Cooking outdoors or with cleaner fuels does not increase malarial risk in children under 5 years: a cross-sectional study of 17 sub-Saharan African countries

Woolley, Katherine E.; Bartington, Suzanne E.; Pope, Francis D.; Greenfield, Sheila M.; Tusting, Lucy S.; Price, Malcolm J.; Thomas, G. Neil

doi:10.1186/s12936-022-04152-3

Table 4 Odds ratio of malarial infection for each cooking practices for the combined dataset, exploratory and sub-analysis

From: Cooking outdoors or with cleaner fuels does not increase malarial risk in children under 5 years: a cross-sectional study of 17 sub-Saharan African countries

Analysis	Outcome	Analysis 1 Biomass vs cleaner cooking				Analysis 2 Wood vs charcoal cooking				Analysis 3 Cooking location
Analysis	Outcome	Cooking fuel	AOR [95% CI]	p value	N	Cooking fuel	AOR [95% CI]	p value	N	Type of cooking location	AOR [95% CI]	p value	N
Combined dataset*	RDT	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.57 [1.30–1.91]	< 0.001	43,759	Wood	1.77 [1.54–2.04]	< 0.001	73,072	In a separate building	0.74 [0.66–0.83]	< 0.001	23,754
		Biomass	1.57 [1.30–1.91]	< 0.001	43,759	Wood	1.77 [1.54–2.04]	< 0.001	73,072	Outdoor	0.94 [0.83–1.05]	0.26	23,754
	Microscopy	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.58 [1.23–2.04]	< 0.001	30,007	Wood	1.21 [1.08–1.37]	0.001	46,206	In a separate building	0.75 [0.67–0.84]	< 0.001	21,383
		Biomass	1.58 [1.23–2.04]	< 0.001	30,007	Wood	1.21 [1.08–1.37]	0.001	46,206	Outdoor	0.97 [0.86–1.09]	0.58	21,383
Sub-analysis
Rural areas	RDT	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.41 [1.02–1.95]	0.04	31,100	Wood	1.43 [1.21–1.70]	< 0.001	54,473	In a separate building	0.70 [0.62–0.80]	< 0.001	16,988
		Biomass	1.41 [1.02–1.95]	0.04	31,100	Wood	1.43 [1.21–1.70]	< 0.001	54,473	Outdoor	0.91 [0.79–1.04]	0.17	16,988
	Microscopy	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	2.10 [1.34–3.32]	0.001	20,290	Wood	1.09 [0.91–1.30]	0.36	34,693	In a separate building	0.73 [0.64–0.84]	< 0.001	15,193
		Biomass	2.10 [1.34–3.32]	0.001	20,290	Wood	1.09 [0.91–1.30]	0.36	34,693	Outdoor	0.92 [0.80–1.07]	0.28	15,193
Urban areas	RDT	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.58 [1.24–2.03]	< 0.001	12,659	Wood	2.23 [1.79–2.78]	< 0.001	18,599	In a separate building	0.96 [0.78–1.19]	0.72	6766
		Biomass	1.58 [1.24–2.03]	< 0.001	12,659	Wood	2.23 [1.79–2.78]	< 0.001	18,599	Outdoor	0.99 [0.81–1.21]	0.90	6766
	Microscopy	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.30 [0.96–1.76]	0.09	9717	Wood	1.40 [1.20–1.64]	< 0.001	11,513	In a separate building	0.86 [0.69–1.07]	0.17	6190
		Biomass	1.30 [0.96–1.76]	0.09	9717	Wood	1.40 [1.20–1.64]	< 0.001	11,513	Outdoor	1.08 [0.90–1.31]	0.40	6190
Mesoendemic areas	RDT	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.58 [1.28–1.95]	< 0.001	35,167	Wood	1.77 [1.49–2.09]	< 0.001	57,814	In a separate building	0.73 [0.65–0.82]	< 0.001	20,349
		Biomass	1.58 [1.28–1.95]	< 0.001	35,167	Wood	1.77 [1.49–2.09]	< 0.001	57,814	Outdoor	0.92 [0.81–1.05]	0.22	20,349
	Microscopy	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.59 [1.21–2.08]	0.001	23,519	Wood	1.26 [1.10–1.44]	0.001	35,898	In a separate building	0.73 [0.65–0.83]	< 0.001	18,209
		Biomass	1.59 [1.21–2.08]	0.001	23,519	Wood	1.26 [1.10–1.44]	0.001	35,898	Outdoor	0.94 [0.83–1.08]	0.37	18,209
Wood only	RDT									Indoor	Ref.
										In a separate building	0.75 [0.67–0.85]	< 0.001	19,406
										Outdoor	0.90 [0.79–1.02]	0.10	19,406
	Microscopy									Indoor	Ref.
										In a separate building	0.77 [0.67–0.87]	< 0.001	17,244
										Outdoor	0.94 [0.82–1.08]	0.36	17,244
Exploratory analysis
Controlling for household mosquito spraying^†	RDT	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.23 [0.94–1.61]	0.14	26,778	Wood	1.94 [1.62–2.33]	< 0.001	36,898	In a separate building	0.85 [0.73–0.99]	0.03	9951
		Biomass	1.23 [0.94–1.61]	0.14	26,778	Wood	1.94 [1.62–2.33]	< 0.001	36,898	Outdoor	0.95 [0.81–1.10]	0.47	9951
	Microscopy	Cleaner	Ref.			Charcoal	Ref.			Indoor	Ref.
		Biomass	1.07 [0.77–1.47]	0.69	18,102	Wood	1.30 [1.13–1.49]	< 0.001	27,115	In a separate building	0.76 [0.65–0.88]	< 0.001	9676
		Biomass	1.07 [0.77–1.47]	0.69	18,102	Wood	1.30 [1.13–1.49]	< 0.001	27,115	Outdoor	0.92 [0.79–1.07]	0.29	9676

AOR Adjusted odds ratio, 95% CI 95% confidence interval, N Number of observations, RDT Rapid diagnostic test, Ref Reference group. Results in bold are statistically significant. Unadjusted results are in Additional file 3: Table S3.1
^*Controlled for: Child’s age, child’s gender, birth order, Child slept under slept under mosquito net last night, modified wealth index, number of household members, place of residence, malarial endemicity, season and cluster altitude
^†Burkina Faso 2017–2018, Cameron 2018, DRC 2013–2014, Malawi 2017, Mali 2018, Nigeria 2018, Tanzania 2017 and Togo 2017 were excluded due to the household mosquito spraying variable being incomplete, high level of missing or low cell counts

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