Prevalence of Indoor Air Pollution by Cooking Fuel and its Association with Respiratory Infections in Children in Peru: An Analysis of a Population Based, Cross-Sectional Survey

Background: Household air pollution accounts for about 3 · 5-4 million deaths every year. Interventions should target priority geographic areas where the problem is more prevalent.

Objective: To estimate the overall prevalence, the prevalence by region and area of residence, of indoor air pollution by cooking fuel in children in Peru; and to study the association of indoor air pollution by cooking fuel with of acute respiratory infection (ARI) in children.

Methodology: We used data from the 2013-Demographic and Health Survey, with nationwide representativeness. We included children under 5 years of age. Air pollution was present if the child lived in a house that used coal, charcoal, wood, straw, bush, grass, crops or livestock dung as a fuel for cooking. We used logistic regression models to study the independent association of air pollution by cooking fuel and ARI, controlling for potential confounders.

Results: We studied 8,616 children; overall prevalence of indoor air pollution was 37.4% (95%CI: 36.4-38.4%). Among those exposed to cooking fuel, in 24.4% (95%CI: 23.5-25.3%) of the houses there were no chimney. The ARI prevalence was 13.0% (95%CI:12.3-13.7%). ARI was associated to indoor air pollution in urban and rural areas, and a dose response pattern was observed (p<0.05). By region the association remained but was statistically significant only in the Forest region.

Conclusion: Prevalence of indoor air pollution caused by cooking fuel in children was high in Peru and ARI was independently associated to it. Interventions to reduce this source of pollution need to be implemented in Peru, and the Forest should be a priority region for any implementation.