Association between household air pollution and pneumonia among children under five years old admitted at the Indira Gandhi children’s hospital in Kabul, Afghanistan

Introduction: Pneumonia is the single largest cause of death of children under the age of five (U5) globally, and nearly half of these (0.6 million/ year) occur because of Household Air Pollution (HAP). Combustion of wood and fossil fuels, inefficient stoves, and poor ventilation exacerbate HAP. Almost one in five deaths among U5 children in Afghanistan is due to pneumonia. The current case-control study is to find the association between pneumonia admissions of U5 children at the Children’s Hospital and HAP in Afghanistan. 
Materials and methods: A hospital-based case-control study was done with caregivers of 70 confirmed pneumonia cases and 127 patients of control group from other departments in the hospital who were interviewed through a structured questionnaire. 
Results: Cases and controls were found to be same on all demographic characteristics except number of children under 1 year of age. Chi-square analysis showed that those without ventilation systems in the house to remove smoke (p=0.036) and those using traditional stoves (p=0.002) were more likely to be higher among patients with pneumonia than control group. There was also a close association between U5 pneumonia and the use of room fresheners at home (p=0.027) and smoke from room heaters (0.002). Household air pollution showed a significant association with pneumonia (p=0.000). 
Conclusion: The incidence of respiratory diseases is higher among children and women in the family who are more likely to be exposed to HAP. Household air pollution is related to pneumonia in U5 children in Afghanistan. Creating awareness among the caregivers about the factors contributing to pneumonia and providing alternatives can help reduce the mortality of children.