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Attributable risk of household solid fuel use and second-hand smoke associated with under-5 mortality in 46 low- and lower-middle-income countries, 2010-2020.
Lwin, Kaung Suu; Nomura, Shuhei; Swe, Khin Thet; Gilmour, Stuart; Alam, Md Ashraful; Hashizume, Masahiro.
Affiliation
  • Lwin KS; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kaungsuulwin@gmail.com.
  • Nomura S; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
  • Swe KT; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
  • Gilmour S; Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
  • Alam MA; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hashizume M; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int J Hyg Environ Health ; 243: 113986, 2022 06.
Article in En | MEDLINE | ID: mdl-35561570
BACKGROUND: Household solid fuel use (including indoor and outdoor) and second-hand smoke (SHS) are considered to be major contributors of under-5 mortality (U5M) in low- and lower-middle-income countries (LMICs). This study provides a comprehensive assessment of their odds ratios and attributable mortality in LMICs. METHODS: We used the Demographic Health Surveys data for under-5 children in 46 LMICs (n = 778,532) from 2010 to 2020. Mixed effect multilevel logistic regressions were conducted to estimate the pooled adjusted odds ratio (aOR) for U5M due to solid fuel use, SHS and their combination compared to no exposure to them in 46 LMICs. The attributable mortality of solid fuel use, SHS, and their combination were assessed for each LMIC. FINDINGS: The pooled aOR of solid fuel use and SHS for U5M was estimated to be 1.27 (95% Confidence Interval (CI): 1.19-1.36) and 1.13 (95%CI: 1.06-1.25), respectively, whereas those of their combination was 1.40 (95%CI: 1.31-1.50). U5M attributable to indoor and outdoor solid fuel use was the highest in Myanmar (18.0%) and the Gambia (16.5%), respectively, while those attributable to SHS was the highest in Indonesia (9.8%). U5M attributable to the combination of solid fuel use and SHS was the highest in Timor-Leste (22.7%). INTERPRETATION: The combined effect of exposure to solid fuel and SHS had a higher risk of U5M than the individual risk. The use of clean fuel and tobacco control measures should be integrated with other child health promotion policies. FUNDING: This research was partially supported by a research grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (21H03203).
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tobacco Smoke Pollution Type of study: Etiology_studies / Risk_factors_studies Aspects: Determinantes_sociais_saude Limits: Child / Humans Language: En Journal: Int J Hyg Environ Health Journal subject: SAUDE AMBIENTAL / SAUDE PUBLICA Year: 2022 Document type: Article Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tobacco Smoke Pollution Type of study: Etiology_studies / Risk_factors_studies Aspects: Determinantes_sociais_saude Limits: Child / Humans Language: En Journal: Int J Hyg Environ Health Journal subject: SAUDE AMBIENTAL / SAUDE PUBLICA Year: 2022 Document type: Article Country of publication: