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Title: The MEDEA childhood asthma study design for mitigation of desert dust health effects: implementation of novel methods for assessment of air pollution exposure and lessons learned
Authors: Kouis, Panayiotis 
Papatheodorou, Stefania 
Kakkoura, Maria G. 
Middleton, Nicos 
Galanakis, Emmanuel 
Michaelidi, Eleni 
Achilleos, Souzana 
Mihalopoulos, Nikolaos 
Neophytou, Marina 
Stamatelatos, Gerasimos 
Kaniklides, Christos 
Revvas, Efstathios 
Tymvios, Filippos 
Savvides, Chrysanthos 
Koutrakis, Petros 
Yiallouros, Panayiotis K. 
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Asian dust;Asthma;Children;Desert dust;Public health intervention
Issue Date: Dec-2021
Source: BMC Pediatrics, 2021, vol. 21, no. 1, articl. no. 13
Volume: 21
Issue: 1
Journal: BMC Pediatrics 
Abstract: Background: Desert dust events in Mediterranean countries, originating mostly from the Sahara and Arabian deserts, have been linked to climate change and are associated with significant increase in mortality and hospital admissions from respiratory causes. The MEDEA clinical intervention study in children with asthma is funded by EU LIFE+ program to evaluate the efficacy of recommendations aiming to reduce exposure to desert dust and related health effects. Methods: This paper describes the design, methods, and challenges of the MEDEA childhood asthma study, which is performed in two highly exposed regions of the Eastern Mediterranean: Cyprus and Greece-Crete. Eligible children are recruited using screening surveys performed at primary schools and are randomized to three parallel intervention groups: a) no intervention for desert dust events, b) interventions for outdoor exposure reduction, and c) interventions for both outdoor and indoor exposure reduction. At baseline visits, participants are enrolled on MEDena® Health-Hub, which communicates, alerts and provides exposure reduction recommendations in anticipation of desert dust events. MEDEA employs novel environmental epidemiology and telemedicine methods including wearable GPS, actigraphy, health parameters sensors as well as indoor and outdoor air pollution samplers to assess study participants’ compliance to recommendations, air pollutant exposures in homes and schools, and disease related clinical outcomes. Discussion: The MEDEA study evaluates, for the first time, interventions aiming to reduce desert dust exposure and implement novel telemedicine methods in assessing clinical outcomes and personal compliance to recommendations. In Cyprus and Crete, during the first study period (February–May 2019), a total of 91 children participated in the trial while for the second study period (February–May 2020), another 120 children completed data collection. Recruitment for the third study period (February–May 2021) is underway. In this paper, we also present the unique challenges faced during the implementation of novel methodologies to reduce air pollution exposure in children. Engagement of families of asthmatic children, schools and local communities, is critical. Successful study completion will provide the knowledge for informed decision-making both at national and international level for mitigating the health effects of desert dust events in South-Eastern Europe. Trial registration: NCT03503812, April 20, 2018.
ISSN: 1471-2431
DOI: 10.1186/s12887-020-02472-4
Rights: © The Author(s). 2021 Open Access
Type: Article
Affiliation : University of Cyprus 
Shiakolas Educational Center of Clinical Medicine 
Cyprus University of Technology 
Harvard T.H. Chan School of Public Health 
University of Oxford 
University of Crete 
E.n.A Consulting LP 
Cyprus Broadcasting Corporation 
Ministry of Agriculture, Natural Resources and Environment, Cyprus 
Ministry of Labor, Welfare and Social Insurance 
Appears in Collections:Άρθρα/Articles

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