The effect of solid fuel use on childhood mortality in Nigeria: evidence from the 2013 cross-sectional household surveyReport as inadecuate

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Environmental Health

, 13:113

Children-s Environmental Health


BackgroundIn Nigeria, approximately 69% of households use solid fuels as their primary source of domestic energy for cooking. These fuels produce high levels of indoor air pollution. This study aimed to determine whether Nigerian children residing in households using solid fuels at <5 years of age were at higher risk of death.

MethodsThe 2013 Nigeria Demographic and Health Survey data were analysed in Cox regression analyses to examine the effects of solid fuel use on deaths of children aged 0–28 days neonatal, 1–11 months post-neonatal, and 12–59 months child.

ResultsThe results indicated that approximately 0.8% of neonatal deaths, 42.9% of post-neonatal deaths, and 36.3% of child deaths could be attributed to use of solid fuels. The multivariable analyses found that use of solid fuel was associated with post-neonatal mortality hazard ratio HR =1.92, 95% confidence interval CI: 1.42–2.58 and child mortality HR = 1.63, CI: 1.09–2.42, but was not associated with neonatal mortality HR = 1.01, CI: 0.73–1.26. Living in rural areas and poor households were associated with an increased risk of death during the three mortality periods.

ConclusionLiving in a rural area and poor households were strongly associated with an increased risk of a child > 1 to < 60 months dying due to use of solid fuels. The health effects of household use of solid fuels are a major public health threat that requires increased research and policy development efforts. Research should focus on populations in rural areas and low socioeconomic households so that child survival in Nigeria can be improved.

KeywordsIndoor air pollution Solid fuels Nigeria Childhood mortality AbbreviationsIAPIndoor air pollution

NDHSNigeria demographic and health survey

NPCNational population commission

WHOWorld health organisation

LPGLiquefied petroleum gas

HRHazard ratio

aHRAdjusted hazard ratio

PARPopulation attributable risk

CIConfidence interval

NMRNeonatal mortality rate

PMRPost-neonatal mortality

CMRChild mortality rate.

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Author: Osita Kingsley Ezeh - Kingsley Emwinyore Agho - Michael John Dibley - John Joseph Hall - Andrew Nicolas Page


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