Household cooking fuel type and childhood anaemia in sub-Saharan Africa: analysis of cross-sectional surveys of 123, 186 children from 29 countries

Iddrisu Amadu; Abdul-Aziz Seidu; Abdul-Rahaman Afitiri; Bright Opoku Ahinkorah; Sanni Yaya

doi:10.1136/bmjopen-2021-048724

Household cooking fuel type and childhood anaemia in sub-Saharan Africa: analysis of cross-sectional surveys of 123, 186 children from 29 countries

BMJ Open. 2021 Jul 20;11(7):e048724. doi: 10.1136/bmjopen-2021-048724.

Authors

Iddrisu Amadu^{1

2}, Abdul-Aziz Seidu^{3

4

5}, Abdul-Rahaman Afitiri⁶, Bright Opoku Ahinkorah⁷, Sanni Yaya^{8

9}

Affiliations

¹ Department of Fisheries and Aquatic Sciences, University of Cape Coast, Cape Coast, Ghana.
² Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana.
³ Department of Population and Health, University of Cape Coast, Cape Coast, Ghana abdul-aziz.seidu@stu.ucc.edu.gh.
⁴ College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, Queensland, Australia.
⁵ Department of Estate Management, Takoradi Technical University, Takoradi, Ghana.
⁶ Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana.
⁷ University of Technology Sydney, Sydney, New South Wales, Australia.
⁸ School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada.
⁹ The George Institute for Global Health, Imperial College London, London, UK.

Abstract

Objective: This study sought to investigate the joint effect of household cooking fuel type and urbanicity (rural-urban residency) on anaemia among children under the age of five in sub-Saharan Africa.

Design: We analysed cross-sectional data of 123, 186 children under the age of five from 29 sub-Saharan African countries gathered between 2010 and 2019 by the Demographic and Health Survey programme. Bivariate (χ² test of independence) and multilevel logistic regression were used to examine the effect of urbanicity-household cooking fuel type on childhood anaemia. Results were reported as adjusted odds ratios (aORs) with 95% CIs at p<0.05.

Outcome measures: Anaemia status of children.

Results: More than half (64%) of children had anaemia. The percentage of children who suffered from anaemia was high in those born to mothers in Western Africa (75%) and low among those born in Southern Africa (54%). Children from rural households that depend on unclean cooking fuels (aOR=1.120; 95% CI 1.033 to 1.214) and rural households that depend on clean cooking fuels (aOR=1.256; 95% CI 1.080 to 1.460) were more likely to be anaemic as compared with children from urban households using clean cooking fuel. Child's age, sex of child, birth order, perceived birth size, age of mother, body mass index of mother, education, marital status, employment status, antenatal care, wealth quintile, household size, access to electricity, type of toilet facility, source of drinking water and geographic region had significant associations with childhood anaemia status.

Conclusions: Our study has established a joint effect of type of household cooking fuel and urbanicity on anaemia among children under the age of five in sub-Saharan Africa. It is therefore critical to promote the usage of clean cooking fuels among households and women in rural areas. These should be done taking into consideration the significant child, maternal, household, and contextual factors identified in this study.

Keywords: anaemia; community child health; public health.

MeSH terms

Africa South of the Sahara / epidemiology
Africa, Southern
Africa, Western
Air Pollution, Indoor*
Anemia* / epidemiology
Anemia* / etiology
Child
Cooking
Cross-Sectional Studies
Female
Health Surveys
Humans
Pregnancy