Assessment of biomas fuel use and its association with acute respiratory infections among under-five children in Zambia

Abstract

Around 3 billion people cook and heat food in their homes using biomass fuels like wood, crop wastes, charcoal, coal and dung. Up to 81% of Sub Sahara Africa (SSA) relies on biomass fuel for cooking. In Zambia, about 98% of rural households and 63% in urban areas use biomass fuel as their main source of cooking energy. Research indicates that, extended exposure to high levels of biomass smoke can impair the clearing ability of the lungs and render them more susceptible to developing acute respiratory infection (ARI). ARI have been said to cause 15% of all deaths in children under the age of five and over half of these deaths occur in developing countries including Zambia. According to the 2013/14 Zambia demographic and health survey (ZDHS), ARI is the leading cause of childhood morbidity and mortality in Zambia. This was a cross-sectional study. Children below the age of five from all the 10 provinces of Zambia were recruited. Secondary data from 2013/14 ZDHS was used for the study. Analytical statistical methods were performed using STATA software version 14. Descriptive statistics were used to provide overall characteristics. Variables such as age, sex, vaccination, mothers’ education status are presented as proportions and frequencies. Bivariate analysis was done to establish association between dependent variable ARI and all the independent variables. Finally, multiple logistic regression model was performed to examine the association between our outcome of interest, ARI and biomass fuel which is our priori independent variable while controlling for other variables. The prevalence of ARI was 30% (n=2,795). After controlling for confounders like type of housing unit walls, sex of the child, nutritional status, mothers age, smoking status, marital status and wealth quantile, it was found that children in households with biomass fuel had higher odds of ARI compared to those with electricity (OR, 1.53, 95%CI 1.04- 2.27). At least 93 percent of children with ARI come from homes that rely on biomass fuel. There is therefore need to sensitize the mothers about the health problems associated biomass combustion and shift to cleaner fuels or promote stoves designed to reduce exposure to smoke. Keywords: Biomass Fuel and Acute Respiratory Infections.