Asthma symptoms, spirometry and air pollution exposure in schoolchildren in an informal settlement and an affluent area of Nairobi, Kenya

The Tupumue project took its name from the Kiswahili for “let us breathe”, and was a cross-institution collaboration between the Kenya Medical Research Institute (KEMRI), the Liverpool School of Tropical Medicine (LSTM) and a number of other university institutions including SEI York. The researchers aimed to compare air pollution exposure in schoolchildren from adjacent residential areas: the informal settlement of Mukuru and the more affluent gated community of Buruburu. In this journal article, the researchers set out their innovative methodology and findings.

Vital to the ethos of this project was ensuring the information generated was relevant to participants, and the researchers actively sought input from the children and the parents of the children taking part, holding co-creation workshops and arts-based projects in each community to raise community awareness of the project and shape all areas of study design, data collection and communications.

All children aged ≤18 years attending schools in Mukuru or Buruburu were eligible to take part. In total, 2373 children took part in the study: 1277 from Mukuru and 1096 from Buruburu. By using a combination of questionnaires, spirometry tests, and air quality monitoring, the researchers compared asthma symptoms and exposure to air pollution in the children from the different neighbourhoods.

The results indicated that children attending schools in the informal settlement of Mukuru had more symptoms consistent with asthma than children attending schools in the more affluent Buruburu. They were also more likely to be exposed to a greater number of air pollution sources: dusts, vapours, gases, fumes, adult smokers in the home, burning mosquito coils and refuse burning within sight of the home. However, children in the informal settlements were also less likely to receive a diagnosis for their symptoms.