PI: Dr Joseph Tlouyamma and Dr Musa Sono
Background
Asthma is one of the most common chronic diseases affecting children globally, with a particularly high burden in low- and middle-income countries such as South Africa. Children are exposed to a complex mix of environmental factors such as air pollution, aeroallergens (e.g. pollen and fungal spores), and changing weather patterns that can trigger or worsen respiratory conditions. These combined exposures, known as the exposome, interact in dynamic ways and are not well understood, especially in African settings. In South Africa, environmental monitoring systems and health data are often fragmented and not integrated, making it difficult to link environmental exposures with health outcomes. Additionally, children in vulnerable communities face increased risks due to poor housing conditions, indoor pollution, and limited access to healthcare.
This study addresses these gaps by generating detailed, long-term data that connects environmental exposures with respiratory health outcomes in children. It introduces a sentinel surveillance approach, where children with asthma are used as early indicators of community-level respiratory health risks. By combining clinical data, environmental monitoring, and community engagement, the study aims to support more responsive and locally relevant public health strategies.
Aim
The study aims to evaluate whether children with asthma can serve as effective, sensitive, and practical sentinel indicators of community-level respiratory health impacts related to environmental exposures such as air pollution, aeroallergens, and weather events.
Objectives
Primary Objectives
- To assess whether trends in asthma symptoms and health outcomes among children can reflect broader community respiratory health patterns, including healthcare utilisation (e.g. clinic visits and hospital admissions).
- To determine how sensitive asthma-related indicators (such as symptoms, lung function, and inflammation markers) are to changes in environmental exposures, including air pollutants, aeroallergens, and extreme weather events.
- To evaluate the feasibility of implementing a sentinel surveillance system by assessing participant adherence, acceptability, and the practicality of environmental and health monitoring tools.
Secondary Objectives
- To describe how environmental exposures (air pollution and aeroallergens) vary across different locations and seasons.
- To examine the relationship between environmental exposures and respiratory symptoms in both children with asthma and other household members.
- To assess the impact of indoor environmental factors (such as housing conditions, fuel use, and ventilation) on respiratory health.
- To evaluate the usability and acceptability of personal and household-level environmental monitoring tools.
- To explore community perceptions of environmental risks and respiratory health using qualitative methods.
To assess changes in knowledge, attitudes, and behaviours related to asthma and environmental health following community engagement activities.