Factors predisposing women and children to indoor air pollution in rural villages, Western Kenya

BACKGROUND: Indoor air pollution (IAP) remains a major global public health hazard more so in developing countries where use of fossil fuels is still very common. However, despite the popularity of kerosene and fuelwood as energy sources among many households in the Sub-Saharan Africa, little is known about their health effects and the predisposing factors particularly on those with direct exposure. This study sought to relate indoor air pollution exposure to self-reported prevalence of respiratory outcomes including (sputum production, congestion, breathing difficulties, eye problems, fatigue, and headaches and wheezing) among women and children of Trans Nzoia County, in the rural villages of western Kenya. METHODS: In this cross-sectional survey, simple random technique was used to select 251 households from 14 villages. Households were the sampling units, while the woman of the household with/or in custody of a child aged less than 5 years old were the unit of analysis. A total of 251 women with/or in custody of a child aged less than 5 years old took part in the study. A structured questionnaire was used to collect information on cause and effects of IAP among women and children. Data was analyzed descriptively and inferentially. We used Poisson generalized linear models with IAP symptoms and indoor cooking as dependent variables and household profiles and other socio-demographics as independent variables to identify the factors that affect health outcome. RESULTS: Mean age of respondents was 36.49 years, (95% CI [35.5, 37.5]). Most (64.5%) houses were semi-permanent, with 58.6% having an average kitchen size (5.6 m(2)). Wood and kerosene were the most preferred fuel types for cooking (96.8%) and lighting (97.4%), respectively. Smoke from the wood was identified as the dominant (96.8%) source of IAP. Most women (92.0%) and children (95.4%) had coughs of varying intensities during the year, while 31.5% of the women reported wheezing. About 98% of them experienced fatigued and headaches. Use of wood fuel was associated with increased coughing (p = 0.03), phlegm (p = 0.02), wheezing (p = 0.04), eye problems (p = 0.03) and headaches (p = 0.01) among women and children in the previous 24 h. Education level, ventilation, main fuel source used in 24 h, indoor cooking and house type were significantly associated with IAP health effects (p ≤ 0.05). CONCLUSIONS: Supporting the impoverished households and increasing their level of awareness on health-effects of IAP occasioned by use of biomass fuel while cooking indoors may be the first step in implementing a programme aimed at reducing exposure among rural households in Trans Nzoia County, in rural parts of Western Kenya.