Over 3 billion people particularly in low-middle income countries rely on biomass fuel as their primary source of domestic energy. Indoor air pollution from combustion of biomass fuels accounts for 1.6 million deaths yearly with 50% of deaths occurring in children due to acute respiratory tract infections and an estimated healthcare cost of USD $10 billion annually. Numerous studies have reported the association between indoor air pollution and respiratory tract infections in children.
The aim of the review is to investigate the association between indoor air pollution from biomass fuels and respiratory diseases (acute lower respiratory infections and asthma) in children under 18 years. It also aims to examine mortality rates from acute respiratory tract infections.
Methods
Design: A systematic review of cohort and case-control studies was conducted.
Data Sources: Five peer reviewed databases; MEDLINE, EMBASE, CINAHL, Web of Science and Global Health were searched with no date limits or language restrictions. Reference lists were also searched to identify studies.
Review Methods: Eligible studies were published cohort or case-control studies that reported outcomes which include acute lower respiratory infections or asthma in children due to exposure to indoor air pollution from household use of biomass fuels. All children under 18 years were eligible with no geographic restrictions. Two reviewers independently checked papers to ensure they met eligibility criteria. The Newcastle-Ottawa scale was used to assess quality of studies. Both quality assessment and data extraction were conducted independently by two reviewers and disagreements were settled by consensus. Homogeneous studies were analysed using meta- analysis in a random effects model. Publication bias and heterogeneity of studies were tested.
Results
A total of 13523 studies were identified and 24 studies (21 case-control and 3 cohort studies) were included in the review after they met inclusion criteria. Out of the selected studies, 18 reported acute lower respiratory infections, 3 reported deaths from acute lower respiratory infections and 3 reported asthma; all attributable to biomass fuel exposure. The studies enrolled a total of 11745 participants within the age group of 0 months to 17 years. 18 studies were suitable for meta-analysis. The overall pooled estimates showed significant associations of biomass fuel exposure with acute lower respiratory infections (OR 1.65; 95% confidence interval 1.09 to 2.22); deaths from acute lower respiratory infections (OR 2.89; 95% confidence interval 1.63 to 4.12) and statistically non-significant association with asthma (OR 1.36; 95% confidence interval -0.31 to 3.02) in children.
Conclusion
Exposure to biomass fuel is associated with increased odds of acute lower respiratory tract infections in children irrespective of geographic locations but especially in low-middle income countries. This emphasizes the need for increased efforts to reduce biomass fuel exposure through interventions such as provision of cook stoves with improved designs that allow effective reduction of smoke emission within households.
Dahiru, Z. (2018). A systematic review and meta-analysis on the association between indoor air pollution from household use of biomass fuels and respiratory diseases in children under 18 years. Afribary. Retrieved from https://afribary.com/works/association-between-indoor-air-pollution-from-household-use-of-biomass-fuels-and-respiratory-diseases-in-children-under-18-years-a-systematic-review-and-meta-analysis
Dahiru, Zainab Ahmed "A systematic review and meta-analysis on the association between indoor air pollution from household use of biomass fuels and respiratory diseases in children under 18 years" Afribary. Afribary, 12 May. 2018, https://afribary.com/works/association-between-indoor-air-pollution-from-household-use-of-biomass-fuels-and-respiratory-diseases-in-children-under-18-years-a-systematic-review-and-meta-analysis. Accessed 22 Dec. 2024.
Dahiru, Zainab Ahmed . "A systematic review and meta-analysis on the association between indoor air pollution from household use of biomass fuels and respiratory diseases in children under 18 years". Afribary, Afribary, 12 May. 2018. Web. 22 Dec. 2024. < https://afribary.com/works/association-between-indoor-air-pollution-from-household-use-of-biomass-fuels-and-respiratory-diseases-in-children-under-18-years-a-systematic-review-and-meta-analysis >.
Dahiru, Zainab Ahmed . "A systematic review and meta-analysis on the association between indoor air pollution from household use of biomass fuels and respiratory diseases in children under 18 years" Afribary (2018). Accessed December 22, 2024. https://afribary.com/works/association-between-indoor-air-pollution-from-household-use-of-biomass-fuels-and-respiratory-diseases-in-children-under-18-years-a-systematic-review-and-meta-analysis