Impact of Locally-Produced, Ceramic Cookstoves on Respiratory Disease in Children in Rural Western Kenya

Eric M. Foote Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Eric M. Foote in
Current site
Google Scholar
PubMed
Close
,
Laura Gieraltowski Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Laura Gieraltowski in
Current site
Google Scholar
PubMed
Close
,
Tracy Ayers Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Tracy Ayers in
Current site
Google Scholar
PubMed
Close
,
Ibrahim Sadumah Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Ibrahim Sadumah in
Current site
Google Scholar
PubMed
Close
,
Sitnah Hamidah Faith Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Sitnah Hamidah Faith in
Current site
Google Scholar
PubMed
Close
,
Benjamin J. Silk Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Benjamin J. Silk in
Current site
Google Scholar
PubMed
Close
,
Adam L. Cohen Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Adam L. Cohen in
Current site
Google Scholar
PubMed
Close
,
Vincent Were Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Vincent Were in
Current site
Google Scholar
PubMed
Close
,
James M. Hughes Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by James M. Hughes in
Current site
Google Scholar
PubMed
Close
, and
Robert E. Quick Emory University School of Medicine, Atlanta, Georgia; Division of Foodborne, Waterborne, and Environmental Diseases, Atlanta, Georgia; Safe Water and AIDS Project, Kisumu, Kenya; Influenza Program, Centers for Disease Control and Prevention South Africa, Pretoria, South Africa; Kenya Medical Research Institute, Kisumu, Kenya

Search for other papers by Robert E. Quick in
Current site
Google Scholar
PubMed
Close
Restricted access

Household air pollution is a risk factor for pneumonia, the leading cause of death among children < 5 years of age. From 2008 to 2010, a Kenyan organization sold ∼2,500 ceramic cookstoves (upesi jiko) that produce less visible household smoke than 3-stone firepits. During a year-long observational study, we made 25 biweekly visits to 200 homes to determine stove use and observe signs of acute respiratory infection in children < 3 years of age. Reported stove use included 3-stone firepit only (81.8%), upesi jiko only (15.7%), and both (2.3%). Lower, but not statistically significant, percentages of children in upesi jiko-using households than 3-stone firepit-using households had observed cough (1.3% versus 2.9%, rate ratio [RR] 0.48, 95% confidence interval [CI]: 0.22–1.03), pneumonia (0.9% versus 1.7%, RR 0.60, 95% CI: 0.24–1.48), and severe pneumonia (0.3% versus 0.6%, RR 0.66, 95% CI: 0.17–2.62). Upesi jiko use did not result in significantly lower pneumonia rates. Further research on the health impact of improved cookstoves is warranted.

Author Notes

* Address correspondence to Robert E. Quick, Division of Waterborne, Foodborne, and Enteric Diseases, Centers for Disease Control and Prevention, Mailstop C09, Atlanta, GA 30333. E-mail: rxq1@cdc.gov

Financial support: This work was supported by PHS Grant (UL1 TR000454, and TL1 TR000456) from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources and National Center for Advancing Translational Sciences; Infectious Disease Society of America; Emory University's Global Health Institute; and the United States Agency for International Development.

Authors' addresses: Eric M. Foote, University of Washington School of Medicine, Seattle, WA, E-mail: efooter@gmail.com. Laura Gieraltowski, Tracy Ayers, Benjamin J. Silk, and Robert E. Quick, Division of Waterborne, Foodborne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: lax2@cdc.gov, eyk6@cdc.gov, bsilk@cdc.gov, and rxq1@cdc.gov. Ibrahim Sadumah and Sitnah Hamidah Faith, Safe Water and AIDS Project, Kisumu, Kenya, E-mails: sirahimah@yahoo.com and sitnahfaith@yahoo.com. Adam L. Cohen, Influenza Program, Centers for Disease Control and Prevention–South Africa, Pretoria, South Africa, E-mail: cohena@sa.cdc.gov. Vincent Were, Kenya Medical Research Institute, Kisian, Kenya, E-mail: vwere@ke.cdc.gov. James M. Hughes, Emory University School of Medicine, Atlanta, GA, E-mail: jmhughe@emory.edu.

  • 1.

    Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R, Eisele T, Liu L, Mathers C, 2010. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375: 19691987.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H, 2008. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ 86: 408416.

  • 3.

    Rehfuess E, Mehta S, Prüss-Üstün A, 2006. Assessing household solid fuel use: multiple implications for the Millennium Development Goals. Environ Health Perspect 114: 373.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Naeher LP, Leaderer BP, Smith KR, 2000. Particulate matter and carbon monoxide in highland Guatemala: indoor and outdoor levels from traditional and improved wood stoves and gas stoves. Indoor Air 10: 200205.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Dherani M, Pope D, Mascarenhas M, Smith KR, Weber M, Bruce N, 2008. Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: a systematic review and meta-analysis. Bull World Health Organ 86: 390398C.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Smith KR, Mehta S, Maeusezahl-Feuz M, 2004. Indoor air pollution from household use of solid fuels. Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Geneva: WHO, 14351493.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Cordes L, 2011. Igniting Change: A Strategy for Universal Adoption of Clean Cookstoves and Fuels. Washington, DC: Global Alliance for Clean Cookstoves. Available at: http://www.cleancookstoves.org/resources/fact-sheets/igniting-change.pdf. Accessed May 14, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Smith KR, McCracken JP, Weber MW, Hubbard A, Jenny A, Thompson LM, Balmes J, Diaz A, Arana B, Bruce N, 2011. Effect of reduction in household air pollution on childhood pneumonia in Guatemala (RESPIRE): a randomized controlled trial. Lancet 378: 17171726.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Silk BJ, Ochieng C, Patel MK, Sadumah I, Person B, Were V, Harris J, Otieno R, Nygren B, Loo J, 2012. A strategy to increase adoption of improved cookstoves in rural Kenyan households. BMC Public Health 12: 359.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Person B, Loo JD, Owuor M, Ogange L, Jefferds MED, Cohen AL, 2012. “It is good for my family's health and cooks food in a way that my heart loves”: qualitative findings and implications for scaling up an improved cookstove project in rural Kenya. Int J Environ Res Public Health 9: 15661580.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Kenya National Bureau of Statistics, 2010. Kenya Demographic and Health Survey 2008–09. Calverton, MD: ICF Macro.

  • 12.

    Adazu K, Lindblade KA, Rosen DH, Odhiambo F, Ofware P, Kwach J, Van Eijk AM, Decock KM, Amornkul P, Karanja D, Vulule JM, Slutsker L, 2005. Health and demographic surveillance in rural western Kenya: a platform for evaluating interventions to reduce morbidity and mortality from infectious diseases. Am J Trop Med Hyg 73: 11511158.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    CDC, 2007. Baseline data from the Nyando Integrated Child Health and Education Project—Kenya, 2007. MMWR Morb Mortal Wkly Rep 56: 11091113.

  • 14.

    Perkins BA, Zucker JR, Otieno J, Jafari HS, Paxton L, Redd SC, Nahlen BL, Schwartz B, Oloo AJ, Olango C, Gove S, Campbell CC, 1997. Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission. Bull World Health Organ 75 (Suppl 1): 3342.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Gove S, 1997. Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO Working Group on Guidelines for Integrated Management of the Sick Child. Bull World Health Organ 75 (Suppl 1): 724.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Northcross A, Chowdhury Z, McCracken J, Canuz E, Smith KR, 2010. Estimating personal PM2.5 exposures using CO measurements in Guatemalan households cooking with wood fuel. JEM 12: 873878.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    WHO, 2006. WHO Air Quality Guidelines for Particulate Matter, Ozone, Nitrogen Dioxide and Sulfur Dioxide: Global Assessment 2005: Summary of Risk Assessment. Geneva: WHO.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Naeher LP, Brauer M, Lipsett M, Zelikoff JT, Simpson CD, Koenig JQ, Smith KR, 2007. Wood smoke health effects: a review. Inhal Toxicol 19: 67106.

  • 19.

    Robinson BE, Baumgartner J, 2011. Cultivating a demand for clean cookstoves. Science 334: 16361637; author reply 1637.

Past two years Past Year Past 30 Days
Abstract Views 2515 2237 82
Full Text Views 437 8 0
PDF Downloads 102 8 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save