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Child mortality from solid-fuel use in India: a nationally-representative case-control study.

Diego G Bassani1, Prabhat Jha, Neeraj Dhingra

  • 1Centre for Global Health Research, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada. bassanid@smh.ca

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Summary
This summary is machine-generated.

Solid fuel use in Indian households significantly increases child mortality, especially for ages 1-4, and is linked to non-fatal pneumonias. This exposure caused an estimated 128,000 child deaths in 2004, highlighting the need for reduced exposure and complementary health strategies.

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Area of Science:

  • Environmental Health
  • Pediatrics
  • Public Health

Background:

  • Solid fuel use for cooking and heating is prevalent in low and middle-income countries, including India.
  • This practice is a known contributor to child mortality, primarily from acute respiratory infections.
  • Direct estimates of solid fuel's impact on child mortality in India are limited.

Purpose of the Study:

  • To estimate the impact of household solid fuel use on child mortality in India.
  • To examine the association between solid fuel exposure and non-fatal pneumonia in children.

Main Methods:

  • A comparative analysis of household solid fuel use in 1998 was conducted.
  • Data included 6,790 child deaths and 609,601 living children from a nationally representative Indian household survey.
  • Analyses were stratified by child's gender, age group, and region, and also examined non-fatal pneumonia cases.

Main Results:

  • Solid fuel use was highly common, reported in 87% of households with child deaths and 77% of households with living children.
  • Adjusted analyses showed solid fuel use significantly increased child deaths at ages 1-4 (PR boys: 1.30; girls: 1.33).
  • Higher mortality from solid fuel exposure was observed in girls compared to boys, and associations with non-fatal pneumonia were also significant for both genders.

Conclusions:

  • Solid fuel exposure was responsible for an estimated 6% of all deaths in children aged 0-4 in India (128,000 deaths in 2004), particularly 20% of deaths in the 1-4 age group.
  • Despite modest declines, solid fuel use remains common, underscoring the need for exposure reduction strategies.
  • Complementary interventions like immunization and treatment are crucial for reducing child mortality from acute respiratory infections linked to solid fuel use.