Two year study finds no evidence that cleaner cookstoves reduce pneumonia in children
LSTM led Cooking and Pneumonia Study (CAPS) finds no evidence that cleaner burning biomass fuelled cookstoves reduce the risk of pneumonia in young children in rural Malawi.
Results from the Liverpool School of Tropical Medicine (LSTM)-led Cooking and Pneumonia Study (CAPS) in Malawi indicate that cooking with cleaner burning biomass-fueled stoves in place of traditional open fires has no effect of the incidence of pneumonia in children under the age of five.
The two year study was the largest of its kind anywhere in the world, with over 10,000 children enrolled across randomised villages in rural Chikhwawa and Chilumba in Malawi. The results, published in the journal, The Lancet today (link is external), show that the risk of pneumonia was the same in the under-fives whose families were assigned the cleaner burning biomass-fueled cookstoves as in those whose families continued to cook over traditional open fires. In a secondary safety analysis a marked 42% reduction in the risk of non-serious burns was seen in children in the cookstove group compared to the open fire group.
Dr Kevin Mortimer, Reader at LSTM and Respiratory Consultant at Aintree University Hospital was lead Investigator on CAPS. He said: “Our study was the first trial to be published looking at the effects of cleaner burning biomass-fuelled cookstove on health outcomes. We asked a very specific question and applied rigorous scientific standards to our search for an answer. There has been an assumption that the use of cleaner cookstoves will bring about health benefits and save lives. Our results are part of a growing body of evidence that suggests that cleaner cookstoves on their own are not as effective on this front as had been hoped.”
According to the WHO, household air pollution results in over four million deaths annually, and with almost three billion people globally still cooking their food on an open fire it is clearly a problem that requires the identification of timely and effective interventions. In Malawi the leading cause of death in the under-fives is pneumonia and the impact on people in poorest communities is the greatest. “While the reductions in burn related injuries is encouraging from a safety perspective,” continued Dr Mortimer, “there remains a substantial burden of disease that needs to be addressed. Our response to that burden needs to be based on robust scientific evidence feeding into evidence-based policy and decision making. I think the findings of CAPS calls for the global health community to rally together to find and implement evidence-based solutions to air pollution – household, outdoor and tobacco-related – so that people everywhere have healthy clean air to breathe.”
Partial results were presented by Dr Mortimer at the 47th World Conference on Lung Health which took place in Liverpool in October. Delegates had the opportunity to witness a demonstration of a recently developed cleaner burning biomass-fueled cookstove. Dr Mortimer worked with local school pupils to design and build replica Malawian housing in which ACE-1 cookstoves and open fires were lit to illustrate the difference in smokiness between the two cooking methods. In partnership with the local fire and rescue services and the charity Operation Florian, the dangers of open fires within the home were highlighted.
The study was part of the LSTM hosted CAHRD collaboration and was funded by a the Joint Global Health Trials Scheme, a partnership of the UK Department for International Development (DfID), the Medical Research Council (MRC) and the Wellcome Trust. It was implemented in Malawi through collaborative partnerships between the Liverpool School of Tropical Medicine, The London School of Hygiene & Tropical Medicine, The Malawi-Liverpool-Wellcome Trust Clinical Research Programme, The Malawi College of Medicine and the Malawi Epidemiology and Intervention Research Unit.
Cookstoves arrive ahead of schedule
1590 cookstoves due to arrive in February have been delivered in Chikwawa on 2 Dec 15
Staff awarded CAPS and MLW joint training scholarships
Left to right: Martha Chipeta, Gloria Banda and Patience Korea
Martha Chipeta and Gloria were awarded scholarships to complete NCC Level 4 Diploma in Computing (Data Management) and Patience Korea was awarded a scholarship to complete a Bachelors in Bisiness Administration.
A message of thanks
Martha Chipeta "I would like to thank you for the opportunity you have given me of upgrading myself to a higher level . I don't take this for granted. I really appreciate this support that has come at the right time"
Gloria Banda "Let me send my thank you regards to CAPS and MLW management for the education support. This opportunity will help me to achieve my goals. Thank you for this and may God bless you abundantly.
Patience Korea "I would like to thank CAPS & MLW management and anyone else who contributed to this obtainment of the scholarship which is a milestone in my career. This is a greatest opportunity that i will live to praise God, and i will work hard in my course for fruitful results for the benefit of the organization and myself. I am so much motivated and delighted person every day"
African Clean Energy (ACE)
First shipment of 1500 cookstoves arrives in Malawi
Casual workers lend a hand to off load the stoves.
The first shipment left Lesotho on 12th September and arrived in Malawi on 9th November. The stoves will be distributed as a free donation to the households who participated in our Malawi Ministry of Health-supported CAPS trial.
Alliance Convenes Group of Global Researchers Examining the Impacts of Clean Cooking on Children’s Health
How much can clean cookstoves and fuels reduce pneumonia in children?
Does using clean cooking technologies and fuels during pregnancy boost birth weights?
These were two of the many questions under discussion by 30 leading global public health researchers during a three-day meeting to discuss how clean cooking impacts children’s health. The Child Survival Workshop, co-hosted by the Alliance and Johns Hopkins University, provided experts with an opportunity to exchange lessons from the field and to take a first look at early results of ongoing research evaluating the child health benefits of clean cookstoves and fuels. Read the full article
How Cookstoves Research is Changing the World
Three billion people in the world, a number unchanged in nearly 30 years, cook their food with an open fire, causing respiratory problems such as pneumonia in children and COPD and lung cancer in adults, as well as cardiovascular diseases. Estimates in 2012 from the Global Burden of Disease project, indicate that smoke from these traditional cooking methods causes a staggering four million premature deaths each year. View article
CAPS and MLW joint Training Scholarship Award
Chifundo Benson Ndamala, CAPS Project Manager is awarded a 2 year scholarship for Bachelor of Arts in Health System Management at Exploits University
Chifundo Benson Ndamala tells his story - The success of acquiring this training funds has come at a convenient period when I was really in need of scholarship to carry on with my education and I have grab this opportunity with open arms.
The process of reaching this far has not been smooth but due to hard work and dedication from the entire team and me, the results have yielded a perfect product.
I am not taking this success for granted. This opportunity has brought the reality of my dreams to one day have the perfect qualification I have wanted dearly and to go on with my future career path way.
This has been a motivation for me and the rest of the team to continue working extra harder to reach the project goal.
I would like to greatly appreciate the CAPS executive personnel and the MLW organization from offering me this once in life opportunity.
|From left to right: Yamikani Dickson, Chifundo B. Ndamala, Bright Mnesa and Wezzie Nyapigoti.|
|Words of appreciation from Yamikani Dickson and Bright Mnesa|
As a Senior Fieldworker, this unexpected recognition of my efforts gives me sense of security and confidence. I hope to devote knowledge gained throughout CAPS Study Cycle and ensuring that activities are being accomplished according to three specified primary objectives of Time, Quality and Cost.
Thank you so much for noticing my efforts and for giving me this study support. ......There are help like this whose presence makes needs such as mine easier to bear!!
With Thanks, Yamikani Dickson (Senior Fieldworker – CAPS)
I would like to thank and appreciate the CAPS senior management for introducing the training development plans for its staff! I am and my family we are very happy and grateful for been considered this training sponsorship! As Malawi is just developing technology, this training will benefit me to be enlightened with the government policies. The organization will highly benefit from the following areas pertaining to IT; installing, configuring, maintaining ICT equipment, software and networking! Possibly I will find a more challenging position in future that will utilize and expands my competencies in Information and Technology.
BBC News Malawi's life-saving stoves
Award presentation at Chikwawa District Hospital
|Chifundo Benson Ndamala, Project Manager for CAPS in Chikhwawa presents Mr. Stephano Master with an award for 'Best Clinician in the Under five outpatient department'. Mr. Stephano Master received the award for his expert documenting of the CAPS participant health passports once they have been diagnosed with Pneumonia. Fellow departmental health workers were there to watch the event.|
DfID minister Lynne Featherstone visits LSTM
|DfID minister Lynne Featherstone visited LSTM to receive a briefing on the impacts of household air pollution on the health of women and children in developing countries. Professor Stephen Gordon informed the minister on the Cooking and Pneumonia Study (CAPS) currently being undertaken in Malawi.|
Cooking and pneumonia: can ‘clean’ stoves reduce infant mortality?
The Cooking and Pneumonia Study (CAPS) has launched a video explaining the main aims of their work in determining the importance of clean cookstoves in preventing pneumonia in children under five years old in Malawi.
Filming visit to the CAPS trial sites in Malawi
Photographs of the first cookstoves arriving at the Chilumba trial site, captured by Jane Ardrey during a recent field trip . The team worked tremendously showing a great team spirit to transfer 1300 cookstoves from a 40ft container into a secure lockup. Well done!
CAPS fieldworkers and Trial Manager recruiting families to the study and taking part in a comminity exercise.
The first stoves and solar chargers to be distributed in Karonga as CAPS gets going at KPS
The Cooking and Pneumonia Study (CAPS) has reached a significant milestone with over 2000 children under 5 recruited to the study. It is now the largest trial of the effects of an advanced cookstove intervention on health outcomes conducted anywhere in the world. 400 of the children enrolled have completed data collection using personal carbon monoxide monitors, which look at the levels of carbon monoxide in the air they breathe.
The Department for International Development has won the “Best Initiative by a Government Body” at the Climate Week Awards, for efforts to enable 100 million households to adopt clean and efficient cooking solutions by 2020.
The second container of cookstoves arrive at Chikhwawa.
Well done to the team who helped support the process of transporting the cookstoves into storage and the successful enrollment of 25 villages (village clusters) so far.
29 January 2014
CAPS study partner shortlisted for green award
A key partner in the Cooking and Pneumonia Study CAPS has been shortlisted for a prestigious environmental award in the UK.
CAPS protocol summary published on the Lancet website: http://www.thelancet.com/protocol-reviews/13PRT-4689
CAPS pilot at Mologeni village.
The piloting project in Mologeni village began in September 2013. 20 households were enrolled, and 24 participants. The villagers were extremely helpful and patient as the CAPS team tested their new equipment and piloted the smartphones that will be used in the study. They were curious about all of the unfamiliar equipment and eager to hear the results when their households were monitored for carbon monoxide and other air pollutants. The villagers indicated that they were delighted with the new stoves and immediately began to use them.
19 September 2013
Delight as the first 100 advanced cookstoves arrive for piloting activities at the trial sites in Malawi
2 September 2013
Chikwawa Community Engagement
Photographs captured during the community engagement exercise
4-5 June 2013
First meeting of Cooking and Pneumonia Study (CAPS) Trial Steering Committee
LSTM hosted the first meeting of the Cooking and Pneumonia Study (CAPS) Trial Steering Committee to discuss various aspects around this cluster randomised trial to investigate an advanced cookstove intervention to prevent pneumonia in children under 5 in Malawi.
The study was recently awarded £2.7 million by the Joint Global Health Trials Scheme, a partnership of the UK Department for International Development (DfID), the Medical Research Council (MRC) and the Wellcome Trust
The Trial Steering Committee taking part in a cookstove demonstration
LSTM & Aintree University Hospital in £2.7m Funding to Save Lives of Children in Africa
13 December 2012
A research team from Liverpool has been awarded £2.7m to fund a trial that could benefit some of the most deprived communities around the world.
Experts from Aintree University Hospital (AUH) and the Liverpool School of Tropical Medicine (LSTM) are leading on the development of the project, which will enable them to investigate how to reduce the effects of domestic smoke inhalation. This is a problem in low and middle income countries around the world, where open fires, used for heating, cooking and lighting, are commonly used inside the main living quarters of homes.