Solid fuel use and pneumonia risk in children

November 12, 2010 · 0 comments

WHO Bulletin, Volume 86, Number 5, May 2008, 321-416

Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: a systematic review and meta-analysis

Full-text: http://www.who.int/bulletin/volumes/86/5/07-044529.pdf

Mukesh Dherani, Daniel Pope, Maya Mascarenhas, Kirk R Smith, Martin Weber, Nigel Bruce

Reduction of indoor air pollution (IAP) exposure from solid fuel use is a potentially important intervention for childhood pneumonia prevention. This review updates a prior meta-analysis and investigates whether risk varies by etiological agent and pneumonia severity among children aged less than 5 years who are exposed to unprocessed solid fuels. Searches were made of electronic databases (including Africa, China and Latin America) without language restriction. Search terms covered all sources of IAP and wide-ranging descriptions of acute lower respiratory infections, including viral and bacterial agents.

From 5317 studies in the main electronic databases (plus 307 African and Latin American, and 588 Chinese studies, in separate databases), 25 were included in the review and 24 were suitable for meta-analysis. Due to substantial statistical heterogeneity, random effects models were used. The overall pooled odds ratio was 1.78 (95% confidence interval, CI: 1.45–2.18), almost unchanged at 1.79 (95% CI: 1.26–2.21) after exclusion of studies with low exposure prevalence (< 15%) and one high outlier. There was evidence of publication bias, and the implications for the results are explored. Sensitivity subanalyses assessed the impact of control selection, adjustment for confounding, exposure and outcome assessment, and age, but no strong effects were identified. Evidence on respiratory syncytial virus was conflicting, while risk for severe or fatal pneumonia was similar to or higher than that for all pneumonia.

Despite heterogeneity, this analysis demonstrated sufficient consistency to conclude that risk of pneumonia in young children is increased by exposure to unprocessed solid fuels by a factor of 1.8. Greater efforts are now required to implement effective interventions.

Perinatal interventions and survival in resource-poor settings

November 12, 2010 · 1 comment

Arch Dis Child doi:10.1136/adc.2009.179366, Oct 2010

Perinatal interventions and survival in resource-poor settings: which work, which don’t, which have the jury out?

David Osrin, Audrey Prost. Email: d.osrin@ich.ucl.ac.uk

Perinatal conditions make the largest contribution to the burden of disease in low-income countries. Although postneonatal mortality rates have declined, stillbirth and early neonatal mortality rates remain high in many countries in Africa and Asia, and there is a concentration of mortality around the time of birth. Our article begins by considering differences in the interpretation of ‘intervention’ to improve perinatal survival. We identify three types of intervention: a single action, a collection of actions delivered in a package and a broader social or system approach. We use this classification to summarise the findings of recent systematic reviews and meta-analyses.

After describing the growing evidence base for the effectiveness of community-based perinatal care, we discuss current concerns about integration: of women’s and children’s health programmes, of community-based and institutional care, and of formal and informal sector human resources. We end with some thoughts on the complexity of choices confronting women and their families in low-income countries, particularly in view of the growth in non-government and private sector healthcare.

Indoor Air Pollution at the Household Level in Tamil Nadu

November 12, 2010 · 0 comments

The Economic Cost of Health Problems due to Indoor Air Pollution at the Household Level in Tamil Nadu, 2010.

Download full-text (pdf, 149KB)

Dr.B.P. Chandramohan, drbpcm@yahoo.co.in; Mr.T.K.S. Villalan, S. Karthikeyan

The use of polluting fuels for cooking poses a major health burden on members of poor households in developing countries. The dependence of biomass is both a cause and consequence of poverty. Reliance on this dirty fuel for cooking can compromise health thereby hold back economic development creating vicious
circle of poverty. Traditionally women take the responsibility of cooking and often they carry children on back close to warm hearth, exposed to vulnerable and hazardous pollutants. Since firewood is obtained from various sources, each source implies varied influence on the quantity and quality of fuel used. The use of different types of biomass result in different levels of indoor air pollutants causes severe health problems such as Acute Respiratory Infections, lung disease, tuberculosis, asthma, blindness and adverse pregnancy outcomes.

The present paper tries to assess the influence of the supply source of fuel woods on the fuel consumption pattern of selected households. The probability of household members affected severely by indoor air pollution will be examined. The cost of illness of households due to indoor air pollution will be analysed with the help of various socio-economic, locational and housing characteristics. The objective assessment of the damages incurred to the households using fuel wood by adopting cost of illness approach will be attempted

Biofuel Smoke and Child Anemia in 29 Developing Countries

November 12, 2010 · 2 comments

Annals of Epidemiology, Volume 20, Issue 11, November 2010, 811-817

Biofuel Smoke and Child Anemia in 29 Developing Countries: A Multilevel Analysis

Hmwe Hmwe Kyu MPH, Katholiki Georgiades PhD and Michael H. Boyle PhD

Purpose – In this study we examined the effect of biofuel smoke exposure at the national and child levels on child anemia.

Methods – Data are from Demographic and Health Surveys conducted between 2003 and 2007. The respondents were women (15−49 years) and their children (0−59 months) (n = 117,454) in 29 developing countries.

Results – In multinomial logistic regression models, both moderate and high exposure to biofuel smoke at the country level are associated with moderate/severe anemia (odds ratio [OR], 2.36; 95% confidence interval [95% CI], 1.28−4.36 vs OR, 2.80; 95% CI, 1.37−5.72) after adjusting for covariates. Exposure to biofuel smoke at home is associated with mild anemia (OR, 1.07; 95% CI, 1.01−1.13), and there are interactions between biofuel smoke exposure and child age in months on mild anemia (OR, 1.004; 95% CI, 1.002−1.006) and moderate/severe anemia (OR, 1.006; 95% CI, 1.004−1.008). There are also interactions between biofuel smoke exposure at home and diarrhea on mild anemia (OR, 1.22; 95% CI, 1.10−1.34) and on moderate/severe anemia (OR, 1.11; 95% CI, 1.01−1.22); and fever on moderate/severe anemia (OR, 1.33; 95% CI, 1.22−1.45).

Conclusions – Given the increasing number of people relying on biofuels in developing countries, policies and programs are necessary to protect children from being exposed to this harmful smoke at home.

Thinking About Clean Cookstoves on World Pneumonia Day

November 12, 2010 · 0 comments

Nov 12, 2010 – Mark Leon Goldberg

The UN Foundation (which supports this blog) is a member of the alliance, as is the United States Centers for Disease Control and Prevention and a number of other public and private organizations.  I recently caught up with Dr. Henry Falk a distinguished fellow at the CDC and the immediate past Director of the CDC’s National Center for Environmental Health and Michael Sage, a Senior Advisor for Global Environmental Health, also with the National Center for Environmental Health at the CDC.   We talked about Pneumonia’s impact in the developing world and how clean cookstoves can make a difference.  Have a listen.

http://www.undispatch.com/thinking-about-clean-cookstoves-on-world-pneumonia-day

 

PCIA Bulletin Issue 25, November 2010

November 8, 2010 · 0 comments

PCIA Bulletin Issue 25

Full-text: http://www.pciaonline.org/bulletin/pcia-bulletin-issue-25

This issue (in English and Spanish) is dedicated to the upcoming 5th Biennial PCIA Forum, to be held in Lima, Peru from February 21 – 26, 2011. Some 262 Partners from 35 countries gathered for the 4th Biennial Forum (2009) in Kampala, Uganda and we expect an even larger turnout for the 2011 event! You don’t want to miss out on this extraordinary networking and learning opportunity.

– 2011 PCIA Forum Overview
– What is the Forum?
– Peru’s National Stove Campaign
– Who comes to the Forum?
– What happens at the Forum?
– What will I get out of the Forum?
– What can I contribute to the Forum?
– Logistics Highlights
– Frequently Asked Questions
– Spotlight on the PCIA Awards Program
– Upcoming Events

Kirk Smith – What's Cooking? A Brief Update

November 8, 2010 · 0 comments

Smith KR, What’s Cooking? A Brief Update, Energy for Sustainable Development (2010), doi:10.1016/j. esd.2010.10.002

Full-text: http://ehs.sph.berkeley.edu/krsmith/publications/2010/ESD_whats_cooking.pdf (pdf, 89KB)

Extensive world press coverage attended the speech by US Secretary of State Hillary Clinton on September 21, 2010 announcing the Global Alliance for Clean Cookstoves. The Alliance, which is coordinated through the United Nations Foundation (UNF), is a unique and innovative combination of founding partner organizations that signed up to the goal of providing 100 million clean cookstoves by 2020. Its objective is to reduce the significant health and other impacts of current use of household biomass fuels in the world’s poorest households. As of the launch, some US$60 million had been committed to the Alliance of the $250 million goal.

The range of activities that the Alliance will undertake to supportits goal has not yet been worked out in detail, but initial indications inpublic announcements and press interviews with principals indicatethat the primary focus will be to support the development of a robustglobal stove industry and market through standard setting, technicalexchange, lobbying for reductions in tariffs and duties, and potentiallyconcessionary loans and other financial incentives. The premise is thatthe private sector provides a well-tested means to achieve sustainableproduction and dissemination of household appliances, including gasand electric cookstoves, in the long term.

Benin – Exposure to combustion of solid fuel and tuberculosis

November 8, 2010 · 1 comment

European Respiratory Journal, Oct 2010

Exposure to combustion of solid fuel and tuberculosis: a matched case-control study

M. Gninafon*, et al.

The study was conducted in Benin to ascertain the association between exposure to combustion of solid fuel (coal and biomass) and tuberculosis.

Cases were consecutive sputum smear positive tuberculosis patients never previously treated for tuberculosis for as much as one month. Two controls were selected from the neighborhood of each case matched by age and sex by a pre-defined procedure.

A total of 200 new smear positive cases and 400 neighborhood controls were enrolled. In univariate analysis, using solid fuel for cooking (Odds Ratio (OR) 1.7, 95% CI 1.1–2.8), ever smoking (OR 5.5, 95% CI 3.1–9.8), male sex (OR 10.5, 95% CI 1.6–71.1), daily use of alcohol beverage (OR 2.3, 95% CI 1.2–4.2) and having a family member with tuberculosis in the previous 5 years (OR 30.5, 95% CI 10.8–85.8) were all significantly associated with tuberculosis cases. When all significant variables were entered into a multivariate conditional logistic regression model, the association between using solid fuel for cooking and tuberculosis cases was no longer statistically significant (adjusted OR 1.4, 95% CI 0.7–2.7).

In conclusions, the association between exposure to combustion of solid fuel and tuberculosis was relatively weak and not statistically significant.

Study of indoor air pollution from household fuels in Gaborone, Botswana

November 8, 2010 · 1 comment

Journal of African Earth Sciences, Volume 58, Issue 4, November 2010, Pages 648-651

Study of indoor air pollution from household fuels in Gaborone, Botswana

T.S. Verma, a, , S. Chimidzaa and T. Molefhia. a Department of Physics, University of Botswana, Pvt. Bag 00704, Gaborone, Botswana

This study monitored indoor air concentrations of CO and particulate matter of size range 0.3–5.0 μm in 30 households representing different income groups from July to September 2007. Selected members of the households were interviewed to assess health effects resulting from the fuel used. Fuels that produced more particles, especially those having the smallest diameters (0.3–0.5 μm), were found in the low income group household.

People from these households reported more health effects when compared with those in the medium and high groups. The fuels that emitted most particles produced more than 10 times more particulate matter than the least emitting fuels. The particle number distributions for the different fuels studied were investigated and the corresponding surface area and volume distributions derived. Both the surface area and volume distributions were found to be bimodal with peaks around 0.5 μm and 2.0 μm.

Biogas plants improve life for rural families in Nepal

November 2, 2010 · 1 comment

Oct 26, 2010 – Many countries in the world lack the infrastructure needed to provide populations in remote regions with heat and light. For half the world’s population, meals are cooked on an open fire fueled by wood, coal, dung, and other smoke-producing combustibles. This not only adversely affects the health of rural populations, it also consumes large amounts of fuel and releases high levels of carbon dioxide. Now, however, there is an alternative.

These days, biogas plants are providing a mainstream renewable energy solution in rural Nepal, allowing people to produce methane by fermenting human and animal waste. Biogas units provide a cleaner and safer source of energy, enabling rural families to produce their own electricity, heat, and fertilizer.

The convenience
One advantage of these plants is that they can be used in exactly the place they’re needed, thereby averting the need for extensive, costly power landlines. They are easy to assemble, user-friendly, and depend on nothing more than fuel naturally supplied by domestic waste.

In developing countries, domestic biogas plants are used first and foremost to meet the immediate needs of rural populations in regions without infrastructure.

It’s an efficient principle, says Andreas Michel, energy expert with the German Technical Cooperation (GTZ). “The dung produced by two or three cows per day is sufficient to make enought methane gas for five hours of cooking or light,” he explains. In recent years, the GTZ has helped fund the installaton of several hundred biogas plants in developing countries such as Bolivia and Rwanda. The nations with the highest number of biogas plants are China, Botswana and India.

According to GTZ research, domestic biogas plants represent the optimal application of biogas production systems. Although larger plants can generate enough electricity to supply entire villages – and are usually installed within existing farms, where a steady supply of biomass can be guaranteed – the benefit of domestic plants in terms of cooking and heating are more significant.

The WWF is currently co-funding the installation of 7,500 biogas methane generators in individual households in Nepal. It estimates that each unit can help save an average 4.5 tonnes of firewood and therefore almost four tonnes of CO2 emmissions per year. As Andreas Michel explains, health improves as a result of less particulate matter in the indoor air. A further benefit is that the slurry generated during production can be used as fertilizer for the fields.

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