Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys
Abstract Background Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP a...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Komiyama Printing Co. Ltd
2020-11-01
|
| Series: | Environmental Health and Preventive Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12199-020-00902-4 |
| _version_ | 1818010797461209088 |
|---|---|
| author | Fanuel Meckson Bickton Latif Ndeketa Grace Thandekire Sibande Juvenal Nkeramahame Chipiliro Payesa Edith B. Milanzi |
| author_facet | Fanuel Meckson Bickton Latif Ndeketa Grace Thandekire Sibande Juvenal Nkeramahame Chipiliro Payesa Edith B. Milanzi |
| author_sort | Fanuel Meckson Bickton |
| collection | DOAJ |
| description | Abstract Background Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries. Methods We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models. Results Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03–1.71]). Children from households who cooked inside the home had higher risk of under-five mortality compared to households that cooked in separate buildings [0.85 (0.73–0.98)] or outside [0.75 (0.64–0.87)]. Lower risk of under-five mortality was also observed in breastfed children [0.09 (0.05-0.18)] compared to non-breastfed children. Conclusions HAP exposure may be associated with an increased risk of under-five mortality in sub-Saharan Africa. More carefully designed longitudinal studies are required to contribute to these findings. In addition, awareness campaigns on the effects of HAP exposure and interventions to reduce the use of biomass fuels are required in SSA. |
| first_indexed | 2024-04-14T06:00:07Z |
| format | Article |
| id | doaj.art-a0b93112b17d4d6d850dcaefebbc5503 |
| institution | Directory Open Access Journal |
| issn | 1342-078X 1347-4715 |
| language | English |
| last_indexed | 2024-04-14T06:00:07Z |
| publishDate | 2020-11-01 |
| publisher | Komiyama Printing Co. Ltd |
| record_format | Article |
| series | Environmental Health and Preventive Medicine |
| spelling | doaj.art-a0b93112b17d4d6d850dcaefebbc55032022-12-22T02:08:48ZengKomiyama Printing Co. LtdEnvironmental Health and Preventive Medicine1342-078X1347-47152020-11-0125111110.1186/s12199-020-00902-4Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveysFanuel Meckson Bickton0Latif Ndeketa1Grace Thandekire Sibande2Juvenal Nkeramahame3Chipiliro Payesa4Edith B. Milanzi5Malawi-Liverpool-Wellcome Trust Clinical Research ProgrammeMalawi-Liverpool-Wellcome Trust Clinical Research ProgrammeCollege of Medicine, University of MalawiFaculty of Medicine and Health Sciences, University of AntwerpMalawi-Liverpool-Wellcome Trust Clinical Research ProgrammeMRC Clinical Trials Unit, University College LondonAbstract Background Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries. Methods We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models. Results Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03–1.71]). Children from households who cooked inside the home had higher risk of under-five mortality compared to households that cooked in separate buildings [0.85 (0.73–0.98)] or outside [0.75 (0.64–0.87)]. Lower risk of under-five mortality was also observed in breastfed children [0.09 (0.05-0.18)] compared to non-breastfed children. Conclusions HAP exposure may be associated with an increased risk of under-five mortality in sub-Saharan Africa. More carefully designed longitudinal studies are required to contribute to these findings. In addition, awareness campaigns on the effects of HAP exposure and interventions to reduce the use of biomass fuels are required in SSA.http://link.springer.com/article/10.1186/s12199-020-00902-4Household air pollutionUnder-five mortalitySub-Saharan AfricaDemographic Health Survey |
| spellingShingle | Fanuel Meckson Bickton Latif Ndeketa Grace Thandekire Sibande Juvenal Nkeramahame Chipiliro Payesa Edith B. Milanzi Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys Environmental Health and Preventive Medicine Household air pollution Under-five mortality Sub-Saharan Africa Demographic Health Survey |
| title | Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys |
| title_full | Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys |
| title_fullStr | Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys |
| title_full_unstemmed | Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys |
| title_short | Household air pollution and under-five mortality in sub-Saharan Africa: an analysis of 14 demographic and health surveys |
| title_sort | household air pollution and under five mortality in sub saharan africa an analysis of 14 demographic and health surveys |
| topic | Household air pollution Under-five mortality Sub-Saharan Africa Demographic Health Survey |
| url | http://link.springer.com/article/10.1186/s12199-020-00902-4 |
| work_keys_str_mv | AT fanuelmecksonbickton householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys AT latifndeketa householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys AT gracethandekiresibande householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys AT juvenalnkeramahame householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys AT chipiliropayesa householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys AT edithbmilanzi householdairpollutionandunderfivemortalityinsubsaharanafricaananalysisof14demographicandhealthsurveys |