Biomass fuel use and acute respiratory infection among children younger than 5 years in Ethiopia: a systematic review and meta-analysis

Enyew, Habtamu Demelash; Mereta, Seid Tiku; Hailu, Abebe Beyene

doi:10.1016/j.puhe.2020.12.016

Cited by 18 publications

(8 citation statements)

References 22 publications

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“…Children, too, suffer respiratory effects of household air pollution from solid biomass fuels. A recent review 17 focused on Ethiopia found that the overall pooled prevalence of acute respiratory infection in children under five, due to living in homes where cooking was done using solid biomass fuels, was 22%. Furthermore, there is a range of adverse health effects, other than respiratory, associated with solid biomass fuel exposure.…”

Section: Introductionmentioning

confidence: 99%

Characterization of fine particulate matter from indoor cooking with solid biomass fuels

et al. 2022

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Household burning of solid biomass fuels emits pollution particles that are a huge health risk factor, especially in low-income countries (LICs) such as those in Sub-Saharan Africa. In epidemiological studies, indoor exposure is often more challenging to assess than outdoor exposure. Laboratory studies of solid biomass fuels, performed under real-life conditions, are an important path toward improved exposure assessments. Using on-and offline measurement techniques, particulate matter (PM) from the most commonly used solid biomass fuels (charcoal, wood, dung, and crops residue) was characterized in laboratory settings using a way of burning the fuels and an air exchange rate that is representative of real-world settings in low-income countries.All the fuels generated emissions that resulted in concentrations which by far exceed both the annual and the 24-hour-average WHO guidelines for healthy air. Fuels with lower energy density, such as dung, emitted orders of magnitude more than, for example, charcoal. The vast majority of the emitted particles were smaller than 300 nm, indicating high deposition in the alveoli tract. The chemical composition of the indoor pollution changes over time, with organic particle emissions often peaking early in the stove operation. The chemical composition of the emitted PM is different for different biomass fuels, which is important to consider both in toxicological studies and in source apportionment efforts. For example, dung and wood yield higher organic aerosol emissions, and for dung, nitrogen content in the organic PM fraction is higher than for the other fuels. We show that aerosol mass spectrometry can be used to differentiate stove-related emissions from fuel, accelerant, and incense. We argue that further emission studies, targeting, for example, vehicles relevant for LICs and trash burning, coupled with field observations of chemical composition, would advance our understanding of air pollution in LIC. We believe this to be a necessary step for improved air quality policy. K E Y W O R D Scharcoal, indoor exposure, PM 2.5 , Sub-Saharan Africa, woodThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Characterization of fine particulate matter from indoor cooking with solid biomass fuels

et al. 2022

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“…Cleaner energy source use remains infrequent in many countries, limiting the inclusion of some countries within the analysis and these countries should encourage policies to improve cleaner energy source usage. Despite this limitation 37 LMICs and 353,802 children were included in our analyses supporting published country or regional level literature on the potential respiratory health benefit of cleaner cooking energy sources [23,[46][47][48][49].…”

Section: Discussionmentioning

confidence: 95%

A Cross-Sectional Analysis of the Association between Domestic Cooking Energy Source Type and Respiratory Infections among Children Aged under Five Years: Evidence from Demographic and Household Surveys in 37 Low-Middle Income Countries

Al-Janabi

Woolley

Thomas

et al. 2021

IJERPH

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Background: In low- and middle-income countries (LMICs), household air pollution as a result of using solid biomass for cooking, lighting and heating (HAP) is associated with respiratory infections, accounting for approximately 4 million early deaths each year worldwide. The majority of deaths are among children under five years. This population-based cross-sectional study investigates the association between solid biomass usage and risk of acute respiratory infections (ARI) and acute lower respiratory infections (ALRI) in 37 LMICs within Africa, Americas, Southeast Asia, European, Eastern Mediterranean and Western Pacific regions. Materials and methods: Using population-based data obtained from Demographic and Health surveys (2010–2018), domestic cooking energy sources were classified solid biomass (wood, charcoal/dung, agricultural crop) and cleaner energy sources (e.g., Liquid Petroleum Gas (LPG), electricity, biogas and natural gas). Composite measures of ARI (shortness of breath, cough) and ALRI (shortness of breath, cough and fever) were composed using maternally reported respiratory symptoms over the two-week period prior to the interview. Multivariable logistic regression was used to identify the association between biomass fuel usage with ARI and ALRI, accounting for relevant individual, household and situational confounders, including stratification by context (urban/rural). Results: After adjustment, in the pooled analysis, children residing in solid biomass cooking households had an observed increased adjusted odds ratio of ARI (AOR: 1.17; 95% CI: 1.09–1.25) and ALRI (AOR: 1.16; 95% CI 1.07–1.25) compared to cleaner energy sources. In stratified analyses, a comparable association was observed in urban areas (ARI: 1.16 [1.06–1.28]; ALRI: 1.14 [1.02–1.27]), but only significant for ARI among those living in rural areas (ARI: 1.14 [1.03–1.26]). Conclusion: Switching domestic cooking energy sources from solid biomass to cleaner alternatives would achieve a respiratory health benefit in children under five years worldwide. High quality mixed-methods research is required to improve acceptability and sustained uptake of clean cooking energy source interventions in LMIC settings.

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“…A systematic review of studies conducted in Ethiopia reported a prevalence of 17.3%, the predictors of which were holding the child on the back during food preparation and the use of non-energy sources for cooking [34]. Likewise, a global analysis reported that the prevalence of respiratory symptoms ranged between 3.4% and 7.9% in Africa and 12.5% in Latin America and the Caribbean [35]. e risk predictors in this study were a high level of PM 2.5 environmental contamination, low socioeconomic status, the presence of smokers in the home, and low birth weight [35].…”

Section: Prevalence Of Arismentioning

confidence: 99%

“…Likewise, a global analysis reported that the prevalence of respiratory symptoms ranged between 3.4% and 7.9% in Africa and 12.5% in Latin America and the Caribbean [35]. e risk predictors in this study were a high level of PM 2.5 environmental contamination, low socioeconomic status, the presence of smokers in the home, and low birth weight [35]. is is similar to what was found in our study, in which the highest proportion of ARIs was found among children aged one year or less than one-year-old, of unmarried or cohabiting mothers, who smoke, and with a low educational or economic level.…”

Section: Prevalence Of Arismentioning

confidence: 99%

Association between the Use of Biomass as Fuel for Cooking and Acute Respiratory Infections in Children under 5 Years of Age in Peru: An Analysis of a Population‐Based Survey, 2019

Zacarias

Cavero

Caira-Chuquineyra

et al. 2022

Journal of Environmental and Public Health

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Background. Acute respiratory infections (ARIs) are the most frequent respiratory diseases associated with the use of biomass as fuel within the home. ARIs are the main cause of mortality in children under 5 years of age. We aimed to evaluate the association between the use of biomass as cooking fuel and ARI in children under 5 years of age in Peru in 2019. Methods. A secondary data analysis of the 2019 Peru Demographic and Family Health Survey (ENDES) has been performed. The outcome variable was a history of ARI. The exposure variable was the use of biomass as fuel for cooking food. To evaluate the association of interest, generalized linear models from the Poisson family with logarithmic link function considering complex sampling to estimate crude prevalence ratio (cPR) and adjusted prevalence ratio (aPR) with their respective 95% confidence intervals have been performed. P values <0.05 were considered statistically significant. Results. A total of 16,043 children were included in the analysis. Of the total, biomass was used as fuel to cook food in the homes of 3,479 (20.0%) children. Likewise, 2,185 (14.3%) of the children had a history of ARI. In the adjusted model, it was found that children living in homes in which biomass was used as cooking fuel had a greater probability of presenting ARI (aPR = 1.13; 95% CI: 1.01–1.28). Conclusions. It has been found that biomass was used to cook food in two of every 10 households. Likewise, almost one-seventh of children under 5 years old presented an ARI. The use of biomass as a source of energy for cooking in the home was associated with a higher probability of presenting ARIs.

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Biomass fuel use and acute respiratory infection among children younger than 5 years in Ethiopia: a systematic review and meta-analysis

Cited by 18 publications

References 22 publications

Characterization of fine particulate matter from indoor cooking with solid biomass fuels

Characterization of fine particulate matter from indoor cooking with solid biomass fuels

A Cross-Sectional Analysis of the Association between Domestic Cooking Energy Source Type and Respiratory Infections among Children Aged under Five Years: Evidence from Demographic and Household Surveys in 37 Low-Middle Income Countries

Association between the Use of Biomass as Fuel for Cooking and Acute Respiratory Infections in Children under 5 Years of Age in Peru: An Analysis of a Population‐Based Survey, 2019

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