Evidence map›Paper›PMID 35477567›Full record

ArticleMalaria journal2022

Cooking outdoors or with cleaner fuels does not increase malarial risk in children under 5 years: a cross-sectional study of 17 sub-Saharan African countries.

Katherine E Woolley, Suzanne E Bartington, Francis D Pope, Sheila M Greenfield, Lucy S Tusting, Malcolm J Price, G Neil Thomas

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Article in Malaria journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Katherine E WoolleyInstitute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.ORCID http://orcid.org/0000-0003-3743-9925
Suzanne E BartingtonInstitute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK. s.bartington@bham.ac.uk.ORCID http://orcid.org/0000-0002-8179-7618
Francis D PopeSchool of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.ORCID http://orcid.org/0000-0001-6583-8347
Sheila M GreenfieldInstitute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.ORCID https://orcid.org/0000-0002-8796-4114
Lucy S TustingDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-6897-8625
Malcolm J PriceInstitute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.ORCID http://orcid.org/0000-0002-7352-3027
G Neil ThomasInstitute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.ORCID http://orcid.org/0000-0002-2777-1847

Funding

Medical Research Council MR/N011570/1Medical Research Council MR/N011570/2
6 · The paper itself

Abstract

backgroundSmoke from solid biomass cooking is often stated to reduce household mosquito levels and, therefore, malarial transmission. However, household air pollution (HAP) from solid biomass cooking is estimated to be responsible for 1.67 times more deaths in children aged under 5 years compared to malaria globally. This cross-sectional study investigates the association between malaria and (i) cleaner fuel usage; (ii) wood compared to charcoal fuel; and, (iii) household cooking location, among children aged under 5 years in sub-Saharan Africa (SSA).

methodsPopulation-based data was obtained from Demographic and Health Surveys (DHS) for 85,263 children within 17 malaria-endemic sub-Saharan countries who were who were tested for malaria with a malarial rapid diagnostic test (RDT) or microscopy. To assess the independent association between malarial diagnosis (positive, negative), fuel type and cooking location (outdoor, indoor, attached to house), multivariable logistic regression was used, controlling for individual, household and contextual confounding factors.

resultsHousehold use of solid biomass fuels and kerosene cooking fuels was associated with a 57% increase in the odds ratio of malarial infection after adjusting for confounding factors (RDT adjusted odds ratio (AOR):1.57 [1.30-1.91]; Microscopy AOR: 1.58 [1.23-2.04]) compared to cooking with cleaner fuels. A similar effect was observed when comparing wood to charcoal among solid biomass fuel users (RDT AOR: 1.77 [1.54-2.04]; Microscopy AOR: 1.21 [1.08-1.37]). Cooking in a separate building was associated with a 26% reduction in the odds of malarial infection (RDT AOR: 0.74 [0.66-0.83]; Microscopy AOR: 0.75 [0.67-0.84]) compared to indoor cooking; however no association was observed with outdoor cooking. Similar effects were observed within a sub-analysis of malarial mesoendemic areas only.

conclusionCleaner fuels and outdoor cooking practices associated with reduced smoke exposure were not observed to have an adverse effect upon malarial infection among children under 5 years in SSA. Further mixed-methods research will be required to further strengthen the evidence base concerning this risk paradigm and to support appropriate public health messaging in this context.

Indexed as

Air Pollution, IndoorMalariaCharcoalChildChild, PreschoolCookingCross-Sectional StudiesHumansSmokeCharcoalSmokeBiomassChildren under 5 yearsHousehold air pollutionLow and middle-income countryMalariaSub-Saharan Africa

Identifiers

PMID35477567
PMCPMC9044678

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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.