**8. Prevalence of respiratory diseases in Nigeria**

**5. Indicators for evaluating housing quality**

facilities and services, and that it must be healthy, safe and secure.

aesthetics, among others [21].

100 Housing

**6. Urbanization and housing quality**

**7. Indoor air and housing quality**

In assessing the quality or suitability of housing, qualitative studies have identified some criteria as relevant indicators for quality evaluation in residential development. Among such is [18] who acknowledged aesthetics, ornamentation, sanitation, drainage, age of building, access to basic housing facilities, burglary, spatial adequacy, noise level within neighborhoods, sewage and waste disposal and air pollution among others, as related quality determinants in housing. However, [19] concluded that qualitative housing involves the provision of infrastructural services, which could bring about sustainable growth and development through improved environmental conditions and improved livelihood. In determining the quality of residential development, [20] stipulates five basic criteria which include compliance with tolerable standard, free from serious disrepair, energy efficient, provided with modern

There are however indications from these various studies that a single variable may not be sufficient to assess the qualitative nature of residential development; therefore, housing acceptability and qualitative assessment should also take into account type of constructions, materials used, services, spatial arrangement and facilities within dwellings, function and

As a result of urbanization and lack of economic opportunities in rural areas, many people move to the urban areas that are already dealing with issues of overcrowding, infrastructure and high cost of living. As a result, most people are forced to seek shelter in slums and urban fringe. United Nation Habitat in 2006 found that 90% of slum residents are in the developing countries with struggling economies. In addition, most urban settings were not designed to handle millions of people which directly impact the availability and affordability of housing, forcing millions to live in substandard dwellings with poor housing quality [22]. This is

Indoor air is defined as the air within an indoor environment, coupled with the quality of housing that remains as major players in ascertaining the wellness and healthy living of occupants. However, the influence of one in ascertaining the state of the other cannot be overemphasized. Housing is said to be of diminished quality, if it does not have basic facilities, infrastructure and services such as adequate space, ventilation, waste collection and disposal facility, sanitation, electricity, water supply and general environmental quality [23, 24], which are important agents that impair the air quality in an indoor environment. A number of factors that include the origination of indoor pollutants such as human activities, building materials and carpets; and pollutants penetration from outdoor environments by forced ventilation, diffusion or infiltration, have been said to dictate the inevitability of human exposure to air

mainly because substandard accommodation in the urban areas is very cheap.

Respiratory problems refer to as the disorders of the airways and lungs that affect human respiration have been reported to be a major cause of mortality and morbidity among Nigerian children (**Table 3**). Acute respiratory infections (ARIs) are group of heterogeneous diseases caused by a diverse group of organisms in which the anatomical site(s) involved consists of the airways from the nostrils, pharynx down to the alveoli [28, 29]. In most developing countries including Nigeria, the burden of respiratory disease is largely unknown; however, on an average, it was reported that every child has about 5 to 6 episodes of ARI in a year accounting for about 30–50% of the total paediatric outpatient visits [30, 31]. Data from national demographic health survey 2013 reported the prevalence of ARIs in Nigeria to be about 2% [32].

In a study conducted by [33] between the year 2000 and 2003, it was reported that pneumonia accounted for 20% of deaths in children under the age of 5 years in Nigeria. However, there is a seasonal variation in acute respiratory infections in Nigerian children with more episodes occurring during the rainy season [34]. Few studies have also investigated the etiology of pneumonia in Nigerian adults. A retrospective study of 3671 adults cases seen at the emergency room at the Federal Medical Centre Ido-Ekiti in South-Western Nigeria showed that 368 adults had respiratory diseases out of which 127 (34.5%) had pneumonia, 108 (29.4%) had complicated and uncomplicated PTB, 90 (24.5%) had acute asthma attack while 38 (10.3%) had acute


exacerbation of Chronic Obstructive Pulmonary Diseases (COPD) (**Table 4**) [35]. A study of 74 patients with pneumonia in Zaria, Northern Nigeria, however, showed that 50% had positive pneumococcal polysaccharide antigen and 16.2% had *Mycoplasma pneumonia* [36]. A prospective cohort study carried out in Ilorin, Nigeria, reported that the rate of acute respiratory infection was three episodes per child per year with pneumonia being responsible for 1.3 episodes per child per year [33]. In another hospital-based study in Ibadan, 28.4% of children admitted to the hospital with acute lower respiratory tract infection had acute bronchiolitis with respiratory syncytial virus being the most common viral etiological agent [35]. WHO [37] reported that about 20% of all deaths in children under 5 years are due to Acute Lower Respiratory Infections (ALRIs - pneumonia, bronchiolitis and bronchitis); 90% of these deaths are due to pneumonia.

Housing Quality and Risk Factors Associated with Respiratory Health Conditions in Nigeria

http://dx.doi.org/10.5772/intechopen.78543

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**9. Meteorological conditions of houses in relation to respiratory** 

**10. Housing risk factors for respiratory conditions**

**Table 5.** Relationship between meteorological condition of the indoor environment and ARI.

**Measurement Category/score Case**

Meteorological conditions refer to the prevailing environmental conditions as they influence the prediction of weather. A case-control study carried out among children under the age of 5 years with and without ARI in Ibadan revealed that a higher proportion of houses visited recorded a relative humidity (RH) value above the comfort level (30–60%) (**Table 5**) [17]. This high RH (above comfort level) observed among a large proportion of houses among cases could be as a result of high moisture content. With such high relative humidity levels, microorganisms such as fungi and bacteria can survive on non-living materials including dusts [38]. High relative humidity above 70% also tends to favour the survival of viruses that infect the membrane of the respiratory tract.

**Comfort High** *P*

High 42 (72.4%) 16 (27.6%)

High 40 (64.5%) 22 (35.5%)

Numerous studies have shown that people who live in poor housing are at increased risk of exposure to the determinants of respiratory diseases [39]. A substandard housing may increase exposures to biological (e.g., moulds, mites, roaches), chemical (e.g., lead, carbon monoxide, volatile organic compounds), and physical (e.g., extreme temperature, fine particles, radon) hazards leading to a wide range of adverse health outcomes, especially respiratory diseases [40–43]. Adequate

Temperature Controls Comfort 4 (50.0%) 4 (50.0%) 0.00

Relative humidity Controls Comfort 2 (50.0%) 2 (50.0%) 0.00

**conditions**

Source: Fakunle et al. [17].

Source: Akanbi et al., 2009.

**Table 3.** Classification of respiratory disease.


**Table 4.** Respiratory diseases seen at the emergency room of the Federal Medical Centre Ido-Ekiti, south western, Nigeria, from November 2004 to December 2010.

exacerbation of Chronic Obstructive Pulmonary Diseases (COPD) (**Table 4**) [35]. A study of 74 patients with pneumonia in Zaria, Northern Nigeria, however, showed that 50% had positive pneumococcal polysaccharide antigen and 16.2% had *Mycoplasma pneumonia* [36]. A prospective cohort study carried out in Ilorin, Nigeria, reported that the rate of acute respiratory infection was three episodes per child per year with pneumonia being responsible for 1.3 episodes per child per year [33]. In another hospital-based study in Ibadan, 28.4% of children admitted to the hospital with acute lower respiratory tract infection had acute bronchiolitis with respiratory syncytial virus being the most common viral etiological agent [35]. WHO [37] reported that about 20% of all deaths in children under 5 years are due to Acute Lower Respiratory Infections (ALRIs - pneumonia, bronchiolitis and bronchitis); 90% of these deaths are due to pneumonia.
