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IJE Advance Access published online on April 22, 2004
International Journal of Epidemiology, doi:10.1093/ije/dyh071
© 2004 by International Epidemiological Association
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Accepted November 13, 2003

Original paper

Household wood and charcoal smoke increases risk of otitis media in childhood in Maputo

João Leopoldo da Costa 1, Albert Navarro 2, José Branco Neves 3, Miguel Martin 2*

1 Department of Community Health, Faculdade de Medicina UEM, Maputo, Mozambique; Grups de Recerca d'Amèrica i d'Àfrica Llatines (GRAAL)
2 Laboratori de Bioestadística i d'Epidemiologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain; Grups de Recerca d'Amèrica i d'Àfrica Llatines (GRAAL)
3 ENT-CHM, Faculdade de Medicina UEM, Maputo, Mozambique

* To whom correspondence should be addressed. E-mail: Miquel.Martin{at}uab.es.


  Abstract

Background This study examined the association of otitis media in children <6 years old and the exposure to wood and charcoal smoke, as well as to other risk factors, in Maputo.

Methods Case-control study. In all 750 children matched by sex and age were enrolled in a hospital-community study. Cases were gathered from among children visiting the Central Hospital of Maputo with otitis media and controls were recruited in the same village as the cases. Conditional logistic regression was performed to evaluate, simultaneously, the effect of each risk factor.

Results Cases were more likely to have been exposed to tobacco smoke (OR = 1.51), to wood (OR = 1.85) and charcoal (OR = 1.50) household smoke, to short term breastfeeding (OR = 1.47), and to live in overcrowded conditions (OR = 1.49). Multivariate analysis stratified by age groups (younger and older than 2 years) showed that cases were more likely to be exposed to wood and charcoal smoke than controls, regardless of age. Among children aged >2 years, Eustachian tube dysfunction was evident (OR = 3.06) particularly in those living in less overcrowded conditions.

Conclusions Findings of this study are consistent with earlier studies that have reported an association between parental smoking, short duration of breastfeeding, and Eustachian tube dysfunction. The association with wood and charcoal smoke indicates that there is a need to educate people regarding the avoidance of exposing their children to this environmental hazard.

Keywords Otitis media, Eustachian tube, wood smoke pollution, tobacco smoke pollution, overcrowding, breastfeeding, case-control studies


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