range
  • 2020-02-29 to 2021-03-29
Accessibility Feature

Relationships

Parents:

This work has no parents.

In Collection:

Items

Thumbnail Title Date Uploaded Visibility Actions
file details AhmedShariaM2020.pdf 2020-02-28 Public Download