Childhood illness in households using biomass fuels in India: secondary data analysis of nationally representative national family health surveys
Childhood illness in households using biomass fuels in India: secondary data analysis of nationally representative national family health surveys
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DOI：
10.1179/2049396712y.0000000013
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发表时间：
2013-03-01
影响因子：
--
通讯作者：
Hibberd, Patricia L.
中科院分区：
文献类型：
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作者：
Patel, Archana B.;Dhande, Leena A.;Hibberd, Patricia L.
背景：世界上一半的人口使用固体燃料作为能源和烹饪，每年导致150万人死亡，其中约三分之一发生在印度。大多数死亡与儿童肺炎或急性下呼吸道感染(ALRI)有关，这些情况很难诊断。生物质燃烧对儿童疾病的总体影响尚不清楚。目的：评估家用燃料类型是否与0-36个月儿童的ALRI(咳嗽和呼吸困难)、腹泻或发烧症状有关。方法：我们分析了1992-2006年间在印度进行的三次全国家庭健康调查中具有全国代表性的0-36个月儿童家庭样本。家庭被分为使用低污染燃料(液化石油气/电力)、中等污染燃料(煤/煤油)或高污染燃料(主要是木材/农业废物)。结果：印度高污染燃料(HPF)的使用变化最小(82%至78%)，而低污染燃料(LPF)的使用从8%增加到18%。HPF与ALRI一致相关[调整后的优势比(95%可信区间)：1992-3为1.48(1.08-2.03)；1998-9为1.54(1.33-1.77)；2005-6为1.53(1.21-1.93)]。在前两次调查中，发热与HPF有关，但在第三次调查中没有。结论：在印度，迫切需要增加LPF或同等清洁家庭燃料的使用，以减轻与IAP相关的儿童疾病的负担。
Background: Half of the world's population uses solid fuels for energy and cooking, resulting in 1.5 million deaths annually, approximately one-third of which occur in India. Most deaths are linked to childhood pneumonia or acute lower respiratory tract infection (ALRI), conditions that are difficult to diagnose. The overall effect of biomass combustion on childhood illness is unclear.Objectives: To evaluate whether type of household fuel is associated with symptoms of ALRI (cough and difficulty breathing), diarrhea or fever in children aged 0-36 months.Methods: We analyzed nationally representative samples of households with children aged 0-36 months from three national family health surveys conducted between 1992 and 2006 in India. Households were categorized as using low (liquid petroleum gas/electricity), medium (coal/kerosene) or high polluting fuel (predominantly wood/agricultural waste). Odds ratios adjusted for confounders for exposure to high and medium polluting fuel were compared with low polluting fuel (LPF).Results: Use of high polluting fuel (HPF) in India changed minimally (82 to 78 %), although LPF use increased from 8% to 18%. HPF was consistently associated with ALRI [ adjusted odds ratio (95% confidence interval) 1.48 (1.08-2.03) in 1992-3; 1.54 (1.33-1.77) in 1998-9; and 1.53 (1.21-1.93) in 2005-6). Fever was associated with HPF in the first two surveys but not in the third survey. Diarrhea was not consistently associated with HPF.Conclusions: There is an urgent need to increase the use of LPF or equivalent clean household fuel to reduce the burden of childhood illness associated with IAP in India.