Assessing Satellite-based Ambient Pm In Relation To Under-five Children Mortality In Ethiopia.

Background: Particulate matter below 2.5 µm diameter (PMrn) is a part of air pollution thatrnhas adverse effects on health. Data on exposure to ambient PMrn2.5rn is not well monitored inrnsub-Saharan Africa due to limited resources and skilled manpower. The effect of PMrn2.5rn onrnhealth is least explored in Ethiopia. rnObjectives: The study has assessed the relationship between satellite-based ambientrnPMrn2.5rn pollution and under-five mortality in Ethiopia. rnMethods: The study used the data from Ethiopian Demographic Health Surveys conducted inrn2016, collected between January 18 and June 27. Under-five children with the child mortalityrninformation and coordinates of geographical location were included. Satellite-based ambientrnPMrn2.5rn concentration was extracted from the Atmospheric Composition Analysis Group rnwebsite at Washington and Dalhousie University, in the United States and Canada, rnrespectively. Datasets were downloaded from their respective websites. Annual pollutionrnlevel and mortality datasets were matched by children’s geographical location, birth, death,rnand interview dates. The relationship between satellite-based ambient PMrn and under-fivernmortality was determined by multilevel multivariable logistic regression. The statisticalrnanalyses were two-sided at 95% confidence interval. rnResults: The study addressed 10452 children with the proportion of under-five mortalityrnbeing 5.4% (95% CI 5.0% - 6.8%). The estimated lifetime mean annual exposure of ambient rnPMrn2.5rn was 20.1 ± 3.3 µgmrn-3rn. Significant clustering of mean annual PMrn concentration andrnunder-five mortality proportion were varied by region. A ten-unit increase in lifetime mean rnannual ambient PMrn2.5rn2.5rn was associated with 2.40 [95% CI 1.51, 3.80] times more odds ofrnunder-five mortality after adjusting for other variables. In addition, children with food cookedrninside a house but with no separate room, mothers without formal education, very large birthrnsize, twins, born at home, and stunting prevalence were significantly positively. rnConclusions: Clustered spatial distribution of ambient PMrn concentration and under-fivernmortality has existed. Satellite-based PMrn2.5rn2.5rn is significantly associated with under-fivernmortality adjusted for other variables. Validating satellite-based PM data with ground-basedrnmeasurements is advised. Additional ground-based PMrn monitoring devices, particularly inrnAfar where PMrn2.5rn2.5rn and under-five mortality were higher, is suggested.

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