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

Int J Tuberc Lung Dis. 2015 Mar;19(3):349-55. doi: 10.5588/ijtld.14.0557.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Botswana / epidemiology
  • Bronchodilator Agents / therapeutic use
  • Cooking
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • Humans
  • Infant
  • Male
  • Malnutrition / complications
  • Malnutrition / epidemiology
  • Multivariate Analysis
  • Pneumonia / drug therapy*
  • Pneumonia / epidemiology*
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Smoke / adverse effects*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Treatment Outcome
  • Wood*

Substances

  • Bronchodilator Agents
  • Smoke