Exposure to household air pollution (HAP) from cooking and heating with solid fuels is major risk factor for morbidity and mortality in sub-Saharan Africa. Children under five are particularly at risk for acute lower respiratory infection. We use baseline data from randomized controlled trial evaluating a household energy intervention in Gisenyi, Rwanda to investigate the role of the microenvironment as a determinant of children's HAP-related health symptoms. Our sample includes 529 households, with 694 children under five. We examine the association between likelihood of HAP-related health symptom prevalence and characteristics of the microenvironment including: dwelling and cooking area structure; distance to nearest road; and tree cover. We find that children residing in groups of enclosed dwellings, in households that cook indoors, and in households proximate to tree cover, are significantly more likely to experience symptoms of respiratory infection, illness with cough and difficulty breathing. On the other hand, children in households with cemented floors and ventilation holes in the cooking area, are significantly less likely to experience the same symptoms. Our findings suggest that in addition to promoting increased access to clean cooking technologies, there are important infrastructure and micro-environment related interventions that mitigate HAP exposure.

中文翻译：

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家庭空气污染、微环境和儿童健康：减少卢旺达城市 HAP 暴露的策略

因使用固体燃料烹饪和取暖而暴露于家庭空气污染 (HAP) 是撒哈拉以南非洲地区发病率和死亡率的主要风险因素。五岁以下的儿童特别容易患急性下呼吸道感染。我们使用来自评估卢旺达吉塞尼家庭能源干预的随机对照试验的基线数据来调查微环境作为儿童 HAP 相关健康症状决定因素的作用。我们的样本包括 529 户家庭，其中 694 名五岁以下儿童。我们研究了 HAP 相关健康症状流行的可能性与微环境特征之间的关联，包括：居住和烹饪区结构；到最近道路的距离；和树盖。我们发现，居住在封闭式住宅群中的儿童，在室内做饭的家庭中，在靠近树木覆盖的家庭中，更容易出现呼吸道感染、咳嗽和呼吸困难的症状。另一方面，在烹饪区有水泥地板和通风孔的家庭中，儿童出现相同症状的可能性要小得多。我们的研究结果表明，除了促进更多地获得清洁烹饪技术外，还有重要的基础设施和与微环境相关的干预措施可以减轻 HAP 暴露。出现相同症状的可能性要小得多。我们的研究结果表明，除了促进更多地获得清洁烹饪技术外，还有重要的基础设施和与微环境相关的干预措施可以减轻 HAP 暴露。出现相同症状的可能性要小得多。我们的研究结果表明，除了促进更多地获得清洁烹饪技术外，还有重要的基础设施和与微环境相关的干预措施可以减轻 HAP 暴露。