Biomass fuel use for household cooking in Swaziland: is there an association with anaemia and stunting in children aged 6-36 months?

Trans R Soc Trop Med Hyg. 2013 Sep;107(9):535-44. doi: 10.1093/trstmh/trt055. Epub 2013 Jul 29.


Background: This study is the second to investigate the association between the use of biomass fuels (BMF) for household cooking and anaemia and stunting in children. Such fuels include coal, charcoal, wood, dung and crop residues.

Methods: Data from the 2006-2007 Swaziland Demographic and Health Survey (a cross-sectional study design) were analysed. Childhood stunting was ascertained through age and height, and anaemia through haemoglobin measurement. The association between BMF use and health outcomes was determined in multinomial logistic regression analyses. Various confounders were considered in the analyses.

Results: A total of 1150 children aged 6-36 months were included in the statistical analyses, of these 596 (51.8%) and 317 (27.6%) were anaemic and stunted, respectively. BMF use was not significantly associated with childhood anaemia in univariate analysis. Independent risk factors for childhood anaemia were child's age, history of childhood diarrhoea and mother's anaemia status. No statistically significant association was observed between BMF use and childhood stunting, after adjusting for child's gender, age, birth weight and preceding birth interval.

Conclusion: This study identified the need to prioritize childhood anaemia and stunting as health outcomes and the introduction of public health interventions in Swaziland. Further research is needed globally on the potential effects of BMF use on childhood anaemia and stunting.

Keywords: Anaemia; Biomass fuels; Demographic and Health Survey; Indoor air pollution; Stunting; Swaziland.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Air Pollution, Indoor / adverse effects
  • Anemia / epidemiology*
  • Biomass*
  • Child, Preschool
  • Cooking / methods*
  • Cross-Sectional Studies
  • Demography
  • Diarrhea / complications
  • Eswatini / epidemiology
  • Female
  • Growth Disorders / epidemiology*
  • Health Surveys
  • Humans
  • Infant
  • Male
  • Maternal Welfare
  • Middle Aged
  • Surveys and Questionnaires
  • Young Adult