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

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  • 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

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.

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