Replacement of biomass fuel with LPG does not reduce the incidence of severe pneumonia among infants

An intervention that replaces biomass fuel (e.g., wood, dung, or agricultural crop waste) with liquefied petroleum gas (LPG) for cooking does not affect the incidence of severe pneumonia among infants, according to a study published in the Jan. 4 issue of the New England Journal of Medicine.

Noting that household air pollution is a risk factor for severe pneumonia, Eric D. McCollum, M.D., M.P.H., from the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues conducted a randomized controlled trial involving pregnant women aged 18 to 34 years and between 9 and <20 weeks of gestation in India, Guatemala, Peru, and Rwanda. The women were assigned to cook with unvented LPG stoves and fuel (intervention group; 1,536 infants) or continue cooking with biomass fuel (control group; 1,525 infants).

The researchers observed a reduction in personal exposure to fine particulate matter among the infants in association with a high uptake of the intervention, with a median exposure of 24.2 and 66.0 µg/m3 in the intervention and control groups, respectively. During the first year of life, 175 episodes of severe pneumonia were identified, with incidences of 5.67 and 6.06 cases per 100 child-years in the intervention and control groups, respectively (incidence rate ratio, 0.96; 95 percent confidence interval, 0.64 to 1.44; P = 0.81). There were no reports of severe adverse events in association with the intervention.

“The incidence of severe infant pneumonia was not significantly lower with the use of LPG cookstoves than with biomass cookstoves,” the authors write.

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