Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia
Eric D. McCollum, John P. McCracken, Miles A. Kirby, Laura M. Grajeda, Shakir Hossen, Lawrence H. Moulton, Suzanne Simkovich, Dina Goodman, Ghislaine Rosa, Alexie Mukeshimana, Kalpana Balakrishnan, Gurusamy Thangavel, Sarada S. Garg, Adly Castañaza, Lisa M. Thompson, Anaité Díaz-Artiga, Aris T. Papageorghiou, Víctor G. Dávila‐Román, Lindsay J. Underhill, Stella M. Hartinger, Kendra N. Williams, Laura Nicolaou, Howard H. Chang, Amy Lovvorn, Joshua P. Rosenthal, Ajay Pillarisetti, Wenlu Ye, Luke P. Naeher, Michael Johnson, Lance A. Waller, Shirin Jabbarzadeh, Jiantong Wang, Yunyun Chen, Kyle Steenland, Thomas Clasen, Jennifer L. Peel, William Checkley
Abstract
BACKGROUND: Exposure to household air pollution is a risk factor for severe pneumonia. The effect of replacing biomass cookstoves with liquefied petroleum gas (LPG) cookstoves on the incidence of severe infant pneumonia is uncertain. METHODS: ]) in the women and their offspring. The trial had four primary outcomes; the primary outcome for which data are presented in the current report was severe pneumonia in the first year of life, as identified through facility surveillance or on verbal autopsy. RESULTS: among the children, with a median exposure of 24.2 μg per cubic meter (interquartile range, 17.8 to 36.4) in the intervention group and 66.0 μg per cubic meter (interquartile range, 35.2 to 132.0) in the control group. A total of 175 episodes of severe pneumonia were identified during the first year of life, with an incidence of 5.67 cases per 100 child-years (95% confidence interval [CI], 4.55 to 7.07) in the intervention group and 6.06 cases per 100 child-years (95% CI, 4.81 to 7.62) in the control group (incidence rate ratio, 0.96; 98.75% CI, 0.64 to 1.44; P = 0.81). No severe adverse events were reported to be associated with the intervention, as determined by the trial investigators. CONCLUSIONS: The incidence of severe pneumonia among infants did not differ significantly between those whose mothers were assigned to cook with LPG stoves and fuel and those whose mothers were assigned to continue cooking with biomass stoves. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).