Household air pollution from solid fuels and its association with diarrhoea among children under five in Pakistan:
Muhammad Amjad1, Wen-Wen Bao1, Zhao-Huan Gui1
1Department of Occupational and Environmental Health, Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Insights
Household air pollution from cooking fuels significantly increases child diarrhoea risk in Pakistan. Transitioning to clean cooking fuels is vital for reducing childhood illness and mortality.
Area of Science:
- Environmental Health
- Pediatric Public Health
- Epidemiology
Background:
- Pakistan faces high child mortality from diarrhoea, a leading cause of under-five deaths in South Asia.
- The impact of household air pollution (HAP) from traditional cooking fuels on childhood diarrhoea remains under-researched in the region.
Purpose of the Study:
- To investigate the association between exposure to polluting cooking fuels and the risk of diarrhoea in children under five years old in Pakistan.
- To identify specific cooking fuels contributing most significantly to childhood diarrhoea incidence.
Main Methods:
- Utilized data from the Pakistan Demographic and Health Survey (PDHS) 2017-18, including 11,947 children.
- Employed multivariable logistic regression models, adjusting for socioeconomic, child, maternal, nutritional, and water, sanitation, and hygiene (WASH) factors.
- Assessed diarrhoea prevalence via maternal self-reports and HAP exposure through the household's primary cooking fuel.
Main Results:
- Diarrhoea was reported in 17.6% of children (2107 out of 11,947).
- Exposure to polluting cooking fuels was significantly associated with increased odds of childhood diarrhoea (OR: 1.13, 95% CI: 1.03-1.25, P=0.013).
- Households using animal dung as fuel showed the highest odds of diarrhoea (OR: 1.41, 95% CI: 1.06-1.84, P=0.015), with stronger associations in infants, stunted children, and those born to uneducated mothers.
Conclusions:
- Cooking with solid fuels is a significant risk factor for childhood diarrhoea in Pakistan.
- Promoting a transition to clean cooking fuels is a critical public health intervention to mitigate childhood diarrhoea burden.
- Addressing HAP is essential for improving child survival rates in Pakistan and similar low-resource settings.
Abstract:
Pakistan has the highest child diarrhoea mortality in South Asia, but the impact of household air pollution from polluting cooking fuels remains understudied. This study explores the association between exposure to such fuels and the odds of diarrhoea in children under five, using PDHS 2017-18 data. Diarrhoea prevalence was based on maternal self-reports of episodes in the past two weeks. Household air pollution exposure was measured using the household's primary cooking fuel. Multivariable logistic regression models were applied, adjusting for socioeconomic, child, maternal, nutritional, and water, sanitation, and hygiene factors. Among 11,947 children included, diarrhoea was reported in 2107 (17.6%). In the fully adjusted model, exposure to polluting cooking fuels was associated with higher odds of diarrhoea (OR: 1.13, 95% CI: 1.03-1.25, P-value = 0.013). Fuel-specific analysis showed that children in households using animal dung had the highest odds of diarrhoea (OR: 1.41, 95% CI: 1.06-1.84, P-value = 0.015). Subgroup analyses showed the strongest association among infants under 1 year, children with stunting, and those born to uneducated mothers. This study found that cooking with solid fuels increases childhood diarrhoea in Pakistan. Transitioning to clean fuels is crucial for public health in Pakistan and similar countries to reduce this burden.
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