Kirk R Smith, John P McCracken, Martin W Weber, Alan Hubbard, Alisa Jenny, Lisa M Thompson, John Balmes, Anaité Diaz, Byron Arana, Nigel Bruce   |   2011
Type: Research Report
Topic: Health
Country: Guatemala
Pneumonia causes more child deaths than does any other disease. Observational studies have indicated that smoke from household solid fuel is a signifi cant risk factor that aff ects about half the world’s children. We investigated whether an intervention to lower indoor wood smoke emissions would reduce pneumonia in children. We undertook a parallel randomised controlled trial in highland Guatemala, in a population using open indoor wood fi res for cooking. We randomly assigned 534 households with a pregnant woman or young infant to receive a woodstove with chimney (n=269) or to remain as controls using open woodfi res (n=265), by concealed permuted blocks of ten homes. Fieldworkers visited homes every week until children were aged 18 months to record the child’s health status. Sick children with cough and fast breathing, or signs of severe illness were referred to study physicians, masked to intervention status, for clinical examination. The primary outcome was physician-diagnosed pneumonia, without use of a chest radiograph. Analysis was by intention to treat (ITT). Infant 48-h carbon monoxide measurements were used for exposure-response analysis after adjustment for covariates.