Environmental exposures, such as ambient air pollution and household fuel use affect health and under-5 mortality (U5M) but there is a paucity of data in the Global South. This study examined early-life exposure to ambient particulate matter with a diameter of 2.5 µm or less (PM), alongside household characteristics (including self-reported household fuel use), and their relationship with U5M in the Navrongo Health and Demographic Surveillance Site (HDSS) in northern Ghana. We employed Satellite-based spatiotemporal models to estimate the annual average PM concentrations with the Navrongo HDSS area (1998 to 2016). Early-life exposure levels were determined by pollution estimates at birth year. Socio-demographic and household data, including cooking fuel, were gathered during routine surveillance. Cox proportional hazards models were applied to assess the link between early-life PM2.5 exposure and U5M, accounting for child, maternal, and household factors. We retrospectively studied 48,352 children born between 2007 and 2017, with 1872 recorded deaths, primarily due to malaria, sepsis, and acute respiratory infection. Mean early-life PM was 39.3 µg/m, and no significant association with U5M was observed. However, Children from households using “unclean” cooking fuels (wood, charcoal, dung, and agricultural waste) faced a 73 % higher risk of death compared to those using clean fuels (adjusted HR = 1.73; 95 % CI: 1.29, 2.33). Being born female or to mothers aged 20–34 years were linked to increased survival probabilities. The use of “unclean” cooking fuel in the Navrongo HDSS was associated with under-5 mortality, highlighting the need to improve indoor air quality by introducing cleaner fuels.

中文翻译：

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加纳生命早期环境空气污染、家庭燃料使用和 5 岁以下儿童死亡率


环境空气污染和家庭燃料使用等环境暴露会影响健康和 5 岁以下儿童死亡率 (U5M)，但南半球国家的数据很少。这项研究调查了生命早期接触直径为 2.5 µm 或更小 (PM) 的环境颗粒物的情况，以及家庭特征（包括自我报告的家庭燃料使用情况），以及它们与 Navrongo 健康和人口监测网站中 U5M 的关系（ HDSS）位于加纳北部。我们采用基于卫星的时空模型来估算 Navrongo HDSS 地区的年平均 PM 浓度（1998 年至 2016 年）。生命早期的暴露水平是根据出生年份的污染估计来确定的。在例行监测期间收集社会人口和家庭数据，包括烹饪燃料。应用 Cox 比例风险模型来评估生命早期 PM2.5 暴露与 U5M 之间的联系，并考虑了儿童、孕产妇和家庭因素。我们回顾性研究了 2007 年至 2017 年间出生的 48,352 名儿童，其中 1872 名儿童死亡，主要死于疟疾、败血症和急性呼吸道感染。生命早期 PM 的平均浓度为 39.3 µg/m，与 U5M 没有显着相关性。然而，与使用清洁燃料的家庭相比，使用“不清洁”烹饪燃料（木材、木炭、粪便和农业废物）的家庭儿童面临的死亡风险高出 73%（调整后 HR = 1.73；95% CI：1.29、2.33） 。出生为女性或母亲年龄为 20-34 岁与生存概率增加有关。纳龙戈 HDSS 中使用“不干净”的烹饪燃料与 5 岁以下儿童死亡率有关，这凸显了通过引入更清洁的燃料来改善室内空气质量的必要性。