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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Kelly, MS; Wirth, KE; Madrigano, J; Feemster, KA; Cunningham, CK; Arscott-Mills, T; Boiditswe, S; Shah, SS; Finalle, R; Steenhoff, AP

Published Date

  • March 2015

Published In

Volume / Issue

  • 19 / 3

Start / End Page

  • 349 - 355

PubMed ID

  • 25686146

Pubmed Central ID

  • PMC4352146

Electronic International Standard Serial Number (EISSN)

  • 1815-7920

Digital Object Identifier (DOI)

  • 10.5588/ijtld.14.0557


  • eng

Conference Location

  • France