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Quinn AK, Adjei IA, Ae-Ngibise KA, Agyei O, Boamah-Kaali EA, Burkart K, Carrión D, Chillrud SN, Gould CF, Gyaase S, Jack DW, Kaali S, Kinney PL, Lee AG, Mujtaba MN, Oppong FB, Owusu-Agyei S, Yawson A, Wylie BJ, Asante KP. Corrigendum to "Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants" [Environ. Int. 155 (2021) 106659]. Environ Int 2022; 158:107006. [PMID: 34924647 PMCID: PMC8673308 DOI: 10.1016/j.envint.2021.107006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
[This corrects the article PMC8628363.].
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Affiliation(s)
- Ashlinn K. Quinn
- Fogarty International Center, National Institutes of
Health, Bethesda, MD, USA
| | | | | | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Daniel Carrión
- Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Steven N. Chillrud
- Mailman School of Public Health, Columbia University, New
York, NY, USA
- Lamont-Doherty Earth Observatory of Columbia University,
Palisades, NY, USA
| | - Carlos F. Gould
- Mailman School of Public Health, Columbia University, New
York, NY, USA
| | | | - Darby W. Jack
- Mailman School of Public Health, Columbia University, New
York, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | - Alison G. Lee
- Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | | | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
- Institute of Health Research, University of Health and
Allied Sciences, Ho, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
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Kinney PL, Asante KP, Lee AG, Ae-Ngibise KA, Burkart K, Boamah-Kaali E, Twumasi M, Gyaase S, Quinn A, Oppong FB, Wylie BJ, Kaali S, Chillrud S, Yawson A, Jack DW, Owusu-Agyei S. Prenatal and Postnatal Household Air Pollution Exposures and Pneumonia Risk: Evidence From the Ghana Randomized Air Pollution and Health Study. Chest 2021; 160:1634-1644. [PMID: 34298005 PMCID: PMC8628168 DOI: 10.1016/j.chest.2021.06.080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown. RESEARCH QUESTION Are prenatal or postnatal household air pollution, or both, associated with pneumonia risk in the first year of life? STUDY DESIGN AND METHODS The Ghana Randomized Air Pollution and Health Study enrolled 1,414 nonsmoking, pregnant women before 24 weeks' gestation with prospective follow-up to the child's age of 1 year. We measured 72-h personal household air pollution exposures, indexed by carbon monoxide (CO), four times prenatally and three times postnatally. Weekly fieldworker surveillance identified ill-appearing children for physician pneumonia assessment. We used quasi-Poisson models to examine associations between prenatal and postnatal CO and physician-diagnosed pneumonia and severe pneumonia. Sex-specific effects were examined. RESULTS Of the 1,306 live births, 1,141 infants were followed up with 55,605 child-weeks of fieldworker surveillance. The estimated risk for pneumonia and severe pneumonia in the first year of life increased by 10% (relative risk [RR], 1.10; 95% CI, 1.04-1.16) and 15% (RR, 1.15; 95% CI, 1.03-1.28), respectively, per 1-part per million (ppm) increase in average prenatal CO exposure and by 6% (RR, 1.06; 95% CI, 0.99-1.13) per 1-ppm increase in average postnatal CO exposure. Sex-stratified analyses suggest that in girls, higher prenatal CO exposure was associated with pneumonia risk, while no association was seen in boys. INTERPRETATION Prenatal household air pollution exposure increased risk of pneumonia and severe pneumonia in the first year of life. Clean-burning interventions may be most effective when begun prenatally. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01335490; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA.
| | - Kwaku-Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Ellen Boamah-Kaali
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Mieks Twumasi
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD
| | - Felix B Oppong
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Seyram Kaali
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY
| | - Abena Yawson
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana
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Quinn AK, Adjei IA, Ae-Ngibise KA, Agyei O, Boamah-Kaali EA, Burkart K, Carrión D, Chillrud SN, Gould CF, Gyaase S, Jack DW, Kaali S, Kinney PL, Lee AG, Mujtaba MN, Oppong FB, Owusu-Agyei S, Yawson A, Wylie BJ, Asante KP. Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants. Environ Int 2021; 155:106659. [PMID: 34134048 PMCID: PMC8628363 DOI: 10.1016/j.envint.2021.106659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Low birth weight and prematurity are important risk factors for death and disability, and may be affected by prenatal exposure to household air pollution (HAP). METHODS We investigate associations between maternal exposure to carbon monoxide (CO) during pregnancy and birth outcomes (birth weight, birth length, head circumference, gestational age, low birth weight, small for gestational age, and preterm birth) among 1288 live-born infants in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We evaluate whether evidence of malaria during pregnancy, as determined by placental histopathology, modifies these associations. RESULTS We observed effects of CO on birth weight, birth length, and gestational age that were modified by placental malarial status. Among infants from pregnancies without evidence of placental malaria, each 1 ppm increase in CO was associated with reduced birth weight (-53.4 g [95% CI: -84.8, -21.9 g]), birth length (-0.3 cm [-0.6, -0.1 cm]), gestational age (-1.0 days [-1.8, -0.2 days]), and weight-for-age Z score (-0.08 standard deviations [-0.16, -0.01 standard deviations]). These associations were not observed in pregnancies with evidence of placental malaria. Each 1 ppm increase in maternal exposure to CO was associated with elevated odds of low birth weight (LBW, OR 1.14 [0.97, 1.33]) and small for gestational age (SGA, OR 1.14 [0.98, 1.32]) among all infants. CONCLUSIONS Even modest reductions in exposure to HAP among pregnant women could yield substantial public health benefits, underscoring a need for interventions to effectively reduce exposure. Adverse associations with HAP were discernible only among those without evidence of placental malaria, a key driver of impaired fetal growth in this malaria-endemic area.
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Affiliation(s)
- Ashlinn K Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Daniel Carrión
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven N Chillrud
- Mailman School of Public Health, Columbia University, New York, NY, USA; Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Carlos F Gould
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Darby W Jack
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Kintampo, Ghana; Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Blair J Wylie
- Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Dzifa D, Boima V, Yorke E, Yawson A, Ganu V, Mate-Kole C. Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa. Lupus 2017; 27:336-342. [PMID: 29173007 DOI: 10.1177/0961203317742710] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.
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Affiliation(s)
- D Dzifa
- 1 Department of Medicine and Therapeutics, 63533 University of Ghana School of Medicine and Dentistry , Accra, Ghana
| | - V Boima
- 1 Department of Medicine and Therapeutics, 63533 University of Ghana School of Medicine and Dentistry , Accra, Ghana
| | - E Yorke
- 1 Department of Medicine and Therapeutics, 63533 University of Ghana School of Medicine and Dentistry , Accra, Ghana
| | - A Yawson
- 3 Department of Community Health, 63533 University of Ghana School of Medicine and Dentistry , Accra, Ghana
| | - V Ganu
- 4 Department of Medicine and Therapeutics, Korle bu Teaching Hospital, Accra, Ghana
| | - C Mate-Kole
- 2 Department of Psychiatry, 63533 University of Ghana School of Medicine and Dentistry , Accra, Ghana
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Kabanywanyi AM, Baiden R, Ali AM, Mahende MK, Ogutu BR, Oduro A, Tinto H, Gyapong M, Sie A, Sevene E, Macete E, Owusu-Agyei S, Adjei A, Compaoré G, Valea I, Osei I, Yawson A, Adjuik M, Akparibo R, Kakolwa MA, Abdulla S, Binka F. Multi-Country Evaluation of Safety of Dihydroartemisinin/Piperaquine Post-Licensure in African Public Hospitals with Electrocardiograms. PLoS One 2016; 11:e0164851. [PMID: 27764178 PMCID: PMC5072600 DOI: 10.1371/journal.pone.0164851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 09/28/2016] [Indexed: 01/06/2023] Open
Abstract
The antimalarial drug piperaquine is associated with delayed ventricular depolarization, causing prolonged QT interval (time taken for ventricular de-polarisation and re-polarisation). There is a lack of safety data regarding dihydroartemisinin/piperaquine (DHA/PPQ) for the treatment of uncomplicated malaria, which has limited its use. We created a platform where electrocardiograms (ECG) were performed in public hospitals for the safety assessment of DHA/PPQ, at baseline before the use of dihydroartemisinin/piperaquine (Eurartesim®), and on day 3 (before and after administration of the final dose) and day 7 post-administration. Laboratory analyses included haematology and clinical chemistry. The main objective of the ECG assessment in this study was to evaluate the effect of administration of DHA/PPQ on QTc intervals and the association of QTc intervals with changes in blood biochemistry, full and differential blood count over time after the DHA/PPQ administration. A total of 1315 patients gave consent and were enrolled of which 1147 (87%) had complete information for analyses. Of the enrolled patients 488 (42%), 323 (28%), 213 (19%) and 123 (11%) were from Ghana, Burkina Faso, Tanzania and Mozambique, respectively. Median (lower—upper quartile) age was 8 (5–14) years and a quarter of the patients were children under five years of age (n = 287). Changes in blood biochemistry, full and differential blood count were temporal which remained within clinical thresholds and did not require any intervention. The mean QTcF values were significantly higher than on day 1 when measured on day 3 before and after administration of the treatment as well as on day 7, four days after completion of treatment (12, 22 and 4 higher, p < 0.001). In all age groups the values of QT, QTcF and QTcB were highest on day 3 after drug intake. The mean extreme QTcF prolongation from baseline was lowest on day 3 before drug intake (33 ms, SD = 19) and highest on day 3 after the last dose (60 ms, SD = 31). There were 79 (7%) events of extreme mean QTcF prolongation which were not clinically significant. Nearly a half of them (n = 37) were grade 3 and mainly among males (33/37). Patients in Burkina Faso, Mozambique and Tanzania had significantly lower mean QTcF than patients in Ghana by an average of 3, 4 and 11 ms, respectively. We found no evidence that Eurartesim® administered in therapeutic doses in patients with uncomplicated malaria and no predisposing cardiac conditions in Africa was associated with adverse clinically significant QTc prolongation.
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Affiliation(s)
| | | | - Ali M. Ali
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | | | | | | | | | - Ali Sie
- Nouna Health Research Centre, Nouna, Burkina Faso
| | - Esperanca Sevene
- Centro de Investigaçãoem Saúde de Manhiça(CISM), Manhiça, Mozambique
| | - Eusebio Macete
- Centro de Investigaçãoem Saúde de Manhiça(CISM), Manhiça, Mozambique
| | | | - Alex Adjei
- Dodowa Health Research Centre, Dodowa, Ghana
| | | | | | - Isaac Osei
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | | | | | - Fred Binka
- University for Health and Allied Sciences, Ho, Ghana
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Baiden R, Oduro A, Halidou T, Gyapong M, Sie A, Macete E, Abdulla S, Owusu-Agyei S, Mulokozi A, Adjei A, Sevene E, Compaoré G, Valea I, Osei I, Yawson A, Adjuik M, Akparibo R, Ogutu B, Upunda GL, Smith P, Binka F. Prospective observational study to evaluate the clinical safety of the fixed-dose artemisinin-based combination Eurartesim® (dihydroartemisinin/piperaquine), in public health facilities in Burkina Faso, Mozambique, Ghana, and Tanzania. Malar J 2015; 14:160. [PMID: 25885858 PMCID: PMC4405867 DOI: 10.1186/s12936-015-0664-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/24/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The World Health Organization recommends artemisinin-based combination (ACT) for the treatment of uncomplicated malaria. Post-licensure safety data on newly registered ACT is critical for evaluating their risk/benefit profile in malaria endemic countries. The clinical safety of the newly registered combination, Eurartesim®, following its introduction into the public health system in four African countries was assessed. METHODS This was a prospective, observational, open-label, non-comparative, longitudinal, multi-centre study using cohort event monitoring. Patients with confirmed malaria had their first dose observed and instructed on how to take the second and the third doses at home. Patients were contacted on day 5 ± 2 to assess adherence and adverse events (AEs). Spontaneous reporting of AEs was continued till day 28. A nested cohort who completed full treatment course had repeated electrocardiogram (ECG) measurements to assess effect on QTc interval. RESULTS A total of 10,925 uncomplicated malaria patients were treated with Eurartesim®. Most patients,95% (10,359/10,925), did not report any adverse event following at least one dose of Eurartesim®. A total of 797 adverse events were reported. The most frequently reported, by system organ classification, were infections and infestations (3. 24%) and gastrointestinal disorders (1. 37%). In the nested cohort, no patient had QTcF > 500 ms prior to day 3 pre-dose 3. Three patients had QTcF > 500 ms (509 ms, 501 ms, 538 ms) three to four hours after intake of the last dose. All the QTcF values in the three patients had returned to <500 ms at the next scheduled ECG on day 7 (470 ms, 442 ms, 411 ms). On day 3 pre- and post-dose 3, 70 and 89 patients, respectively, had a QTcF increase of ≥ 60 ms compared to their baseline, but returned to nearly baseline values on day 7. CONCLUSION Eurartesim® single course treatment for uncomplicated falciparum malaria is well-tolerated. QT interval prolongation above 500 ms may occur at a rate of three per 1,002 patients after the third dose with no association of any clinical symptoms. QT interval prolongation above 60 ms was detected in less than 10% of the patients without any clinical abnormalities.
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Affiliation(s)
| | | | - Tinto Halidou
- Nanoro Health Research Centre, Nanoro, Burkina Faso.
| | | | - Ali Sie
- Nouna Health Research Centre, Nouna, Burkina Faso.
| | - Eusebio Macete
- Centro de InvestigaçãoemSaúde de Manhiça, CISM, Manhiça, Mozambique.
| | | | | | | | - Alex Adjei
- Dodowa Health Research Centre, Dodowa, Ghana.
| | - Esperanca Sevene
- Centro de InvestigaçãoemSaúde de Manhiça, CISM, Manhiça, Mozambique.
| | | | | | - Isaac Osei
- Navrongo Health Research Centre, Navrongo, Ghana.
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana.
| | | | | | | | | | - Peter Smith
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Fred Binka
- INDEPTH Network, Accra, Ghana. .,University for Health and Allied Sciences, Ho, Ghana.
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