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Effect of indoor air pollution on infant and child-mortality in Myanmar: Evidence from the first Demographic and Health Survey
Rakibul M Islam
Razia Aliani
Md Nuruzzaman Khan
Juwel Rana
Novel Coronavirus
Acceso Abierto
Atribución-NoComercial-SinDerivadas
10.1101/19010801
Background: Indoor air pollution (IAP) from solid fuels for cooking has been considered as a public health threat, particularly for women and children in low- and lower-middle-income countries (LMICs). We investigated the effects of solid fuel use (SFU) on neonatal, infant and under-five child mortality in Myanmar. Materials and Methods: We used data from Myanmars first Demographic and Health Survey conducted in 2016. The sample consists of ever-married mothers with under-five children in the household (n=3249). We calculated the adjusted odds ratio (aOR) to investigate the effects of SFU on neonatal, infant, and under-five mortality using multivariable logistic regression model accounting for survey weight and clustering. Additional analysis was conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking (high exposure, moderate, and unexposed). Results: The prevalence of SFU was 79.0%, and the neonatal, infant and the under-five mortality rates were 26, 45 and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child mortality (aOR 2.22, 95% CI: 1.24, 3.95) were higher in households with SFU compared with households with clean fuel use. When applying an augmented measure of exposure to IAP by incorporating both SFU and the kitchens location, the likelihood of infant and under-five mortality was higher among moderately and highly exposed children compared to unexposed children with similar trends. Neonatal mortality was not associated with both SFU and levels of exposure to IAP. Conclusion: Infants and under-five children are at higher risk of mortality from exposure to IAP. The findings suggest that the risk of infants and under-five child mortality may be reduced by increasing access to clean cookstoves and clean fuels in LMICs, especially in Myanmar. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research received no external funding. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes DHS program gave us formal approval to obtain the de-identified data from the DHS online archive after. Details: https://dhsprogram.com/data/Using-325 DataSets-for-Analysis.cfm <https://dhsprogram.com/data>
Cold Spring Harbor Laboratory Press
2019
Preimpreso
https://www.medrxiv.org/content/10.1101/19010801v1
Inglés
VIRUS RESPIRATORIOS
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