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Zeidan RS, McElroy T, Rathor L, Martenson MS, Lin Y, Mankowski RT. Sex differences in frailty among older adults. Exp Gerontol 2023; 184:112333. [PMID: 37993077 DOI: 10.1016/j.exger.2023.112333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
By definition, aging is a natural, gradual and continuous process. On the other hand, frailty reflects the increase in vulnerability to stressors and shortens the time without disease (health span) while longevity refers to the length of life (lifespan). The average life expectancy has significantly increased during the last few decades. A longer lifespan has been accompanied by an increase in frailty and decreased independence in older adults, with major differences existing between men and women. For example, women tend to live longer than men but also experience higher rates of frailty and disability. Sex differences prevent optimization of lifestyle interventions and therapies to effectively prevent frailty. Sex differences in frailty and aging are rooted in a complex interplay between uncontrollable (genetic, epigenetic, physiological), and controllable factors (psychosocial and lifestyle factors). Thus, understanding the underlying causes of sex differences in frailty and aging is essential for developing personalized interventions to promote healthy aging and improve quality of life in older men and women. In this review, we have discussed the key contributors and knowledge gaps related to sex differences in aging and frailty.
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Affiliation(s)
- Rola S Zeidan
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Taylor McElroy
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Laxmi Rathor
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Matthew S Martenson
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Yi Lin
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Robert T Mankowski
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
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Habtamu D, Abebe B, Seid T. Health risk perceptions of household air pollution and perceived benefits of improved stoves among pregnant women in rural Ethiopia: a mixed method study. BMJ Open 2023; 13:e072328. [PMID: 37648392 PMCID: PMC10471873 DOI: 10.1136/bmjopen-2023-072328] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE Since community perceptions of the risk of biomass smoke and the benefits of improved stoves play a critical role in behaviour change to the uptake and sustainable utilisation of improved stoves, we aimed to assess the level of health risk perception on kitchen smoke and benefits of using improved stoves among pregnant women. DESIGN A community-based cross-sectional mixed method study. SETTING In six kebeles of a low-income rural community of South Gondar Zone, Northwestern Ethiopia. PARTICIPANTS All 455 households with pregnant women aged 18-38 years, in their first-trimester or second-trimester gestation, exclusively use traditional biomass-fuelled or locally modified mud stoves, and the primary cook in her household were included. But completed data were obtained only from 422 households. RESULT From 422 completed data, more than half, 63% (95% CI 58% to 68%) had high-level health risk perception of household air pollution, and nearly three-fourths, 74% (95% CI 70% to 79%) of the respondents perceived that using improved stove had benefits for their families. Participants in the 32-38 years age group, rich in asset index, presence of under-five children, being a member of any women group and large family size were positively associated with high-level health risk perception. Whereas respondents in the 18-24 years age group, presence of under-five children, husbands of primary or higher education, high health risk perception and not happy with the current stove were positively associated with perceived benefits of using an improved stove. CONCLUSION The observed level of health risk perception of biomass smoke and the benefits of using improved stoves may help to adopt effective intervention measures. This study also suggests that for successful intervention, clean cooking programmes and policies must consider many local factors influencing health risk perception and benefits of using improved stoves. TRIAL REGISTRATION NUMBER ACTR202111534227089.
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Affiliation(s)
| | - Beyene Abebe
- Department of Environmental Health Science and Technology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Tiku Seid
- Department of Environmental Health Science and Technology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
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Shine S, Tamirie M, Kumie A, Addissie A, Athlin S, Mekonnen H, Girma E, Molla M, Kaba M. Pregnant women's perception on the health effects of household air pollution in Rural Butajira, Ethiopia: a phenomenological qualitative study. BMC Public Health 2023; 23:1636. [PMID: 37626318 PMCID: PMC10463278 DOI: 10.1186/s12889-023-16578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Household air pollution is the major public health problem in developing countries. Pregnant women spent the majority of their time at home and are the most affected population by household air pollution. Exploring the perception of pregnant women on adverse health effects is important to enhance the mitigation strategies. Therefore, this study aim to explore the pregnant women's perceptions about health effects of household air pollution in rural Butajira, Ethiopia. METHODS A phenomenological qualitative study design was conducted among 15 selected pregnant women. All interviews were carried out at the participants´ house and audio-recorded while housing and cooking conditions were observed and appropriate notes were taken for each. The collected data were transcribed verbatim and translated into the English language. Then, the data were imported into Open code software to manage the overall data coding processes and analyzed thematically. RESULTS Study participants perceived that respiratory problems such as coughing, sneezing and asthma and eye problem were the major health problem caused by household air pollution among pregnant women. Study participants also mentioned asphyxiated, abortion, reduces weight, and hydrocephalus was caused by household air pollution on the foetus. Study participants perceived that financial inability, spouse negligence, autonomy and knowledge level of the women were the barriers to tackling household air pollution. Study participant also suggested that opening the door and window; using improved cookstove and reduce workload were the perceived solution for household air pollution. CONCLUSIONS This study explores pregnant women's perceptions on health effects of household air pollution. The finding of this study was important to deliver suitable intervention strategies to mitigate household air pollution. Therefore, educating the women on way of mitigating household air pollution, improving existing structure of the house and minimize the time to stay in the kitchen is important to mitigate household air pollution exposure.
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Affiliation(s)
- Sisay Shine
- Department of Public Health, School of Public Health, Debre Berhan University, P.O.Box 445, Debre Berhan, Ethiopia.
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia.
| | - Mulugeta Tamirie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Simon Athlin
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Hussen Mekonnen
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Mitike Molla
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
| | - Mirgissa Kaba
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia
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Saleh S, Sambakunsi H, Makina D, Kumwenda M, Rylance J, Chinouya M, Mortimer K. "We threw away the stones": a mixed method evaluation of a simple cookstove intervention in Malawi. Wellcome Open Res 2022; 7:52. [PMID: 35330615 PMCID: PMC8933645 DOI: 10.12688/wellcomeopenres.17544.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Air pollution exposure is responsible for a substantial burden of respiratory disease globally. Household air pollution from cooking using biomass is a major contributor to overall exposure in rural low-income settings. Previous research in Malawi has revealed how precarity and food insecurity shape individuals' daily experiences, contributing to perceptions of health. Aiming to avoid a mismatch between research intervention and local context, we introduced a simple cookstove intervention in rural Malawi, analysing change in fine particulate matter (PM 2.5) exposures, and community perceptions. Methods: Following a period of baseline ethnographic research, we distributed 'chitetezo mbaula', locally-made cookstoves, to all households (n=300) in a rural Malawian village. Evaluation incorporated village-wide participant observation and concurrent exposure monitoring using portable PM 2.5 monitors at baseline and follow-up (three months post-intervention). Qualitative data were thematically analysed. Quantitative analysis of exposure data included pre-post intervention comparisons, with datapoints divided into periods of combustion activity (almost exclusively cooking) and non-combustion periods. Findings were integrated at the interpretation stage, using a convergent design mode of synthesis. Results: Individual exposure monitoring pre- and post-cookstove intervention involved a sample of 18 participants (15 female; mean age 43). Post-intervention PM 2.5 exposures (median 9.9μg/m 3 [interquartile range: 2.2-46.5]) were not significantly different to pre-intervention (11.8μg/m 3 [3.8-44.4]); p=0.71. On analysis by activity, background exposures were found to be reduced post-intervention (from 8.2μg/m 3 [2.5-22.0] to 4.6μg/m 3 [1.0-12.6]; p=0.01). Stoves were well-liked and widely used by residents as substitutes for previous cooking methods (mainly three-stone fires). Commonly cited benefits related to fuel saving and shorter cooking times. Conclusions: The cookstove intervention had no impact on cooking-related PM 2.5 exposures. A significant reduction in background exposures may relate to reduced smouldering emissions. Uptake and continued use of the stoves was high amongst community members, who preferred using the stoves to cooking over open fires.
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Affiliation(s)
- Sepeedeh Saleh
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Henry Sambakunsi
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Debora Makina
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Moses Kumwenda
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Jamie Rylance
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Martha Chinouya
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Kevin Mortimer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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Woolley KE, Bartington SE, Pope FD, Greenfield SM, Tusting LS, Price MJ, Thomas GN. Cooking outdoors or with cleaner fuels does not increase malarial risk in children under 5 years: a cross-sectional study of 17 sub-Saharan African countries. Malar J 2022; 21:133. [PMID: 35477567 PMCID: PMC9044678 DOI: 10.1186/s12936-022-04152-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Smoke from solid biomass cooking is often stated to reduce household mosquito levels and, therefore, malarial transmission. However, household air pollution (HAP) from solid biomass cooking is estimated to be responsible for 1.67 times more deaths in children aged under 5 years compared to malaria globally. This cross-sectional study investigates the association between malaria and (i) cleaner fuel usage; (ii) wood compared to charcoal fuel; and, (iii) household cooking location, among children aged under 5 years in sub-Saharan Africa (SSA). Methods Population-based data was obtained from Demographic and Health Surveys (DHS) for 85,263 children within 17 malaria-endemic sub-Saharan countries who were who were tested for malaria with a malarial rapid diagnostic test (RDT) or microscopy. To assess the independent association between malarial diagnosis (positive, negative), fuel type and cooking location (outdoor, indoor, attached to house), multivariable logistic regression was used, controlling for individual, household and contextual confounding factors. Results Household use of solid biomass fuels and kerosene cooking fuels was associated with a 57% increase in the odds ratio of malarial infection after adjusting for confounding factors (RDT adjusted odds ratio (AOR):1.57 [1.30–1.91]; Microscopy AOR: 1.58 [1.23–2.04]) compared to cooking with cleaner fuels. A similar effect was observed when comparing wood to charcoal among solid biomass fuel users (RDT AOR: 1.77 [1.54–2.04]; Microscopy AOR: 1.21 [1.08–1.37]). Cooking in a separate building was associated with a 26% reduction in the odds of malarial infection (RDT AOR: 0.74 [0.66–0.83]; Microscopy AOR: 0.75 [0.67–0.84]) compared to indoor cooking; however no association was observed with outdoor cooking. Similar effects were observed within a sub-analysis of malarial mesoendemic areas only. Conclusion Cleaner fuels and outdoor cooking practices associated with reduced smoke exposure were not observed to have an adverse effect upon malarial infection among children under 5 years in SSA. Further mixed-methods research will be required to further strengthen the evidence base concerning this risk paradigm and to support appropriate public health messaging in this context. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04152-3.
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Affiliation(s)
- Katherine E Woolley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Suzanne E Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Sheila M Greenfield
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Lucy S Tusting
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.,Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Malcolm J Price
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
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Saleh S, Sambakunsi H, Makina D, Kumwenda M, Rylance J, Chinouya M, Mortimer K. "We threw away the stones": a mixed method evaluation of a simple cookstove intervention in Malawi. Wellcome Open Res 2022; 7:52. [PMID: 35330615 PMCID: PMC8933645 DOI: 10.12688/wellcomeopenres.17544.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Air pollution exposure is responsible for a substantial burden of respiratory disease globally. Household air pollution from cooking using biomass is a major contributor to overall exposure in rural low-income settings. Previous research in Malawi has revealed how precarity and food insecurity shape individuals' daily experiences, contributing to perceptions of health. Aiming to avoid a mismatch between research intervention and local context, we introduced a simple cookstove intervention in rural Malawi, analysing change in fine particulate matter (PM 2.5) exposures, and community perceptions. Methods: Following a period of baseline ethnographic research, we distributed 'chitetezo mbaula', locally-made cookstoves, to all households (n=300) in a rural Malawian village. Evaluation incorporated village-wide participant observation and concurrent exposure monitoring using portable PM 2.5 monitors at baseline and follow-up (three months post-intervention). Qualitative data were thematically analysed. Quantitative analysis of exposure data included pre-post intervention comparisons, with datapoints divided into periods of combustion activity (almost exclusively cooking) and non-combustion periods. Findings were integrated at the interpretation stage, using a convergent design mode of synthesis. Results: Individual exposure monitoring pre- and post-cookstove intervention involved a sample of 18 participants (15 female; mean age 43). Post-intervention PM 2.5 exposures (median 9.9μg/m 3 [interquartile range: 2.2-46.5]) were not significantly different to pre-intervention (11.8μg/m 3 [3.8-44.4]); p=0.71. On analysis by activity, background exposures were found to be reduced post-intervention (from 8.2μg/m 3 [2.5-22.0] to 4.6μg/m 3 [1.0-12.6]; p=0.01). Stoves were well-liked and widely used by residents as substitutes for previous cooking methods (mainly three-stone fires). Commonly cited benefits related to fuel saving and shorter cooking times. Conclusions: The cookstove intervention had no impact on cooking-related PM 2.5 exposures. A significant reduction in background exposures may relate to reduced smouldering emissions. Uptake and continued use of the stoves was high amongst community members, who preferred using the stoves to cooking over open fires.
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Affiliation(s)
- Sepeedeh Saleh
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Henry Sambakunsi
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Debora Makina
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Moses Kumwenda
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Jamie Rylance
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Martha Chinouya
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Kevin Mortimer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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Saleh S, Sambakunsi H, Makina D, Kumwenda M, Rylance J, Chinouya M, Mortimer K. "We threw away the stones": a mixed method evaluation of a simple cookstove intervention in Malawi. Wellcome Open Res 2022; 7:52. [PMID: 35330615 PMCID: PMC8933645 DOI: 10.12688/wellcomeopenres.17544.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Exposure to air pollution is responsible for a substantial burden of respiratory disease globally. Household air pollution from cooking using biomass is a major contributor to overall exposure in rural low-income settings. Previous research in Malawi has revealed how precarity and food insecurity shape individuals' daily experiences, contributing to perceptions of health. Aiming to avoid a mismatch between research intervention and local context, we introduced a simple cookstove intervention in rural Malawi, analysing change in fine particulate matter (PM 2.5) exposures, and community perceptions. Methods: Following a period of baseline ethnographic research, we distributed 'chitetezo mbaula', locally made clay cookstoves, to all households (n=300) in a rural Malawian village. Evaluation incorporated village-wide participant observation and concurrent exposure monitoring using portable PM 2.5 monitors at baseline and follow-up (three months post-intervention). Qualitative data were thematically analysed. Quantitative analysis of exposure data included pre-post intervention comparisons, with datapoints divided into cooking and non-cooking ('baseline') periods. Findings were integrated at the interpretation stage, using a convergent design mode of synthesis. Results: Individual exposure monitoring pre- and post-cookstove intervention involved a sample of 18 participants (15 female; mean age 43). Post-intervention PM 2.5 exposures (median 9.9μg/m 3 [interquartile range: 2.2-46.5]) were not significantly different to pre-intervention (11.8μg/m 3 [3.8-44.4]); p=0.71. On analysis by activity, 'baseline' exposures were found to be reduced post-intervention (from 8.2μg/m 3 [2.5-22.0] to 4.6μg/m 3 [1.0-12.6]; p=0.01). Stoves were well-liked and widely used by residents as substitutes for previous cooking methods (mainly three-stone fires). Most cited benefits related to fuel saving and shorter cooking times. Conclusions: The cookstove intervention had no impact on cooking-related PM 2.5 exposures. A significant reduction in baseline exposures may relate to reduced smouldering emissions. Uptake and continued use of the stoves was high amongst community members, who preferred using the stoves to cooking over open fires.
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Affiliation(s)
- Sepeedeh Saleh
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Henry Sambakunsi
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Debora Makina
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Moses Kumwenda
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Jamie Rylance
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool Wellcome trust Clinical Research Programme, Blantyre, Malawi
| | - Martha Chinouya
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Kevin Mortimer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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Women’s Perceptions and Attitudes to Household Air Pollution Exposure and Capability to Change Cooking Behaviours in Urban Rwanda. SUSTAINABILITY 2022. [DOI: 10.3390/su14031608] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Household air pollution (HAP) from cooking on biomass fuel presents significant health, environmental and socioeconomic consequences worldwide. However, there is a lack of understanding of the factors influencing cooking behaviours that affect HAP exposure in Rwanda (e.g., cooking location, removing children from the cooking area). Sixteen qualitative in-depth interviews were undertaken with women living in an underprivileged neighbourhood in Kigali, Rwanda. Deductive thematic analysis was carried out using the Behaviour Change Wheel (Capability—ability to engage with chosen activity, Opportunity—factors which are beyond the individual’s control and Motivation—brain processes which direct behaviour: COM-B) to determine the thoughts and perceptions around cooking location and removing children from the cooking area. Facilitators and barriers were subsequently identified within the COM-B framework for the following HAP mitigation interventions: outdoor cooking, removing children from the cooking area and Liquid Petroleum Gas (LPG) use. Of the 16 interviewed, 12 cooked outdoors (75%), two (12.5%) cooked indoors (in the main home) and two (12.5%) in a separate kitchen. Despite the majority cooking outdoors, this was reported not to be a favourable cooking location. Levels of awareness of HAP sources and knowledge of the health effects of air pollution were observed to be limited, reducing women’s capability to change, along with stated barriers of cost, housing constraints and safety. Factors out of the individuals’ control (opportunities) included weather, socio-economic and educational factors. Preconceived beliefs, experiencing smoke reduction and the briefly described short-term health effects, directed motivation. Furthermore, participants identified a need for community-based education as a facilitator to changing their behaviour. Despite a high level of observed motivation towards reducing HAP exposure, many women lacked the capability and opportunity to change their behaviour. There are research and policy implications concerning development of community-based interventions which involved end-users and relevant stakeholders in the development process.
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Measurement of Air Pollution Parameters in Montenegro Using the Ecomar System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126565. [PMID: 34207201 PMCID: PMC8296430 DOI: 10.3390/ijerph18126565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022]
Abstract
Particulate matter air pollution is one of the most dangerous pollutants nowadays and an indirect cause of numerous diseases. A number of these consequences could possibly be avoided if the right information about air pollution were available at a large number of locations, especially in urban areas. Unfortunately, this is not the case today. In the whole of Europe, there are just approximately 3000 automated measuring stations for PM10, and only about 1400 stations equipped for PM2.5 measurement. In order to improve this issue and provide availability of real-time data about air pollution, different low-cost sensor-based solutions are being considered both on-field and in laboratory research. In this paper, we will present the results of PM particle monitoring using a self-developed Ecomar system. Measurements are performed in two cities in Montenegro, at seven different locations during several periods. In total, three Ecomar systems were used during 1107 days of on-field measurements. Measurements performed at two locations near official automated measuring stations during 610 days justified that the Ecomar system performance is satisfying in terms of reliability and measurement precision (NRMSE 0.33 for PM10 and 0.44 for PM2.5) and very high in terms of data validity and operating stability (Ecomar 94.13%-AMS 95.63%). Additionally, five distant urban/rural locations with different traffic, green areas, and nearby industrial objects were utilized to highlight the need for more dense spatial distributions of measuring locations. To our knowledge, this is the most extensive study of low-cost sensor-based air quality measurement systems in terms of the duration of the on-field tests in the Balkan region.
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Wilkinson R, Afework T, Mortimore A, Phillips DIW, Willcox M, Levene D, Kaba M. A neglected source of household air pollution: a preliminary, mixed methods study of purposely produced household smoke in Wollo, Ethiopia. J Public Health (Oxf) 2020; 43:e645-e655. [PMID: 33300580 DOI: 10.1093/pubmed/fdaa197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/14/2020] [Accepted: 10/10/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ill health associated with household air pollution (HAP) is increasingly recognized as a public health problem in sub-Saharan Africa. To date, attempts to reduce HAP have focussed on smoke from cooking fires and have ignored traditional cultural practices which generate purposely produced smoke (PPS). This study aimed to investigate PPS prevalence, reasons for use and safety perceptions. METHODS The study was conducted in Wollo, Ethiopia, and used a mixed methods approach of quantitative surveys (analysed descriptively) and qualitative interviews with householders and healthcare workers (analysed thematically). RESULTS PPS use was reported by 99% of survey respondents and it was considered a fundamental part of life. Although reasons for use included housekeeping, culture/religion and well-being, coffee ceremony was most commonly cited (44% of respondents). Both householders and healthcare workers appeared to assume PPS is safe, except for people with certain underlying conditions. Healthcare workers felt the lack of evidence of harm from PPS meant there was no justification for intervention. CONCLUSION This study, the first in-depth study of PPS, has shown its use to be widespread, with many perceived benefits and thus a very important part of local culture in this sample Ethiopian community. Consequently, any public health interventions aimed at reducing HAP in this setting need to consider PPS.
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Affiliation(s)
- R Wilkinson
- Public Health Registrar, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - T Afework
- Research Assistant, School of Public Health, Addis Ababa Mortality Surveillance Program, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Mortimore
- Visiting Fellow/Consultant in Public Health, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - D I W Phillips
- Professor of Metabolic and Endocrine Programming, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - M Willcox
- Academic Clinical Lecturer, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - D Levene
- Professor of Semitics and the History of Religion, Faculty of Arts and Humanities, University of Southampton, Avenue Campus, Southampton, UK
| | - M Kaba
- Professor of Medical Anthropology, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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11
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McCarron A, Uny I, Caes L, Lucas SE, Semple S, Ardrey J, Price H. Solid fuel users' perceptions of household solid fuel use in low- and middle-income countries: A scoping review. ENVIRONMENT INTERNATIONAL 2020; 143:105991. [PMID: 32738767 DOI: 10.1016/j.envint.2020.105991] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Almost half of the global population is exposed to household air pollution (HAP) from the burning of biomass fuels primarily for cooking, and this has been linked with considerable mortality and morbidity. While alternative cooking technologies exist, sustained adoption of these is piecemeal, indicating that there is insufficient knowledge of understandings of HAP within target communities. To identify potential gaps in the literature, a scoping review was conducted focused on solid fuel users' perceptions of HAP and solid fuel use in low- and middle-income countries. From the initial 14,877 search returns, 56 were included for final analysis. An international multi-disciplinary workshop was convened to develop the research question; six key domains: health; family and community life; home, space, place and roles; cooking and cultural practices, environment; and policy and practice development, were also identified using a Social Ecological Model framework. The review showed a series of disconnects across the domains which highlighted the limited research on perceptions of HAP in the literature. Reviewed studies showed that participants emphasized short-term health impacts of HAP as opposed to longer-term health benefits of interventions and prioritized household security over improved ventilation. There was also a socio-demographic gendered disconnect as although women and children generally have most exposure to HAP, their decision-making power about use of solid fuels is often limited. In the domain of policy and practice, the review identified the importance of community norms and cultural traditions (including taste). Research in this domain, and within the environment domain is however limited and merits further attention. We suggest that interventions need to be locally situated and community-led and a deeper understanding of perceptions of HAP could be obtained using participatory and innovative research methods. Bridging the disconnects and gaps identified in this review is essential if the global disease burden associated with HAP is to be reduced.
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Affiliation(s)
- Amy McCarron
- Biological and Environmental Sciences, Faculty of Natural Science, University of Stirling, Stirling FK9 4LA, UK.
| | - Isabelle Uny
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Line Caes
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
| | - Siân E Lucas
- Social Work, Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK
| | - Sean Semple
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Jane Ardrey
- Liverpool School of Tropical Medicine, Department of Clinical Sciences, Pembroke Place, Liverpool L3 5QA, UK
| | - Heather Price
- Biological and Environmental Sciences, Faculty of Natural Science, University of Stirling, Stirling FK9 4LA, UK
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12
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Pathak U, Kumar R, Suri TM, Suri JC, Gupta NC, Pathak S. Impact of biomass fuel exposure from traditional stoves on lung functions in adult women of a rural Indian village. Lung India 2019; 36:376-383. [PMID: 31464208 PMCID: PMC6710971 DOI: 10.4103/lungindia.lungindia_477_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Exposure to biomass fuel (BMF) from traditional cookstoves inflicts an enormous burden of morbidities in women across the developing world. This study aims to assess the lung function and its association with the indoor air pollutants generated using BMF. Materials and Methods This cross-sectional study including 310 women was conducted in a rural village of India. Households were divided into two groups based on the cooking fuel, the BMF group and the liquefied petroleum gas (LPG) group. Information on respiratory symptoms and socioeconomic status was obtained using a standard questionnaire. Indoor air concentration for PM10and PM2.5was measured during cooking hours. Pulmonary function tests (PFTs) were conducted for the women inhabitants. Results On comparing the two groups, the concentration of PM10(890.26 ± 59.59 vs. 148.66 ± 31.97) μg/m3 and PM2.5(728.90 ± 50.20 vs. 99.76 ± 41.80) μg/m3 (P < 0.01) were higher in the group using BMF. The respiratory symptoms such as wheezing, dyspnea, chronic cough, and nocturnal cough, were significantly more common in the group using BMF. A significant difference was seen in the lung function indices between the two groups. A significant negative correlation of respiratory indices with duration of exposure and the particulate matter (PM) values suggested a greater decline on lung function among women exposed to increased concentrations of PM. On comparing participants with normal and abnormal PFT, it was seen that the use of BMF (odds ratio [OR] 8.01; 95% confidence interval [CI] 4.80, 13.36, P < 0.001) and the duration of exposure to BMF (OR 1.16; 95% CI 1.13, 1.20., P < 0.001) increased the odds of having an abnormal PFT. Conclusions This study shows a high prevalence of respiratory symptoms and an abnormal pulmonary function in women exposed to BMF.
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Affiliation(s)
- Utkarsha Pathak
- University School of Environment Management, Guru Gobind Singh Indraprastha University, Dwarka, New Delhi, India
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Tejas M Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, AlIMS, New Delhi, India
| | - J C Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - N C Gupta
- University School of Environment Management, Guru Gobind Singh Indraprastha University, Dwarka, New Delhi, India
| | - Sharmishtha Pathak
- Department of Neuroanaesthesiology and Neuro Critical Care, AIIMS, New Delhi, India
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13
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Tamire M, Addissie A, Skovbjerg S, Andersson R, Lärstad M. Socio-Cultural Reasons and Community Perceptions Regarding Indoor Cooking Using Biomass Fuel and Traditional Stoves in Rural Ethiopia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092035. [PMID: 30231480 PMCID: PMC6164706 DOI: 10.3390/ijerph15092035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/10/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022]
Abstract
Around three billion people in the world and 90% of the rural households in low-and middle-income countries are exposed to wood smoke with varying exposure levels and resulting health risks. We aimed to explore perceptions of the community towards indoor cooking and the socio-cultural barriers to bring change in Butajira, rural Ethiopia. We conducted a qualitative study involving ten separate focus group discussions with purposively selected members of the community and two key informant interviews with health extension workers. Content analysis was carried out using ATLAS.ti software. Participants reported the use of fuel wood and traditional three-stone cook stove to cook food. Economic status, lack of commitment, cultural views and concern along with safety and security issues were found to be barriers to change from traditional to cleaner methods of cooking. The community perceived wood smoke to have effects on their eyes and respiratory health, though they culturally viewed it as beneficial for postpartum mothers and newborns, avoiding bad smell and insects and in order to strengthen the fabric of their houses. Health education at community level is essential in order to bring about change in the cultural views and cooking behaviors focusing on opening windows and keeping young children away during cooking.
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Affiliation(s)
- Mulugeta Tamire
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 366 Code 1029, Ethiopia.
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, 41390 Gothenburg, Sweden.
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 366 Code 1029, Ethiopia.
| | - Susann Skovbjerg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, SE 41346 Gothenburg, Sweden.
| | - Rune Andersson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, SE 41346 Gothenburg, Sweden.
| | - Mona Lärstad
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, 41390 Gothenburg, Sweden.
- Department of Respiratory Medicine and Allergology, Institute of Medicine, Sahlgrenska University Hospital, SE 41390 Gothenburg, Sweden.
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Khan MSB, Lohano HD. Household air pollution from cooking fuel and respiratory health risks for children in Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:24778-24786. [PMID: 29926328 DOI: 10.1007/s11356-018-2513-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
Around 2.7 billion people in the world cook with polluting fuels, such as wood, crop residue, animal dung, charcoal, coal, and kerosene. Household air pollution from cooking with polluting fuels is recognized as a major risk factor for the disease burden. In this study, we examine the effect of using polluting fuels for cooking on the respiratory health of children in Pakistan. This study uses cross-sectional data from Pakistan Demographic and Health Survey 2012-13, with the sample size of 11,040 children under 5 years of age. Using logistic regression model, we control for factors such as averting activities, child characteristics, household characteristics, mother characteristics, and the unobserved factors using fixed effects. The results show that children in households using polluting fuels are 1.5 times more likely to have symptoms of acute respiratory infection (ARI) than children in households using cleaner fuels.
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Affiliation(s)
- Mohammad Shayan Babar Khan
- Department of Economics, Institute of Business Administration, University Road, Karachi, 75270, Pakistan.
| | - Heman D Lohano
- Department of Economics, Institute of Business Administration, University Road, Karachi, 75270, Pakistan
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