Biomass fuel use and acute respiratory tract infection among under five children in rural areas of Pakistan

Objectives: To evaluate the association of biomass fuel use and respiratory illness episodes in under 5 children in Pakistan.

Methods: We conducted a cross-sectional study during July – October 2007 in a rural sub-district in Sindh Province of Pakistan. We selected 566 children from 379 households using cluster survey technique. We interviewed mothers about number of respiratory complaint episodes, days of illness, symptoms and care seeking during past one month. We also collected information about type of fuel use, observation of kitchen layout, and socio-demographic factors. We used Poisson regression with robust variance to assess the association between biomass fuel use and the number of respiratory episodes.

Results: Rate of respiratory complaints during past one month was 0.59 per child per month. Multivariable model revealed that after adjusting for child's age, wealth index, household density, children in households using wood, dung, or straw for cooking were more likely to suffer from ARI as compared to children from households using LPG/natural gas (PR= 1.61, 95% CI: 1.28- 2.03). Children always accompanying mother to kitchen during cooking were about twice more likely to suffer from ARI (PR: 1.88, 95% CI: 1.21- 2.92) in comparison to those who accompany never to some time. Children in families where some one smoked were also more likely to suffer from higher episodes of ARI (PR: 1.43, 95% CI: 1.20- 1.72).

Conclusion: Use of biomass fuel and environmental tobacco smoke were associated with higher episodes of acute respiratory illness in the children in Pakistan.