The role of indoor air pollution and other factors in the incidence of pneumonia in under-five children

Abstract

Background The World Health Organization has asked for a special attention to the relation between pneumonia and indoor air pollution, i.e., household biomass fuel smoke, cigarette smoke, and mosquito coil smoke, especially in developing countries. Objective To analyze the role of indoor air pollution and other factors as risk factors for pneumonia in under-five-year children. Methods This case-control study was carried out from August until December 2000 at Public Health Centers in Banjarnegara, Kebumen, Jepara, and Pekalongan districts. All children qualifying pneumonia classification as recommended by WHO in IMCI (Integrated Management of Childhood Illness) were defined as cases and without pneumonia as controls. Severe pneumonia and no pneumonia (as classified in IMCI) were excluded. Statistical analysis was done using bivariate and logistic regression. Results There were three hundreds and five children with pneumonia and 289 children without pneumonia. By bivariate analysis, biomass fuel smoke (OR=3.25; 95%CI 1.50;7.07) and cigarette smoke exposure from other family members (OR=1.63; 95%CI 1.11;2.38) were risk factors for pneumonia, while mosquito coil smoke (OR=1.13; 95%CI 0.79;1.69) was not. History of wheezing (OR=2.60; 95%CI 2.7;8.55), malnutrition (OR=2.60; 95%CI 1.33;5.07), and male sex (OR=1.47; 95%CI 1.06;2.04) were other risk factors. Conclusions Household biomass fuel smoke and cigarette smoke were risk factors for pneumonia. Other variables as risk factors were history of wheezing, male sex, and malnutrition