title: The effect of solid fuel use on childhood mortality in Nigeria: evidence from the 2013 cross-sectional household survey.
abstract: BACKGROUND
  In Nigeria, approximately 69% of households use solid fuels as their primary source of domestic energy for cooking. These fuels produce high levels of indoor air pollution. This study aimed to determine whether Nigerian children residing in households using solid fuels at <5 years of age were at higher risk of death.
  
  
  METHODS
  The 2013 Nigeria Demographic and Health Survey data were analysed in Cox regression analyses to examine the effects of solid fuel use on deaths of children aged 0-28 days (neonatal), 1-11 months (post-neonatal), and 12-59 months (child).
  
  
  RESULTS
  The results indicated that approximately 0.8% of neonatal deaths, 42.9% of post-neonatal deaths, and 36.3% of child deaths could be attributed to use of solid fuels. The multivariable analyses found that use of solid fuel was associated with post-neonatal mortality (hazard ratio [HR] =1.92, 95% confidence interval [CI]: 1.42-2.58) and child mortality (HR = 1.63, CI: 1.09-2.42), but was not associated with neonatal mortality (HR = 1.01, CI: 0.73-1.26). Living in rural areas and poor households were associated with an increased risk of death during the three mortality periods.
  
  
  CONCLUSIONS
  Living in a rural area and poor households were strongly associated with an increased risk of a child > 1 to < 60 months dying due to use of solid fuels. The health effects of household use of solid fuels are a major public health threat that requires increased research and policy development efforts. Research should focus on populations in rural areas and low socioeconomic households so that child survival in Nigeria can be improved.
authors.affiliation: School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2571, Australia. ezehosita@yahoo.com.
authors.forename: Osita Kingsley
authors.initials: OK
authors.lastname: Ezeh
authors.forename: Kingsley Emwinyore
authors.initials: KE
authors.lastname: Agho
authors.forename: Michael John
authors.initials: MJ
authors.lastname: Dibley
authors.forename: John Joseph
authors.initials: JJ
authors.lastname: Hall
authors.forename: Andrew Nicolas
authors.initials: AN
authors.lastname: Page
mesh_terms: D002606:Charcoal; D046688:Child Mortality; D002675:Child, Preschool; D003031:Coal; D003296:Cooking; D018556:Crops, Agricultural; D005191:Family Characteristics; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008372:Manure; D009549:Nigeria / Q000453:epidemiology; D006109:Poaceae; D012959:Socioeconomic Factors; D014934:Wood
chemical_list: D003031:Coal; D008372:Manure; D002606:Charcoal