# Digital Auscultation and Pulmonary Function Testing Among Rural Bangladeshi Infants

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2020 · $92,424

## Abstract

PROJECT SUMMARY:
This is a re-submission for a National Institute of Environmental Health Sciences R21 award aiming to
comprehensively evaluate digital auscultation and pulmonary function testing among Bangladeshi infants as
innovative respiratory outcomes for future air pollution research in low-middle income countries (LMICs).
Household air pollution (HAP) is the number one environmental cause of death worldwide and disproportionally
affects the health of rural women and children in LMICs like Bangladesh. Particulate matter with an
aerodynamic diameter <2.5 µm (PM2.5) is an important indoor pollutant that is primarily generated by biomass
fuel use during cooking, heating, and lighting. Elevated PM2.5 exposure has been associated with a
substantially increased risk of child pneumonia mortality, the leading cause of infectious death in children
globally, and childhood asthma incidence, the number one chronic lung disease among children worldwide. To
date LMIC HAP research aiming to evaluate respiratory outcomes in children associated with PM2.5 exposure
has focused on the acute endpoint of World Health Organization-defined pneumonia, a diagnosis known as
poorly accurate and highly non-specific for studying pediatric respiratory health effects attributable to HAP.
We aim to generate evidence supporting digital auscultation and pulmonary function testing as feasible,
innovative, and diagnostically accurate pediatric respiratory health outcomes for inclusion in future LMIC HAP
research within the rural communities most affected by HAP. To accomplish this overall goal we will conduct a
longitudinal birth cohort study among 400 rural Bangladeshi pregnant women and their infants until the age of
two months. For Aim 1 we will systematically evaluate lung sound recording quality by community
health workers using a novel digital stethoscope during their care of rural Bangladeshi infants. We
hypothesize that >90% of sounds will meet quality criteria, high interpretation agreement will be achieved
between human listeners and also between automated computer analysis and humans, and that elevated
prenatal PM2.5 concentrations will be associated with a higher incidence of abnormal digitally recorded lung
sounds among infants. For Aim 2 we will create population reference values and evaluate the feasibility
and validity of non-invasive, unsedated lung function testing of rural Bangladeshi two month old
infants. We hypothesize that >90% of measurements will meet international validation criteria, infant lung
function testing will be feasible, and that prenatal exposure to elevated PM2.5 concentrations will be associated
with lower infant lung function.
Successful completion of the research described in this application will dramatically advance the methodology
for accurate assessment of acute and chronic child respiratory outcomes for future LMIC HAP research, and
can also serve as crosscutting methods suitable for resource-rich settings and non-HAP research in ...

## Key facts

- **NIH application ID:** 9922276
- **Project number:** 5R21ES029330-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Eric Douglass McCollum
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $92,424
- **Award type:** 5
- **Project period:** 2019-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9922276

## Citation

> US National Institutes of Health, RePORTER application 9922276, Digital Auscultation and Pulmonary Function Testing Among Rural Bangladeshi Infants (5R21ES029330-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9922276. Licensed CC0.

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