Household smoke exposure risk and acute respiratory infection among children under five years in sub-Saharan Africa: evidence from the demographic and health surveys.

BACKGROUND: Exposure to smoke from unclean fuels increases children's risk of acute respiratory infection (ARI). Although studies have extensively examined the association between the type of cooking fuel used and ARI in sub-Saharan Africa (SSA), few have accounted for the composite effect of the type of cooking fuel and the place of cooking on ARI. This study examined the effect of household smoke exposure risk on ARI among children under five years in SSA by accounting for the composite effect of the type of cooking fuel and place of cooking. It also examined the covariates of ARI among children under five years in SSA. METHODS: The study used the Demographic and Health Survey (2010-2020) of 33 sub-Saharan African countries. While controlling for household, child and maternal characteristics, logit models were used to examine the effect of household smoke exposure risk on ARI among children under five years, along with their associated odds ratios and marginal effects. RESULTS: The results showed that the prevalence of ARI among children under five years was 4.4% in SSA. The majority of households (56%) were exposed to a high risk of household smoke exposure. Household smoke exposure risk was a significant predictor of ARI among children under five years. In addition, characteristics of children (sex, age, breastfeeding, and a child living with a mother), mothers (age, education, and marital status), and household (place of residence, wealth index, main floor material and the number of children under 5 years old per household) were significant predictors of ARI among children under five years. CONCLUSIONS: Health practitioners and policymakers should consider these factors when developing interventions to curb ARI among children under five years in SSA.