The effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana.

TitleThe effect of exposure to wood smoke on outcomes of childhood pneumonia in Botswana.
Publication TypeJournal Article
Year of Publication2015
AuthorsKelly MS, Wirth KE, Madrigano J, Feemster KA, Cunningham CK, Arscott-Mills T, Boiditswe S, Shah SS, Finalle R, Steenhoff AP
JournalInt J Tuberc Lung Dis
Volume19
Issue3
Pagination349-55
Date Published03/2015
ISSN1815-7920
Abstract

SETTING: Tertiary hospital in Gaborone, Botswana.

OBJECTIVE: To examine whether exposure to wood smoke worsens outcomes of childhood pneumonia.

DESIGN: Prospective cohort study of children aged 1-23 months meeting clinical criteria for pneumonia. Household use of wood as a cooking fuel was assessed during a face-to-face questionnaire with care givers. We estimated crude and adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for treatment failure at 48 h by household use of wood as a cooking fuel. We assessed for effect modification by age (1-5 vs. 6-23 months) and malnutrition (none vs. moderate vs. severe).

RESULTS: The median age of the 284 enrolled children was 5.9 months; 17% had moderate or severe malnutrition. Ninety-nine (35%) children failed treatment at 48 h and 17 (6%) died. In multivariable analyses, household use of wood as a cooking fuel increased the risk of treatment failure at 48 h (RR 1.44, 95%CI 1.09-1.92, P = 0.01). This association differed by child nutritional status (P = 0.02), with a detrimental effect observed only among children with no or moderate malnutrition.

CONCLUSIONS: Exposure to wood smoke worsens outcomes for childhood pneumonia. Efforts to prevent exposure to smoke from unprocessed fuels may improve pneumonia outcomes among children.

DOI10.5588/ijtld.14.0557
Alternate JournalInt. J. Tuberc. Lung Dis.
PubMed ID25686146
PubMed Central IDPMC4352146
Grant ListP30 AI045008 / AI / NIAID NIH HHS / United States
P30 AI064518 / AI / NIAID NIH HHS / United States
P30-AI045008 / AI / NIAID NIH HHS / United States
P30-AI064518 / AI / NIAID NIH HHS / United States
T32 HD060558 / HD / NICHD NIH HHS / United States