scholarly journals Effectiveness of interventions to reduce household air pollution from solid biomass fuels and improve maternal and child health outcomes in low- and middle-income countries: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katherine E. Woolley ◽  
Emma Dickinson-Craig ◽  
Suzanne E. Bartington ◽  
Tosin Oludotun ◽  
Bruce Kirenga ◽  
...  
Keyword(s):  
Systematic Review ◽  
Air Pollution ◽  
Pregnant Women ◽  
Biomass Fuels ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Children ◽  
Solid Biomass ◽  
And Child Health ◽  
Children Under 5

Abstract Background A variety of public health interventions have been undertaken in low- and middle-income countries (LMICs) to prevent morbidity and mortality associated with household air pollution (HAP) due to cooking, heating and lighting with solid biomass fuels. Pregnant women and children under five are particularly vulnerable to the effects of HAP, due to biological susceptibility and typically higher exposure levels. However, the relative health benefits of interventions to reduce HAP exposure among these groups remain unclear. This systematic review aims to assess, among pregnant women, infants and children (under 5 years) in LMIC settings, the effectiveness of interventions which aim to reduce household air pollutant emissions due to household solid biomass fuel combustion, compared to usual cooking practices, in terms of health outcomes associated with HAP exposure. Methods This protocol follows standard systematic review processes and abides by the PRISMA-P reporting guidelines. Searches will be undertaken in MEDLINE, EMBASE, CENTRAL, WHO International Clinical Trials Registry Platform (ICTRP), The Global Index Medicus (GIM), ClinicalTrials.gov and Greenfile, combining terms for pregnant women and children with interventions or policy approaches to reduce HAP from biomass fuels or HAP terms and LMIC countries. Included studies will be those reporting (i) pregnant women and children under 5 years; (ii) fuel transition, structural, educational or policy interventions; and (iii) health events associated with HAP exposure which occur among pregnant women or among children within the perinatal period, infancy and up to 5 years of age. A narrative synthesis will be undertaken for each population-intervention-outcome triad stratified by study design. Clinical and methodological homogeneity within each triad will be used to determine the feasibility for undertaking meta-analyses to give a summary estimate of the effect for each outcome. Discussion This systematic review will identify the effectiveness of existing HAP intervention measures in LMIC contexts, with discussion on the context of implementation and adoption, and summarise current literature of relevance to maternal and child health. This assessment reflects the need for HAP interventions which achieve measurable health benefits, which would need to be supported by policies that are socially and economically acceptable in LMIC settings worldwide. Systematic review registration PROSPERO CRD42020164998

Household Air Pollution in Low and Middle Income Countries

2017 ◽  
Author(s):  
Caroline A. Ochieng ◽  
Cathryn Tonne ◽  
Sotiris Vardoulakis ◽  
Jan Semenza
Keyword(s):  
Air Pollution ◽  
National Level ◽  
Household Air Pollution ◽  
Solid Fuels ◽  
Chronic Obstructive ◽  
Biomass Fuels ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Household air pollution from use of solid fuels (biomass fuels and coal) is a major problem in low and middle income countries, where 90% of the population relies on these fuels as the primary source of domestic energy. Use of solid fuels has multiple impacts, on individuals and households, and on the local and global environment. For individuals, the impact on health can be considerable, as household air pollution from solid fuel use has been associated with acute lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, and other illnesses. Household-level impacts include the work, time, and high opportunity costs involved in biomass fuel collection and processing. Harvesting and burning biomass fuels affects local environments by contributing to deforestation and outdoor air pollution. At a global level, inefficient burning of solid fuels contributes to climate change. Improved biomass cookstoves have for a long time been considered the most feasible immediate intervention in resource-poor settings. Their ability to reduce exposure to household air pollution to levels that meet health standards is however questionable. In addition, adoption of improved cookstoves has been low, and there is limited evidence on how the barriers to adoption and use can be overcome. However, the issue of household air pollution in low and middle income countries has gained considerable attention in recent years, with a range of international initiatives in place to address it. These initiatives could enable a transition from biomass to cleaner fuels, but such a transition also requires an enabling policy environment, especially at the national level, and new modes of financing technology delivery. More research is also needed to guide policy and interventions, especially on exposure-response relationships with various health outcomes and on how to overcome poverty and other barriers to wide-scale transition from biomass fuels to cleaner forms of energy.

scholarly journals Prevalence of Abnormal Umbilical Arterial Flow on Doppler Ultrasound in Low-risk and Unselected Pregnant Women: A Systematic Review

2020 ◽  
Author(s):  
Joshua Peter Vogel ◽  
Valerie Vannevel ◽  
Gianna Robbers ◽  
George Gwako ◽  
Tina Lavin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Observational Studies ◽  
Arterial Flow ◽  
Ultrasound Screening ◽  
Lower Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lower Income Countries

Abstract Background: While Doppler ultrasound screening is beneficial for women with high-risk pregnancies, there is insufficient evidence on its benefits and harms in low- and unselected-risk pregnancies. This may be related to fewer events of abnormal Doppler flow, however the prevalence of absent or reversed end diastolic flow (AEDF or REDF) in such women is unknown. In this systematic review, we aimed to synthesise available data on the prevalence of AEDF or REDF.Methods: We searched PubMed, Embase, CINAHL, CENTRAL and Global Index Medicus with no date, setting or language restrictions. All randomized or non-randomized studies reporting AEDF or REDF prevalence based on Doppler assessment of umbilical arterial flow >20 weeks’ gestation were eligible. Two authors assessed eligibility and extracted data on primary (AEDF and REDF) and secondary (fetal, perinatal, and neonatal mortality, caesarean section) outcomes, with results presented descriptively. Results: A total of 42 studies (18,282 women) were included. Thirty-six studies reported zero AEDF or REDF cases. However, 55 AEDF or REDF cases were identified from just six studies (prevalence 0.08% to 2.13%). Four of these studies were in unselected-risk women and five were conducted in high-income countries. There was limited evidence from low- and middle-income countries.Conclusions: Evidence from largely observational studies in higher-income countries suggests that AEDF and REDF are rare among low- and unselected-risk pregnant women. There are insufficient data from lower-income countries and further research is required.

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