Impact of Improved "Injera" Baking Stove Use on Childhood Acute Respiratory Infection Prevention in Northwest Ethiopia

NCT03612362 | Unknown DMC

• 2 other identifiers: 088/18-04U1111-1215-1090
• Study Type: interventional
• Target: 5,500
• Locations: 1 country
• Sites: 1

Brief Summary

In Ethiopia, great majorities (95%) of households rely on solid biomass fuels such as wood, muck, crop residues, and charcoal burned in highly polluting stoves to meet the basic household energy needs with its severe health consequences due to emission of toxic indoor air pollutants. Correspondingly, household air pollution (HAP) from biomass fuel use is now estimated to be responsible for nearly 3.5 million premature deaths annually, with the highest disease burdens experienced by countries in sub-Saharan Africa. HAP ranks as the highest environmental risk factors to premature deaths globally and 2nd leading risk factor next to childhood underweight in most of sub-Saharan Africa countries as well as 3rd leading risk factor of disease next to childhood underweight, and suboptimal breastfeeding in Ethiopia. Usually prevention efforts aimed at reducing HAP and related health burdens have been focused on the use of energy efficient cookstoves. There is, however, rigorous lack of evidence in Ethiopia or in other similar settings whether it is possible to achieve adequate HAP reduction and improve health with locally made energy efficient baking stoves from a public health point of view. Particularly, the popular Ethiopian energy efficient "Injera" baking stove has not been researched through stove trial inquiry. Therefore, research studies are required in Ethiopia on health benefits achieved when households adopt energy efficient baking stoves. In view of that, cluster randomized controlled trial will be employed with experimental study design for one year to test the effectiveness of the Ethiopian improved "Injera" baking stove intervention on reducing HAP and childhood acute respiratory infection (ARI) through comparing equal size groups of children before and after part of households received an improved "Injera" baking stove. Accordingly, the proposed stove trial aims to address an important research gap by determining whether the Ethiopian improved "Injera" baking biomass stove intervention can adequately reduce HAP exposure to prevent childhood acute respiratory infection. With this objective, the proposed stove trial will test the hypothesis that there is a statistically significant difference in HAP levels and incidence of childhood ARI when using traditional versus improved "Injera" baking stove in Northwest Ethiopia

Conditions

Acute Respiratory Infection; Pneumonia Childhood

Keywords

Acute Respiratory Infection, Household Air Pollution

Outcome Measures

Primary Outcomes (1)

• Longitudinal proportion of childhood acute respiratory infection as measured by childhood pneumonia status using World Health Organization's Integrated Management of Neonatal and Childhood Illness algorism.

  Childhood acute respiratory infection/pneumonia status will be assessed using standard case recording form by field workers during household visits where the index child mothers/caregivers are asked about ARI signs \& symptoms in the preceding two weeks. Moreover, to overcome some of the limitations of the self-reported health data, physical examination of the ill index child will be conducted by field workers trained in World Health Organization's Integrated Management of Neonatal and Childhood Illness algorism.

  Change from baseline childhood ARI due to Improved "Injera" Baking Stove Intervention will be assessed at one year.

Secondary Outcomes (1)

• Household air pollution as measured by concentration of indoor particulate matter with an aerodynamic diameter of less than 2.5 microns (PM2.5) in µg/m3

  Change from baseline HAP (indoor PM2.5 concentration) due to Improved "Injera" Baking Stove Intervention will be assessed at one year.

Study Arms (2)

Improved "Injera" Baking Biomass Stove

EXPERIMENTAL

2750 eligible households with in 50 randomly selected clusters/"Gotes" are allocated into the improved "Injera" backing stove intervention arm.

Device: Improved "Injera" Baking Biomass Stove

Control arm

NO INTERVENTION

Similarly 2750 eligible households with in 50 randomly selected clusters/Gotes will continue to use the traditional "Injera" baking biomass stove and will be used as control arm.

Interventions

Improved "Injera" Baking Biomass Stove DEVICE

Replacing of the Ethiopian traditional "Injera" baking biomass stove with improved baking biomass stove, the well-known commercially distributed type of baking stove in Ethiopia, will be the intervention for this study. Control HHs will continue to use the traditional baking biomass stove. Concerning intervention duration, since the life span of the Ethiopian improved baking stove is about 5 years, the length of the intervention period will be one year to account for seasonal factors that have major effect on both ARI incidence \& HAP level in Ethiopia as well as to maintain a balance between achieving a sufficiently long follow-up period for outcome measurements \& suitably short follow-up period to decrease attrition.

Improved "Injera" Baking Biomass Stove

Eligibility Criteria

• Age: Up to 48 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Households with children up to 4 years old to ensure a minimum of one year longitudinal data collection before the child's 5th birthday.
• Households who bake "Injera" exclusively with a traditional baking stove

You may not qualify if:

• Households who do not have any enclosed main cooking area (kitchen) structure
• Children who will be born during the course of the study

Sponsors & Collaborators

• Bahir Dar University: lead

Study Sites (1)

"Mecha" Health and Demographic Surveillance System (MHDSS) Site, Bahir Dar University

Bahir Dar, Amhara Regional State, P.O.Box 79, Ethiopia

RECRUITING

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Study Officials

• Mesafint M. Adane, MPH,BSc.,

  School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia

  PRINCIPAL INVESTIGATOR

• Prof. Getu D. Alene, PhD,

  Department of Epidemiology and Biostatics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia

  STUDY CHAIR

• Dr. Seid T. Mereta, PhD,

  Department of Environmental Health Science & Technology, School of Public Health, Jimma University

  STUDY DIRECTOR

Central Study Contacts

Mesafint M. Adane, MPH,BSc.,

CONTACT

+251918121064; mesafintm@bdu.edu.et

Prof. Getu D. Alene, PhD,

CONTACT

+251918776010; adgetu123@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor at School of Public Health, College of Medicine and Health Sciences

Model Details: Cluster randomized control trial

Study Record Dates

• First Submitted: July 24, 2018
• First Posted: August 2, 2018
• Study Start: June 1, 2018
• Primary Completion: July 1, 2019
• Study Completion: July 1, 2019
• Last Updated: August 2, 2018

Record last verified: 2018-08

Locations

ET (1)