A Cross-Sectional Study of Household Biomass Fuel Use among a Peri-Urban Population in Malawi. Ann Am Thorac Soc. 2014 Jun 24.
Piddock KC1, Gordon SB, Ngwira A, Msukwa M, Nadeau G, Davis KJ, Nyirenda MJ, Mortimer K.
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Corresponding Author: Kevin Mortimer, Email: Kevin.Mortimer@liverpool.ac.uk
Rationale: The Global Burden of Disease Study suggests almost 3.5 million people die as a consequence of household air pollution every year. Respiratory diseases including chronic obstructive pulmonary disease and pneumonia in children are strongly associated with exposure to household air pollution. Smoke from burning biomass fuels for cooking, heating and lighting is the main contributor to high household air pollution levels in low-income countries like Malawi. A greater understanding of biomass fuel use in Malawi should enable us to address household air pollution associated communicable and non-communicable diseases more effectively.
Objectives: To conduct a cross-sectional analysis of biomass fuel use and population demographics among adults in Blantyre, Malawi. Methods: We used GPS-enabled PDAs to collect data on location, age, sex, marital status, education, occupation and fuel use. We describe these data and explore associations between demographics and reported fuel type.
Measurements and Main Results: 16079 adults participated (nine households refused), median age 30, similar distribution of males and females, 60% married and 62% received secondary school education. The most commonly reported male and female occupation was ‘salaried employment’ (40.7%) and ‘petty trader and marketing’ (23.5%) respectively. Charcoal (81.5% of households), wood (36.5%) and electricity (29.1%) were the main fuels used at home. Only 3.9% of households used electricity exclusively. Lower educational and occupational attainment was associated with greater use of wood.
Conclusions: This large cross-sectional study has identified extensive use of biomass fuels in a typical sub-Saharan Africa peri-urban population in which women and people of lower socio-economic status are disproportionately affected. Biomass fuel use is likely to be a major driver of existing communicable respiratory disease and the emerging non-communicable disease (especially respiratory and cardiovascular) epidemic in this region. Our data will help inform the rationale for specific intervention studies and the development of appropriately targeted public health strategies to tackle this important and poverty-related global health problem.
