Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18 : a geospatial modelling study
- Frostad, Joseph, Nguyen, QuynhAnh, Baumann, Mathew, Blacker, Brigette, Marczak, Laurie, Deshpande, Aniruddha, Wiens, Kirsten, LeGrand, Kate, Johnson, Kimberly, Abbasi-Kangevari, Mohsen, Abdoli, Amir, Abolhassani, Hassan, Abreu, Lucas, Abrigo, Michael, Abu-Rmeileh, Niveen, Adekanmbi, Victor, Agrawal, Anurag, Ahmed, Muktar, Al-Aly, Ziyad, Alanezi, Fahad, Alcalde-Rabanal, Jacqueline, Alipour, Vahid, Altirkawi, Khalid, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson, Amegah, Adeladza, Amini, Saeed, Amiri, Fatemeh, Amugsi, Dickson, Rahman, Muhammad Aziz
- Authors: Frostad, Joseph , Nguyen, QuynhAnh , Baumann, Mathew , Blacker, Brigette , Marczak, Laurie , Deshpande, Aniruddha , Wiens, Kirsten , LeGrand, Kate , Johnson, Kimberly , Abbasi-Kangevari, Mohsen , Abdoli, Amir , Abolhassani, Hassan , Abreu, Lucas , Abrigo, Michael , Abu-Rmeileh, Niveen , Adekanmbi, Victor , Agrawal, Anurag , Ahmed, Muktar , Al-Aly, Ziyad , Alanezi, Fahad , Alcalde-Rabanal, Jacqueline , Alipour, Vahid , Altirkawi, Khalid , Alvis-Guzman, Nelson , Alvis-Zakzuk, Nelson , Amegah, Adeladza , Amini, Saeed , Amiri, Fatemeh , Amugsi, Dickson , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 10, no. 10 (2022), p. e1395-e1411
- Full Text:
- Reviewed:
- Description: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Frostad, Joseph , Nguyen, QuynhAnh , Baumann, Mathew , Blacker, Brigette , Marczak, Laurie , Deshpande, Aniruddha , Wiens, Kirsten , LeGrand, Kate , Johnson, Kimberly , Abbasi-Kangevari, Mohsen , Abdoli, Amir , Abolhassani, Hassan , Abreu, Lucas , Abrigo, Michael , Abu-Rmeileh, Niveen , Adekanmbi, Victor , Agrawal, Anurag , Ahmed, Muktar , Al-Aly, Ziyad , Alanezi, Fahad , Alcalde-Rabanal, Jacqueline , Alipour, Vahid , Altirkawi, Khalid , Alvis-Guzman, Nelson , Alvis-Zakzuk, Nelson , Amegah, Adeladza , Amini, Saeed , Amiri, Fatemeh , Amugsi, Dickson , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 10, no. 10 (2022), p. e1395-e1411
- Full Text:
- Reviewed:
- Description: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17 : analysis for the global burden of disease study 2017
- Reiner, Robert, Wiens, Kirsten, Deshpande, Aniruddha, Baumann, Mathew, Rahman, Muhammad Aziz
- Authors: Reiner, Robert , Wiens, Kirsten , Deshpande, Aniruddha , Baumann, Mathew , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Vol. 395, no. 10239 (2020), p. 1779-1801
- Full Text:
- Reviewed:
- Description: Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. ***Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Rahman” is provided in this record***
- Description: C A T Antonio reports grants and personal fees from Johnson & Johnson (Philippines), outside the submitted work. S J Dunachie reports grants from The Fleming Fund at UK Department of Health & Social Care, during the conduct of the study. M Jakovljevic reports grants from Ministry of Education Science and Technological Development of The Republic of Serbia, outside the submitted work. J J Jó
- Authors: Reiner, Robert , Wiens, Kirsten , Deshpande, Aniruddha , Baumann, Mathew , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Vol. 395, no. 10239 (2020), p. 1779-1801
- Full Text:
- Reviewed:
- Description: Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. ***Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Rahman” is provided in this record***
- Description: C A T Antonio reports grants and personal fees from Johnson & Johnson (Philippines), outside the submitted work. S J Dunachie reports grants from The Fleming Fund at UK Department of Health & Social Care, during the conduct of the study. M Jakovljevic reports grants from Ministry of Education Science and Technological Development of The Republic of Serbia, outside the submitted work. J J Jó
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