Trial reportLancet (London, England)2017
A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial.
Trial report in Lancet (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
142 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Evaluating effectiveness of protective interventions towards environmental contamination among under-five children: systematic review and meta-analysis in Africa.BMC public health · 2026Pooled it
- A Systematic Review and Meta-Analysis Assessing the Impact of Improved Cookstove Technology Trials (ICTs) on Household Air Pollution and Human Health in Sub-Saharan Africa.Current environmental health reports · 2025Pooled it
- Indoor air pollution from solid fuel on children pneumonia in low- and middle-income countries: a systematic review and meta-analysis.Environmental science and pollution research international · 2022Pooled it
- Adverse health effects associated with household air pollution: a systematic review, meta-analysis, and burden estimation study.The Lancet. Global health · 2020Pooled it
- Exposure to Wood Smoke and Associated Health Effects in Sub-Saharan Africa: A Systematic Review.Annals of global health · 2020Pooled it
- Understanding the effect of indoor air pollution on pneumonia in children under 5 in low- and middle-income countries: a systematic review of evidence.Environmental science and pollution research international · 2019Pooled it
- Impact of improved stove intervention on infant acute respiratory infections: Results from a randomized trial in Northwest Ethiopia.PloS one · 2026Trial
- Exposure to Household Air Pollution From Biomass Cooking and Severe Pneumonia in Infants.JAMA network open · 2025Trial
- Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia.The New England journal of medicine · 2024Trial
- A secondary data analysis of a cluster randomized controlled trial: improved cookstoves associated with reduction in incidence of low birthweight in rural Malawi.International journal of epidemiology · 2022Trial
- Efficacy of air filtration and education interventions on fine particulate matter among rural Native American homes heated with wood stoves: Results from the EldersAIR randomized trial.The Science of the total environment · 2022Trial
- Effectiveness of a home-environmental intervention package and an early child development intervention on child health and development in high-altitude rural communities in the Peruvian Andes: a cluster-randomised controlled trial.Infectious diseases of poverty · 2022Trial
- Efficacy of Air Filtration and Education Interventions on Indoor Fine Particulate Matter and Child Lower Respiratory Tract Infections among Rural U.S. Homes Heated with Wood Stoves: Results from the KidsAIR Randomized Trial.Environmental health perspectives · 2022Trial
- Trial
- LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial.Environmental pollution (Barking, Essex : 1987) · 2021Trial
- Health impacts of a randomized biomass cookstove intervention in northern Ghana.BMC public health · 2021Trial
- Fidelity and Adherence to a Liquefied Petroleum Gas Stove and Fuel Intervention during Gestation: The Multi-Country Household Air Pollution Intervention Network (HAPIN) Randomized Controlled Trial.International journal of environmental research and public health · 2021Trial
- Trial
- A cluster randomised trial of cookstove interventions to improve infant health in Ghana.BMJ global health · 2021Trial
- Effects of a Household Air Pollution Intervention with Liquefied Petroleum Gas on Cardiopulmonary Outcomes in Peru. A Randomized Controlled Trial.American journal of respiratory and critical care medicine · 2021Trial
82 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundWHO estimates exposure to air pollution from cooking with solid fuels is associated with over 4 million premature deaths worldwide every year including half a million children under the age of 5 years from pneumonia. We hypothesised that replacing open fires with cleaner burning biomass-fuelled cookstoves would reduce pneumonia incidence in young children.
methodsWe did a community-level open cluster randomised controlled trial to compare the effects of a cleaner burning biomass-fuelled cookstove intervention to continuation of open fire cooking on pneumonia in children living in two rural districts, Chikhwawa and Karonga, of Malawi. Clusters were randomly allocated to intervention and control groups using a computer-generated randomisation schedule with stratification by site, distance from health centre, and size of cluster. Within clusters, households with a child under the age of 4·5 years were eligible. Intervention households received two biomass-fuelled cookstoves and a solar panel. The primary outcome was WHO Integrated Management of Childhood Illness (IMCI)-defined pneumonia episodes in children under 5 years of age. Efficacy and safety analyses were by intention to treat. The trial is registered with ISRCTN, number ISRCTN59448623.
findingsWe enrolled 10 750 children from 8626 households across 150 clusters between Dec 9, 2013, and Feb 28, 2016. 10 543 children from 8470 households contributed 15 991 child-years of follow-up data to the intention-to-treat analysis. The IMCI pneumonia incidence rate in the intervention group was 15·76 (95% CI 14·89-16·63) per 100 child-years and in the control group 15·58 (95% CI 14·72-16·45) per 100 child-years, with an intervention versus control incidence rate ratio (IRR) of 1·01 (95% CI 0·91-1·13; p=0·80). Cooking-related serious adverse events (burns) were seen in 19 children; nine in the intervention and ten (one death) in the control group (IRR 0·91 [95% CI 0·37-2·23]; p=0·83).
interpretationWe found no evidence that an intervention comprising cleaner burning biomass-fuelled cookstoves reduced the risk of pneumonia in young children in rural Malawi. Effective strategies to reduce the adverse health effects of household air pollution are needed.
fundingMedical Research Council, UK Department for International Development, and Wellcome Trust.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.