Abstract
Background: Household air pollution (HAP) remains a significant global health challenge, particularly in low- and middle-income countries where reliance on solid fuels for cooking and heating is prevalent. This study assesses the relationship between HAP and respiratory diseases among children under five years in Mpumalanga Province, South Africa, a region with a high prevalence of solid fuel use and industrial pollution.
Method: Using data from the 2016 South African Demographic and Health Survey (SADHS), a secondary data cross-sectional analysis was conducted on 332 children under five years. Descriptive statistics and logistic regression were applied to explore the association between HAP exposure and respiratory health outcomes (fever, cough, and rapid breathing).
Results: Findings revealed that 23.8% of households used solid fuels (primarily wood and coal), predominantly in rural settings (75.1%). The study found fever, cough, and short, rapid breaths as common respiratory diseases, with prevalence rates of 20.6%, 33%, and 5.5%, respectively, in Mpumalanga province. The significant determinants were shown to be fuel type and household size, with fever and rapid breathing showing a statistically significant association with solid fuel use (p = 0.009 for fever and p=0,005 for short, rapid breaths). Children in households using clean fuels had significantly lower odds of developing fever (OR = 0.197 for those with fever), cough (OR = 0.172 for those with a cough), and short, rapid breaths (OR = 0.136 for those with this symptom), emphasising the protective effect of clean fuel usage. Children in households using solid fuels were significantly more likely to develop respiratory conditions, with fever being notably associated with solid fuel exposure.
Conclusion: The study underscores the need for targeted public health interventions to reduce HAP exposure through the promotion of clean energy alternatives. Addressing HAP in regions like Mpumalanga could significantly lower the prevalence of respiratory disease in children and improve overall community health. Further longitudinal studies are recommended to establish causal relationships and guide policy development.