Impact of improved cookstoves on women's and child health in low and middle income countries: a systematic review and meta-analysis

Megha Thakur; Paulien A. W. Nuyts; Esther A. Boudewijns; Javier Flores Kim; Timor Faber; Giridhara R. Babu; Onno C. P. van Schayck; Jasper V. Been

doi:10.1136/thoraxjnl-2017-210952

Impact of improved cookstoves on women's and child health in low and middle income countries: a systematic review and meta-analysis

Megha Thakur, Paulien A. W. Nuyts, Esther A. Boudewijns, Javier Flores Kim, Timor Faber, Giridhara R. Babu, Onno C. P. van Schayck^*, Jasper V. Been

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

60 Citations (Scopus)

Abstract

Objectives Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).Design Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.Setting LMICsParticipants Women and childrenInterventions Improved biomass cookstovesMain outcome measures Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.Results We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI -13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.Conclusion Improved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.Registration PROSPERO: CRD42016033075

Original language	English
Pages (from-to)	1026-1040
Number of pages	15
Journal	Thorax
Volume	73
Issue number	11
DOIs	https://doi.org/10.1136/thoraxjnl-2017-210952
Publication status	Published - Nov 2018

Bibliographical note

Funding:
GRB is supported by an Intermediate Fellowship by the Wellcome
Trust DBT India Alliance (Clinical and Public Health Research Fellowships). JVB is
supported by fellowships from the Netherlands Lung Foundation (4.2.14.063JO) and
the Erasmus MC.

Research programs

EMC MGC-02-52-01-A
EMC MM-03-54-04-A

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/thoraxjnl-2017-210952

http://hdl.handle.net/1765/109002

Cite this

@article{74d5a00af5c6469dac3fb528a15f17de,

title = "Impact of improved cookstoves on women's and child health in low and middle income countries: a systematic review and meta-analysis",

abstract = "Objectives Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).Design Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.Setting LMICsParticipants Women and childrenInterventions Improved biomass cookstovesMain outcome measures Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.Results We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI -13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.Conclusion Improved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.Registration PROSPERO: CRD42016033075",

author = "Megha Thakur and Nuyts, {Paulien A. W.} and Boudewijns, {Esther A.} and Kim, {Javier Flores} and Timor Faber and Babu, {Giridhara R.} and {van Schayck}, {Onno C. P.} and Been, {Jasper V.}",

note = "Funding: GRB is supported by an Intermediate Fellowship by the Wellcome Trust DBT India Alliance (Clinical and Public Health Research Fellowships). JVB is supported by fellowships from the Netherlands Lung Foundation (4.2.14.063JO) and the Erasmus MC.",

year = "2018",

month = nov,

doi = "10.1136/thoraxjnl-2017-210952",

language = "English",

volume = "73",

pages = "1026--1040",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

number = "11",

}

TY - JOUR

T1 - Impact of improved cookstoves on women's and child health in low and middle income countries

T2 - a systematic review and meta-analysis

AU - Thakur, Megha

AU - Nuyts, Paulien A. W.

AU - Boudewijns, Esther A.

AU - Kim, Javier Flores

AU - Faber, Timor

AU - Babu, Giridhara R.

AU - van Schayck, Onno C. P.

AU - Been, Jasper V.

N1 - Funding: GRB is supported by an Intermediate Fellowship by the Wellcome Trust DBT India Alliance (Clinical and Public Health Research Fellowships). JVB is supported by fellowships from the Netherlands Lung Foundation (4.2.14.063JO) and the Erasmus MC.

PY - 2018/11

Y1 - 2018/11

N2 - Objectives Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).Design Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.Setting LMICsParticipants Women and childrenInterventions Improved biomass cookstovesMain outcome measures Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.Results We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI -13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.Conclusion Improved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.Registration PROSPERO: CRD42016033075

AB - Objectives Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).Design Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.Setting LMICsParticipants Women and childrenInterventions Improved biomass cookstovesMain outcome measures Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.Results We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI -13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.Conclusion Improved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.Registration PROSPERO: CRD42016033075

UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:000450419800008&DestLinkType=FullRecord&DestApp=WOS

U2 - 10.1136/thoraxjnl-2017-210952

DO - 10.1136/thoraxjnl-2017-210952

M3 - Article

C2 - 29925674

SN - 0040-6376

VL - 73

SP - 1026

EP - 1040

JO - Thorax

JF - Thorax

IS - 11

ER -

Impact of improved cookstoves on women's and child health in low and middle income countries: a systematic review and meta-analysis

Abstract

Bibliographical note

Research programs

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this