Universidad Peruana Cayetano Heredia

Effects of a Liquefied Petroleum Gas, Continuous Fuel Delivery and Behavioral Messaging Intervention on Linear Growth in Children With Exposure to Household Air Pollution: A Multi-country Randomized Controlled Trial

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dc.contributor.author Checkley, W
dc.contributor.author Thompson, L
dc.contributor.author Sinharoy, S
dc.contributor.author Hossen, S
dc.contributor.author Moulton, L
dc.contributor.author Chang, H
dc.contributor.author Waller, L
dc.contributor.author Steenland, K
dc.contributor.author Rosa, G
dc.contributor.author Mukeshimana, A
dc.contributor.author Ndagijimana, F
dc.contributor.author McCracken, J
dc.contributor.author Diaz-Artiga, A
dc.contributor.author Balakrishnan, K
dc.contributor.author Garg, S
dc.contributor.author Thangavel, G
dc.contributor.author Aravindalochanan, V
dc.contributor.author Hartinger Peña, Stella Maria
dc.contributor.author Chaing, M
dc.contributor.author Kirby, M
dc.contributor.author Papageorghiou, A
dc.contributor.author Ramakrishnan, U
dc.contributor.author Williams, KN
dc.contributor.author Nicolaou, L
dc.contributor.author Jabbarzadeh, S
dc.contributor.author Wang, J
dc.contributor.author Johnson, M
dc.contributor.author Pillarisetti, A
dc.contributor.author Rosenthal, JP
dc.contributor.author McCollum, ED
dc.contributor.author Clasen, T
dc.date.accessioned 2023-10-12T15:30:09Z
dc.date.available 2023-10-12T15:30:09Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14301
dc.description.abstract Background: Household air pollution (HAP) is a widespread environmental exposure in low- andmiddle-income countries and may lead to stunted growth in children. We evaluated whether aliquefied petroleum gas (LPG) intervention to mitigate HAP lowered the risk of childhood stunting.Methods: We conducted a randomized controlled trial in four resource-poor settings of Guatemala,India, Peru, and Rwanda where biomass fuels are used as the primary source of energy forcooking. Stunting (length-for-age Z-score two standard deviations below the median of standardpopulation) at age 12 months was one of four primary outcomes. We randomized pregnant womenaged 18-34 years at 9-19 weeks gestation confirmed by ultrasound. Intervention participantsreceived a LPG stove, continuous free fuel delivery and regular behavioral reinforcements for 18months. Controls continued usual cooking practices. We assessed children for linear growth at 12months and monitored personal exposures to PM2.5 and carbon monoxide starting at pregnancythrough the first year of life. We conducted an intention-to-treat analysis adjusted for randomizationstrata to estimate the relative risk (RR) of stunting and the difference in length-for-age Z-score at 12months for intervention children when compared to controls. Given that the trial has four primaryoutcomes, the threshold for statistical significance was set at 0.0125 and thus we present a 98.75%CI for the primary stunting outcome to control the familywise Type I error rate at 0.05. The study wasconducted between May 2018 and September 2021. Results: We randomized 3200 pregnantwomen, and 3061 (96%) children were born alive. Of these, 1171 (76%) and 1186 (78%) had alength measurement at age 12 months, and 320 (27%) and 300 (25%) were stunted in theintervention and control arms, respectively. The COVID-19 pandemic did not affect delivery of theintervention, but some length measurements were missed. Children in the intervention arm had asimilar risk of stunting (RR=1.10, 95% familywise CI 0.97 to 1.24; p=0.15) and similar mean length-for-age Z-score (difference= -0.03 Z-scores, 95% CI -0.11 to 0.05; p=0.45) at age 12 months whencompared to controls. Conclusions: An intervention strategy aimed at mitigating HAP from mid-pregnancy through infancy did not reduce the risk of childhood stunting at one year of age. en_US
dc.language.iso eng
dc.publisher American Thoracic Society
dc.relation.ispartofseries American Journal of Respiratory and Critical Care Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Liquefied Petroleum Gas en_US
dc.subject Continuous Fuel Delivery en_US
dc.subject Behavioral Messaging en_US
dc.subject Children en_US
dc.subject Household Air Pollution en_US
dc.subject.mesh Industria del Petróleo y Gas
dc.subject.mesh Aceites Combustibles
dc.subject.mesh Niños
dc.subject.mesh Contaminación del Aire
dc.title Effects of a Liquefied Petroleum Gas, Continuous Fuel Delivery and Behavioral Messaging Intervention on Linear Growth in Children With Exposure to Household Air Pollution: A Multi-country Randomized Controlled Trial en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A2786
dc.relation.issn 1535-4970


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