Trial reportChest2020
Pneumonia and Exposure to Household Air Pollution in Children Under the Age of 5 Years in Rural Malawi: Findings From the Cooking and Pneumonia Study.
Trial report in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Impact of prenatal and postnatal household air pollution exposure on respiratory morbidity and lung function in sub-Saharan African children: a systematic review and meta-analysis.Environmental health : a global access science source · 2025Pooled 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
- Development of personal air pollution exposure report-back materials to Household Air Pollution Intervention Network (HAPIN) trial participants in Guatemala and Rwanda: a qualitative study.BMJ global health · 2025Trial
- Exposure Contrasts of Pregnant Women during the Household Air Pollution Intervention Network Randomized Controlled Trial.Environmental health perspectives · 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
- 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
- Trial
- 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
- Trial
- Early Environments, Lasting Effects: Air Pollution, Microbes, and Respiratory Infection Risk in Children.Pediatric pulmonology · 2026Review
- Urban environmental and climatic correlates of pediatric respiratory infection: microscale spatiotemporal evidence from Fuzhou, China.BMC pediatrics · 2026Article
- Household energy use and health in low-income and middle-income countries.The Lancet. Global health · 2026Review
- Long-term effects of cooking with liquefied petroleum gas or biomass on linear growth trajectories from birth to the pre-school years in Puno, Peru: a prospective cohort study.Lancet regional health. Americas · 2026Article
- Association between PMArchives of public health = Archives belges de sante publique · 2026Article
- Pneumonia incidence and determinants in South Punjab, Pakistan (2016-2020): a spatial epidemiological study at Tehsil-level.International journal of health geographics · 2025Article
- The impact of environmental conditions on non-communicable diseases in sub-Saharan Africa: A scoping review of epidemiologic evidence.Journal of global health · 2024Article
- Identifying sensitive windows of prenatal household air pollution on birth weight and infant pneumonia risk to inform future interventions.Environment international · 2023Article
- Article
- Association between household air pollution and nasopharyngeal pneumococcal carriage in Malawian infants (MSCAPE): a nested, prospective, observational study.The Lancet. Global health · 2022Observational
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundExposure to household air pollution is associated with an increased risk of pneumonia in children in low- and middle-income countries; however, exposure-response data are limited, and there are uncertainties around the extent to which biomass-fueled cookstoves can reduce these exposures. RESEARCH QUESTION: What is the association between exposure to household air pollution and pneumonia in children under the age of 5 years in rural Malawi and what are the effects of a biomass-fueled cookstove intervention on personal exposure to household air pollution? STUDY DESIGN AND
methodsWe measured personal exposure to carbon monoxide (CO; 48 hours of continuous measurement and transcutaneous carboxyhemoglobin) every 6 months in children who participated in a cluster-randomized controlled trial of a cleaner burning biomass-fueled cookstove intervention to prevent pneumonia in children under the age of 5 years in rural Malawi (the Cooking And Pneumonia Study). Exposure-response and multivariable analyses were done.
resultsWe recruited 1805 (928 intervention; 877 control) children (mean age, 25.6 months; 50.6% female). We found no evidence of an association between exposure to CO (incident rate ratio, 1.0; 95% CI, 0.967 to 1.014; P = .53) or carboxyhemoglobin (incident rate ratio, 1.00; 95% CI, 0.993 to 1.003; P = .41) in children who experienced pneumonia vs those who did not. Median exposure to CO in the intervention and control groups was was 0.34 (interquartile range, 0.15 to 0.81) and 0.37 parts per million (interquartile range, 0.15 toa 0.97), respectively. The group difference in means was 0.46 (95% CI, -0.95 to 0.012; P = .06).
interpretationExposure to CO in our population was low with no association seen between exposure to CO and pneumonia incidence and no effect of the Cooking And Pneumonia Study intervention on these exposures. These findings suggest that CO may not be an appropriate measure of household air pollution exposure in settings such as rural Malawi and that there is a need to develop ways to measure particulate matter exposures directly in young children instead. CLINICAL
trial registrationISRCTN59448623.
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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.