gms | German Medical Science

Introduction: Forty percent of the world’s population is at risk for malaria; however, most of the risk is borne by sub-Saharan Africa [Ref. 1]. Biomass smoke may offer some protection from malaria by creating environments that are inhospitable for mosquitoes and therefore interrupting the transmission of malaria [Ref. 2], [Ref. 3].

Methods and Materials: A retrospective, matched case-control study was carried out to examine the biomass smoke concentrations and cooking practices in the homes of women (15-45 years) and/or children (≤9 years) together with the occurrence of severe malaria in Nouna, Burkina Faso. Cases were matched to controls on age, sex, ethnicity and geographic location. Real-time measurements of fine particulate matter and carbon monoxide concentrations were assessed and an extensive survey of the kitchen characteristics and cooking practices of participating households was conducted. Conditional logistic regression for a matched case-control study was used in the analyses with SAS 9.1 [Ref. 4].

Results: Mean area PM2.5 concentration for cases was 2069µg/m³ and 2387µg/m³ for controls. Mean personal CO concentrations for cases and controls were 1.95ppm and 2.71ppm, respectively. The PM2.5 and CO case and control concentrations were not significantly different (OR=0.95, p=0.36, 95%CL=0.85-1.06, OR=0.93, p=0.35, 95%CL=0.81-1.08, respectively). In terms of cooking practices, use of an improved stove was associated with an increase in the risk of severe malaria (OR=3.39, p=0.004, 95%CL=1.49-7.75) as was an average cooking time less than three hours per day (OR=2.18, p=0.02, 95%CL=1.14-4.18).

Conclusions: Our results indicate that there was no statistically significant difference between cases and controls in terms of mean area PM2.5 and mean personal CO concentrations. Interestingly, the use of an improved stove and average cooking time of less than three hours per day were associated with an increased risk. These results suggest that biomass smoke could be protective; however, further follow-up is necessary.