Household Air Pollution and Under-Five Mortality in Bangladesh (2004-2011)
Sabrina Naz1, Andrew Page2, Kingsley Emwinyore Agho3
1Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia. sabrinanaz@gmail.com.
Insights
Household air pollution from cooking fuel is a risk factor for child mortality in Bangladesh. Interventions targeting indoor kitchens and promoting breastfeeding can reduce child deaths.
Area of Science:
- Environmental Health
- Pediatrics
- Public Health
Background:
- Household air pollution (HAP) is a major cause of respiratory illness and mortality in children under five in Bangladesh.
- Cooking fuel emissions contribute significantly to HAP, posing a substantial public health challenge.
Purpose of the Study:
- To investigate the association between HAP from cooking fuel and mortality in neonates, infants, and children under five in Bangladesh.
- To examine how environmental and behavioral factors modify the HAP-mortality association.
Main Methods:
- Utilized Bangladesh Demographic and Health Survey (BDHS) data from 2004-2011, including 18,308 children.
- Employed multilevel logistic regression models to analyze the relationship between HAP exposure and mortality outcomes.
Main Results:
- HAP showed a significant association with neonatal mortality (OR=1.49) but not strongly with infant or under-five mortality overall.
- The association between HAP and mortality was stronger in households with indoor kitchens using polluting fuels and in women who never breastfed.
Conclusions:
- Reducing exposure to cooking fuel pollution is crucial for further decreasing under-five mortality in Bangladesh.
- Household design modifications and behavioral interventions, such as promoting breastfeeding, are recommended to mitigate HAP-related risks.
Abstract:
Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among children under five years in Bangladesh. This study investigates the association between HAP from cooking fuel and under-five mortality using Bangladesh Demographic and Health Survey (BDHS) datasets over the period 2004-2011 (n = 18,308 children), and the extent to which this association differed by environmental and behavioral factors affecting level of exposure. The association between HAP and neonatal (age between 0-28 days), infant (age between 0 and 11 months) and under-five (age between 0 and 59 months) mortality was examined using multilevel logistic regression models. HAP was not strongly associated with overall neonatal (OR = 1.49, 95% CI = 1.01-2.22, p = 0.043), infant (OR = 1.27, 95% CI = 0.91-1.77, p = 0.157) or under-five mortality (OR = 1.14, 95% CI = 0.83-1.55, p = 0.422) in the context of overall decreasing trends in under-five mortality. The association was stronger for households with an indoor kitchen using polluting fuels, and in women who had never breastfed. Reductions in exposure to pollution from cooking fuel, given it is a ubiquitous and modifiable risk factor, can result in further declines in under-five mortality with household design and behavioural interventions.
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