Browsing by Author "Castro, M.C."
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Item Geographical inequalities and social and environmental risk factors for under-five mortality in Ghana in 2000 and 2010: Bayesian spatial analysis of census data.(PMED, 2016) Arku, R.A.; Bennett, J.E.; Castro, M.C.; Agyeman-Duah, K.; Mintah, S.E.; Ware, J.H.; Nyarko, P.; Spengler, J.D.; Agyei-Mensah, S.; Ezzati, M.Background Under-five mortality is declining in Ghana and many other countries. Very few studies have measured under-five mortality—and its social and environmental risk factors—at fine spatial resolutions, which is relevant for policy purposes. Our aim was to estimate under-five mortality and its social and environmental risk factors at the district level in Ghana. Methods and Findings We used 10% random samples of Ghana’s 2000 and 2010 National Population and Housing Censuses. We applied indirect demographic methods and a Bayesian spatial model to the information on total number of children ever born and children surviving to estimate under-five mortality (probability of dying by 5 y of age, 5q0) for each of Ghana’s 110 districts. We also used the census data to estimate the distributions of households or persons in each district in terms of fuel used for cooking, sanitation facility, drinking water source, and parental education. Median district 5q0 declined from 99 deaths per 1,000 live births in 2000 to 70 in 2010. The decline ranged from <5% in some northern districts, where 5q0 had been higher in 2000, to >40% in southern districts, where it had been lower in 2000, exacerbating existing inequalities. Primary education increased in men and women, and more households had access to improved water and sanitation and cleaner cooking fuels. Higher use of liquefied petroleum gas for cooking was associated with lower 5q0 in multivariate analysis. Conclusions Under-five mortality has declined in all of Ghana’s districts, but the cross-district inequality in mortality has increased. There is a need for additional data, including on healthcare, and additional environmental and socioeconomic measurements, to understand the reasons for the variations in mortality levels and trends.Item Personal particulate matter exposures and locations of students in four neighborhoods in Accra, Ghana.(NCBI, 2015) Arku, R.E.; Dionisio, K.L.; Hughes, A.F.; Vallarino, J.; Spengler, J.D.; Castro, M.C.; Agyei-Mensah, S.; Ezzati, M.Air pollution exposure and places where the exposures occur may differ in cities in the developing world compared with high-income countries. Our aim was to measure personal fine particulate matter (PM2.5) exposure of students in neighborhoods of varying socioeconomic status in Accra, Ghana, and to quantify the main predictors of exposure. We measured 24-hour PM2.5 exposure of 56 students from eight schools in four neighborhoods. PM2.5 was measured both gravimetrically and continuously, with time-matched global positioning system coordinates. We collected data on determinants of exposure, such as distances of homes and schools from main roads and fuel used for cooking at their home or in the area of residence/school. The association of PM2.5 exposure with sources was estimated using linear mixed-effects models. Personal PM2.5 exposures ranged from less than 10 μg/m(3) to more than 150 μg/m(3) (mean 56 μg/m(3)). Girls had higher exposure than boys (67 vs 44 μg/m(3); P-value=0.001). Exposure was inversely associated with distance of home or school to main roads, but the associations were not statistically significant in the multivariate model. Use of biomass fuels in the area where the school was located was also associated with higher exposure, as was household's own biomass use. Paved schoolyard surface was associated with lower exposure. School locations in relation to major roads, materials of school ground surfaces, and biomass use in the area around schools may be important determinants of air pollution exposure.Item Personal particulate matter exposures and locations of students in four neighborhoods in Accra, Ghana.(Journal of Exposure Science and Environmental Epidemiology, 2015-11) Arku, R.E.; Dionisio, K.L.; Hughes, A.F.; Vallarino, J.; Spengler, J.D.; Castro, M.C.; Agyei-Mensah, S.; Ezzati, M.Air pollution exposure and places where the exposures occur may differ in cities in the developing world compared with high-income countries. Our aim was to measure personal fine particulate matter (PM2.5) exposure of students in neighborhoods of varying socioeconomic status in Accra, Ghana, and to quantify the main predictors of exposure. We measured 24-hour PM2.5 exposure of 56 students from eight schools in four neighborhoods. PM2.5 was measured both gravimetrically and continuously, with time-matched global positioning system coordinates. We collected data on determinants of exposure, such as distances of homes and schools from main roads and fuel used for cooking at their home or in the area of residence/school. The association of PM2.5 exposure with sources was estimated using linear mixed-effects models. Personal PM2.5 exposures ranged from less than 10 μg/m3 to more than 150 μg/m3 (mean 56 μg/m3). Girls had higher exposure than boys (67 vs 44 μg/m3; P-value=0.001). Exposure was inversely associated with distance of home or school to main roads, but the associations were not statistically significant in the multivariate model. Use of biomass fuels in the area where the school was located was also associated with higher exposure, as was household’s own biomass use. Paved schoolyard surface was associated with lower exposure. School locations in relation to major roads, materials of school ground surfaces, and biomass use in the area around schools may be important determinants of air pollution exposure.