Early-life exposures on lung function in African preschool children

Shaakira Chaya’s PhD thesis has made several observations around early life factors which can contribute to lung function in African preschool children. One of these is that the high prevalence of household air pollution and environmental tobacco smoke contributes significantly to early respiratory impairment.

“We were also able to demonstrate that even mild lower respiratory tract infections can have an impact on lung function, and that factors like being born moderate to late preterm or exposure to HIV can independently affect lung development,” she said.

Shaakira, a paediatric pulmonologist, will on 31 March be counted among the University of Cape Town’s (UCT) PhD graduates, after she explored “The impact of early life exposures on lung function in African preschool children” for her research.

“I was surprised by the scale and long-term impact of early-life respiratory exposures and events. What was particularly valuable was the ability to measure and quantify how these factors impact lung health over time. The ability to measure lung function from early infancy using state-of-the-art techniques shows that impairments are often present much earlier than previously recognised as they can now be measured.”

“My PhD was nested within the Drakenstein Child Health Study, a birth cohort study that enrolled mother–infant pairs and followed the children from infancy over time. The study looked at several aspects, one of which was lung health,” Shaakira explained. “State of the art lung function tests were used to monitor and track lung growth. The principal investigator of the study is Professor Heather Zar with Professor Diane Gray as the lung function lead, both of whom were my supervisors.”

The term “life exposures” refers to various environmental conditions and factors that children are exposed to in early life. These exposures include air pollution, household indoor pollutants (such as tobacco smoke or biomass fuel). Some exposures occur during the antenatal period, meaning they affect the mother during pregnancy, and can be transferred to the developing fetus.

Community-based approach

“Our study focuses on children between the ages of three and five. This is a critical period in early childhood, as the lungs and respiratory system are still developing, making them potentially more vulnerable to environmental influences.

“I would also like to acknowledge my parents, whose unwavering support, encouragement, and belief in me have always been my guiding light.”

Shaakira added: “The community-based approach allowed staff to establish meaningful connections with both the children and their families, making them feel comfortable and valued. Additionally, the consistency of the team such as having the same respiratory technologist conducting the lung function tests over time helped children become familiar with the team, thus reducing anxiety and building trust.”

“While significant progress has been made in identifying early-life factors (such as environmental pollutants, respiratory infections, nutrition, and genetics) that influence lung development, a key question remains, whether impacts of early exposures can be reversed as children grow, and if specific interventions during childhood and adolescence can repair or mitigate the initial damage.”

Dedication

Shaakirah said that she dedicates her PhD to all the children and parents involved in the study. “Without their participation and support, this work would not have been possible. I also extend my heartfelt thanks to the study staff, my supervisors Diane Gray and Heather Zar, as well as to all my friends and family whose encouragement and presence have truly enriched this journey. I would also like to acknowledge my parents, whose unwavering support, encouragement, and belief in me have always been my guiding light. Though they are no longer physically with me, their inspiring words continue to motivate and empower me every day.”

Shaakira is currently enrolled in a postdoctoral programme where she is building on her PhD work. “The children in the study are now 11 years old. My primary goal is to investigate how early-life exposures affect lung function as the children progress into adolescence, a critical period when lung growth and development are still ongoing.”