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Impact of biomass fuel smoke on respiratory health of children under 15 years old in Madagascar - 06/06/23

Doi : 10.1016/j.resmer.2023.100989 
Nolwenn Jestin-Guyon a, , El Hassane Ouaalaya a, b, Michel Tiaray Harison c, Kiady Ravahatra d, Jocelyn Rakotomizao c, Rondro Nirina Raharimanana e, Joelson Lovaniaina Rakotoson f, Jobeline Rajaoarifetra g, Jean-Claude Andriamihaja Rakotoarisoa h, Giannie Rasamimanana i, Charlin Randriamananjara j, Bakoly Ravalison j, Ange Andrianarisoa c, Andrianaivo Ralison i, Raoelina Andriambololona k, Denis Charpin l, Jean De Dieu Marie Rakotomanga m, Iantsoatiana Davidson Rakotondrabe c, Marie Odette Rasoafaranirina c, Zisler Michael Rakotondravola c, Aglaé Rakotoson c, Jean Robert Rakotondriaka c, Anjara Nandimbiniaina c, Orelys Ratsirahonana j, Patricia Feno j, Mampionona Razafindramboa n, Brigitte Rahoelina o, Jean-Marie Tschopp p, Martial Coutaz q, Stéphane Garrone r, Pierre L'Her s, Chantal Raherison-Semjen a, t
a Inserm, Bordeaux Population Health Research Center, Team: EPICENE, UMR1219, Bordeaux University, 146 Rue Léo Saignat, Bordeaux 33076 CEDEX, France 
b High Institute of Nursing Professions and Health Techniques, ISPITS, Agadir, Morocco 
c University-Hospital of Befelatanana, Antananarivo, Madagascar 
d University-Hospital of Anosiala, Antananarivo, Madagascar 
e University-Hospital of Fenoarivo, Fenoarivo, Madagascar 
f University-Hospital of Fianarantsoa, Fianarantsoa, Madagascar 
g University-Hospital of Toamasina, Toamasina, Madagascar 
h University-Hospital of Ravoahangy, Antananarivo, Madagascar 
i University-Hospital of Mahajanga, Mahajanga, Madagascar 
j University-Hospital of Antananarivo, Antananarivo, Madagascar 
k National Institute of Nuclear Sciences and Techniques (INSTN), Antananarivo, Madagascar 
l University-Hospital of Marseille, Marseille, France 
m National Institute of Public Health and Community Health (INSPC), Antananarivo, Madagascar 
n Espace Santé de Parasol, Villeneuve sur Lot, France 
o Medical Office, Saint Denis, Reunion 
p Geneva Faculty of Medecine, Geneva, Switzerland 
q Valais Hospital, Geneva, Switzerland 
r Medical Office, Monthey, Switzerland 
s Soutien Pneumologique International (SPI), Paris, France 
t University-Hospital of Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe 

Corresponding author.

Highlights

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.

El texto completo de este artículo está disponible en PDF.

Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.

El texto completo de este artículo está disponible en PDF.

Keywords : Biomass, Respiratory symptoms, Madagascar, Children, Spirometry

Abbreviations : ATS, EI, ERS, FEV1, FEV1/FVC, FVC, GLI, GOLD, HAP


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© 2023  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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