Nasanen-Gilmore S Pieta K, Saha Subir, Rasul Izaz, Rousham Emily K
Department of Health, National Institute for Health and Welfare of Finland, PL30, Helsinki, Finland.
Office of School Wellness Programs, New York City Department of Education, New York.
Am J Hum Biol. 2015 Nov-Dec;27(6):851-8. doi: 10.1002/ajhb.22736. Epub 2015 May 20.
Respiratory tract infections (RTI) are one of the leading causes of under-five mortality in Bangladesh. Solid biomass fuels are the main source of domestic fuel used for cooking across Bangladesh, leading to smoke and pollution exposure in the home. This article aims to identify risk factors for RTI among children aged under five years in Bangladesh with a particular focus on the household environment, fuel use, and cooking practices.
A cross-sectional household-health survey was carried out in 321 households in northern Bangladesh. The survey included care-giver interviews on cooking practices, child health, and household behaviors during cooking. Health status of the youngest child (under five years) from each household was recorded through maternal interviews, medical diagnosis, and assessment of biomarkers (C-reactive protein (CRP), hemoglobin) from finger-prick blood samples. Anthropometric status (weight, height) was recorded.
Children who spent ≥30 minutes/day within 5 feet of the stove during cooking had a significantly increased risk of moderate/severe RTI compared with children spending <30 minutes/day close to the stove (OR = 2.15, 95%CI: 1.20-3.86, P = 0.01), independent of socio-economic status (SES), biomass fuel type (wood, dung, plant-derived, compressed rice husks), child age, anthropometric status, CRP and hemoglobin.
In environments with a heavy reliance on solid biomass fuels, the amount of time a child spends near the stove during cooking may be an important risk for RTI. These novel findings from Bangladesh warrant further investigation of mother-infant behaviors during cooking in relation to child health, to ascertain whether the association is likely to be causal.
呼吸道感染（RTI）是孟加拉国五岁以下儿童死亡的主要原因之一。固体生物质燃料是孟加拉国全国用于烹饪的主要家庭燃料来源，导致家庭中存在烟雾和污染暴露。本文旨在确定孟加拉国五岁以下儿童呼吸道感染的风险因素，特别关注家庭环境、燃料使用和烹饪习惯。
在孟加拉国北部的321户家庭中进行了一项横断面家庭健康调查。该调查包括对照顾者进行关于烹饪习惯、儿童健康和烹饪期间家庭行为的访谈。通过母亲访谈、医学诊断以及对指尖血样中生物标志物（C反应蛋白（CRP）、血红蛋白）的评估，记录每户最年幼（五岁以下）儿童的健康状况。记录人体测量状况（体重、身高）。
与每天在炉灶附近停留不到30分钟的儿童相比，烹饪期间每天在炉灶5英尺范围内停留≥30分钟的儿童发生中度/重度呼吸道感染的风险显著增加（比值比=2.15，95%置信区间：1.20-3.86，P=0.01），且独立于社会经济地位（SES）、生物质燃料类型（木材、粪便、植物源、压缩稻壳）、儿童年龄、人体测量状况、CRP和血红蛋白。
在严重依赖固体生物质燃料的环境中，儿童在烹饪期间靠近炉灶的时间可能是呼吸道感染的一个重要风险因素。孟加拉国的这些新发现值得进一步研究烹饪期间母婴行为与儿童健康的关系，以确定这种关联是否可能是因果关系。
