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Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review.

Thomas E, Wickramasinghe K, Mendis S, Roberts N, Foster C - BMC Public Health (2015)

Bottom Line: When well-designed, implemented and monitored, stove interventions can have positive effects.However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels.Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

View Article: PubMed Central - PubMed

Affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. emma.thomas@dph.ox.ac.uk.

ABSTRACT

Background: Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.

Methods: We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.

Results: The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.

Conclusions: Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

Review registration: The review was registered on Prospero (registration number CRD42014009796).

No MeSH data available.


Related in: MedlinePlus

The location of included studies. Countries are grouped as per the Global Burden of Disease regions and colour coordinated in terms of burden of disease attributable to HAP from solid fuels. The numbers of studies in each region are illustrated by the size of the circular marker. High to low burden of disease attributable to HAP from solid fuels as per Lim et. al. [5] is represented by  signifying highest levels of disease burden to  signifying lowest levels of disease burden. This figure was created by the authors using ArcInfo 10.2.1
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Fig2: The location of included studies. Countries are grouped as per the Global Burden of Disease regions and colour coordinated in terms of burden of disease attributable to HAP from solid fuels. The numbers of studies in each region are illustrated by the size of the circular marker. High to low burden of disease attributable to HAP from solid fuels as per Lim et. al. [5] is represented by signifying highest levels of disease burden to signifying lowest levels of disease burden. This figure was created by the authors using ArcInfo 10.2.1

Mentions: Figure 2 shows the distribution of study countries identified in the review. In-keeping with the inclusion criteria, only studies from LMIC were included. Fifteen different study countries were identified across Central and South America, Africa and Asia. Figure 2 groups study countries according to the Global Burden of Disease Regions. The countries are colour-coded to highlight areas of high burden of disease attributable to HAP from solid fuels as per Lim et.al. 5]. Studies have occurred across a range of settings and locations. Importantly, a range of studies have occurred in South Asia and Sub-Saharan Africa where HAP from solid fuels has the highest disease burden.Fig. 2


Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review.

Thomas E, Wickramasinghe K, Mendis S, Roberts N, Foster C - BMC Public Health (2015)

The location of included studies. Countries are grouped as per the Global Burden of Disease regions and colour coordinated in terms of burden of disease attributable to HAP from solid fuels. The numbers of studies in each region are illustrated by the size of the circular marker. High to low burden of disease attributable to HAP from solid fuels as per Lim et. al. [5] is represented by  signifying highest levels of disease burden to  signifying lowest levels of disease burden. This figure was created by the authors using ArcInfo 10.2.1
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499941&req=5

Fig2: The location of included studies. Countries are grouped as per the Global Burden of Disease regions and colour coordinated in terms of burden of disease attributable to HAP from solid fuels. The numbers of studies in each region are illustrated by the size of the circular marker. High to low burden of disease attributable to HAP from solid fuels as per Lim et. al. [5] is represented by signifying highest levels of disease burden to signifying lowest levels of disease burden. This figure was created by the authors using ArcInfo 10.2.1
Mentions: Figure 2 shows the distribution of study countries identified in the review. In-keeping with the inclusion criteria, only studies from LMIC were included. Fifteen different study countries were identified across Central and South America, Africa and Asia. Figure 2 groups study countries according to the Global Burden of Disease Regions. The countries are colour-coded to highlight areas of high burden of disease attributable to HAP from solid fuels as per Lim et.al. 5]. Studies have occurred across a range of settings and locations. Importantly, a range of studies have occurred in South Asia and Sub-Saharan Africa where HAP from solid fuels has the highest disease burden.Fig. 2

Bottom Line: When well-designed, implemented and monitored, stove interventions can have positive effects.However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels.Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

View Article: PubMed Central - PubMed

Affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. emma.thomas@dph.ox.ac.uk.

ABSTRACT

Background: Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.

Methods: We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.

Results: The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.

Conclusions: Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

Review registration: The review was registered on Prospero (registration number CRD42014009796).

No MeSH data available.


Related in: MedlinePlus