Impact of biomass fuel smoke on respiratory health of children under 15 years old in Madagascar

• Published in: Respiratory medicine and research Vol. 83; p. 100989
• Main Authors: Jestin-Guyon, Nolwenn, Ouaalaya, El Hassane, Harison, Michel Tiaray, Ravahatra, Kiady, Rakotomizao, Jocelyn, Raharimanana, Rondro Nirina, Rakotoson, Joelson Lovaniaina, Rajaoarifetra, Jobeline, Rakotoarisoa, Jean-Claude Andriamihaja, Rasamimanana, Giannie, Randriamananjara, Charlin, Ravalison, Bakoly, Andrianarisoa, Ange, Ralison, Andrianaivo, Andriambololona, Raoelina, Charpin, Denis, Rakotomanga, Jean De Dieu Marie, Rakotondrabe, Iantsoatiana Davidson, Rasoafaranirina, Marie Odette, Rakotondravola, Zisler Michael, Rakotoson, Aglaé, Rakotondriaka, Jean Robert, Nandimbiniaina, Anjara, Ratsirahonana, Orelys, Feno, Patricia, Razafindramboa, Mampionona, Rahoelina, Brigitte, Tschopp, Jean-Marie, Coutaz, Martial, Garrone, Stéphane, L'Her, Pierre, Raherison-Semjen, Chantal
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-06-2023
• Subjects: Adolescent; Air Pollution, Indoor - adverse effects; Biomass; Birth Weight; Child; Children; Cross-Sectional Studies; Humans; Madagascar; Madagascar - epidemiology; Nicotiana; Respiratory symptoms; Smoke - adverse effects; Spirometry; Madagascar; ATS; Spirometry; GOLD; EI; GLI; ERS; Madagascar; Biomass; FVC; HAP; Respiratory symptoms; FEV1/FVC; FEV1; Children
• ISSN: 2590-0412; 2590-0412
• DOI: 10.1016/j.resmer.2023.100989

•Biomass widely used in households for cooking and heating.•High respiratory symptoms prevalence among children in Madagascar.•91.9% of children had normal respiratory function.•Exposure index related to biomass exposure associated with 1 respiratory symptom.•Provinces, tobacco, pollution and birthweight associated with respiratory health.
Children exposed to biomass used in households are at risk to develop diseases or respiratory symptoms. In Madagascar more than 95% of households use it daily. The main objective is to study the impact of chronic exposure to biomass on respiratory health of children under 15 years old in Madagascar.
Descriptive cross-sectional study conducted with questionnaires among urban and rural population of Antananarivo and Mahajanga provinces between 2016 and 2017. Variables were collected: number of hours spent in kitchen per day, respiratory symptoms and spirometric data. Categorized symptoms score and exposure index expressing chronic exposure to biomass were analyzed with multinomial logistic regression models.
Of the 661 children included in the analysis, 27.7% had 1 respiratory symptom and 29.3% had 2 or more respiratory symptoms. Moderate exposure index (aOR=1.57; CI95%=[1.30–1.89]; p<0.001) and high exposure index (aOR=1.76; CI95%=[1.39–2.24]; p<0.001) were significantly associated with 1 respiratory symptom, adjusted with provinces, household members and visitors smoking, perceived discomfort related to air pollution and birthweight. Exposure index was not significantly associated with an increased risk of having 2 or more respiratory symptoms (p = 0.754).
Respiratory symptoms were associated with exposure to biomass, living in coastal areas, birthweight, tobacco and perceived discomfort related to air pollution. Recommendations and actions must be implemented in order to improve respiratory health related to biomass among children.