Exposure to Indoor Air Pollution From Household Fuels and Effect on Treatment Response Amongst Children Aged Between 2 and 59 Months Admitted With Pneumonia at the Kenyatta National Hospital, Nairobi, Kenya

Abstract

Background On average, 50% the world’s population relies on high polluting fuels for their domestic energy requirements. The primary target of air pollutants emitted by these fuels is the respiratory system and can result in pneumonia which at 16% is the second leading cause of death of children less than 5 years of age in Kenya. Approximately 20% of children admitted to hospital in Kenya with pneumonia and receive treatment as per the WHO recommended guidelines experience a poor response to treatment at 48 hours. Objectives The main aim of the study was to determine the prevalence of exposure to IAPs from household fuels and its effect on treatment outcomes amongst children aged between 2 and 59 months admitted with pneumonia at the Kenyatta National Hospital (KNH) in Nairobi, Kenya. Methodology A prospective cohort study undertaken over a three month period of time in the general pediatric wards of KNH. The study population was of children aged between 2 and 59 months admitted with WHO-defined severe pneumonia and started on the WHO recommended treatment regimen. Data Management and Analysis A standardized questionnaire was used to collect data. Data entry was through the Epi-info computer package and was then exported to the statistical package for social sciences (SPSS) for analysis. Association is presented using odds ratio with a 95% confidence interval to determine whether there is an association between household fuel exposure and response to treatment after 48 hours in children aged between 2 and 59 months admitted with clinical features of pneumonia KNH. Survival analysis was done to assess the effects of IAP exposure from household fuels on 5-day outcome using variable of time from admission to outcome death versus time to survival/recovery as the outcome in the model. Results A total of 127 respondents were recruited for the study. Exposure to high levels of IAP from household fuels was found to be significantly associated with a poor response to pneumonia treatment with an odds ratio of 1.49, a 95% confidence interval of 1.02 to 2.21 and a P value of 0.0406 . There was also a significant association between..............................................................