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Effects of a Multi-component Liquefied Petroleum Gas Stove Intervention on Severe Pneumonia Incidence During Infancy: HAPIN Randomized Controlled Trial

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dc.contributor.author Mccollum, ED
dc.contributor.author McCracken, JP
dc.contributor.author Kirby, MA
dc.contributor.author Hossen, S
dc.contributor.author Grajeda, L
dc.contributor.author Moulton, LH
dc.contributor.author Simkovich, SM
dc.contributor.author Goodman, D
dc.contributor.author Rosa, G
dc.contributor.author Balakrishnan, K
dc.contributor.author Thangavel, G
dc.contributor.author Garg, SS
dc.contributor.author Castanaza, A
dc.contributor.author Thompson, LM
dc.contributor.author Diaz-Artiga, A
dc.contributor.author Papageorghiou, AT
dc.contributor.author Davila-Roman, V
dc.contributor.author Underhill, LJ
dc.contributor.author Hartinger Peña, Stella Maria
dc.contributor.author Chang, HH
dc.contributor.author Lovvorn, AE
dc.contributor.author Rosenthal, JP
dc.contributor.author Pillarisetti, A
dc.contributor.author Johnnson, MA
dc.contributor.author Waller, LA
dc.contributor.author Jabbarzadeh, S
dc.contributor.author Wang, J
dc.contributor.author Chen, Y
dc.contributor.author Steenland, K
dc.contributor.author Clasen, TF
dc.contributor.author Peel, JL
dc.contributor.author Checkley, W
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/20.500.12866/14302
dc.description.abstract Rationale: Childhood pneumonia is a leading cause of death worldwide. Household air pollution (HAP) from biomass cooking fuelmay be an important child pneumonia risk factor. It is unknown whether liquefied petroleum gas (LPG) cookstoves reduce severepediatric pneumonia. Methods: We conducted a randomized controlled trial of an LPG cookstove, continuous fuel distribution andbehavioral messaging, compared to usual biomass-burning cookstove use, among 3,200 pregnant women and their householdsin 10 resource-poor settings in India, Guatemala, Peru, and Rwanda between May 2018-September 2021. Pregnant women 18-34 years old and 9-19 weeks gestation (by ultrasound) were eligible; follow-up was through the offspring’s first birthday. Wemeasured 24-hour fine particulate matter (PM2.5), black carbon and carbon monoxide at baseline, pregnancy, and during thechild’s first year of life. Cookstove use was monitored for compliance. Active surveillance for severe pneumonia in hospitals andselected health centers was conducted using the following case definition: observed and/or reported cough and/or difficultbreathing, and (1) >1 World Health Organization (WHO)-defined general danger sign with ultrasonographic or radiographicalveolar consolidation, or (2) hypoxemia; or (3) any pneumonia death by verbal autopsy. Secondary WHO pneumonia casedefinitions were also analyzed. All case episodes were included accounting for intra-child correlation. Analyses were intention-to-treat. Results: 3,200 pregnant women were randomized and there were 3,061 live births. LPG and control group antenatal PM2.5levels were 24.0 μg/m3 and 70.7 μg/m3, and antenatal traditional stove use in the LPG arm was a median of <1 day/month.Baseline characteristics of liveborn children were balanced between arms (Table). Overall, there were 175 severe pneumoniacases, 67% (n=118) in <6 month olds and 51% (n=89) in females. Hypoxemia was frequent (69%, 120/175) and eitherultrasonographic or radiographic consolidation occurred in 49% (86/175) of cases. We observed a severe pneumonia incidencerate ratio (IRR) of 0.96 (95% confidence interval, 0.70, 1.32; p-value=0.81) during the first year of life in the LPG arm compared tothe control arm. Twelve children died from pneumonia, 8.8% (n=8) were controls and 4.7% (n=4) were from LPG households.Although secondary WHO pneumonia cases were more frequent than primary definition cases, they had qualitatively similar IRRs.Conclusions: Overall pneumonia incidence and detection may have been affected by the COVID-19 pandemic. Despite PM2.5exposure decreases and high intervention compliance, we found no difference in severe pneumonia incidence among infants ofwomen randomized to a multi-component LPG intervention than usual biomass-burning cookstove practices. 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 Stove Intervention en_US
dc.subject Pneumonia en_US
dc.subject Infancy en_US
dc.subject.mesh Industria del Petróleo y Gas
dc.subject.mesh Neumonía
dc.subject.mesh Niño
dc.title Effects of a Multi-component Liquefied Petroleum Gas Stove Intervention on Severe Pneumonia Incidence During Infancy: HAPIN 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.A4628
dc.relation.issn 1535-4970


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