Exposure to household air pollution and childhood multimorbidity risk in Jimma, Ethiopia

Background: Childhood multimorbidity, characterized by the simultaneous occurrence of multiple medical conditions in children, is a global concern. Notably, exposure to household air pollution has been linked to various health issues, particularly affecting vulnerable segments of the population residing in poorly ventilated homes. However, evidence regarding the impact of household air pollution on the risk of multimorbidity in low-income settings remains scarce. Therefore, this study aims to investigate the association between household air pollution and childhood multimorbidity in Jimma, Ethiopia. Methods: A comparative cross-sectional study was conducted to collect data from 280 children under the age of five who lived in households using solid fuel (n = 140) and clean fuel (n = 140). The Demographic Health Survey morbidity questionnaire was used to collect information from mothers about common childhood illnesses. Multiple logistic regression analysis was employed to explore the relationship between the use of solid fuel for cooking in households and the likelihood of childhood multimorbidity. In addition, Poisson regression estimation was used to determine if exposure to solid fuel could increase the number of morbidities. Results: The overall prevalence of childhood multimorbidity was 34.3% [95% CI: 0.29-0.40]. Among these cases, 23.9% were among children from solid fuel user households, whereas about 10.4% were from clean fuel user households. Adjusted for all possible socioeconomic, demographic, water, sanitation, hygiene, and health care covariates, children living in solid fuel user households had more than three times the odds of childhood multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI [1.42-6.95], p < 0.001). Moreover, household air pollution from solid fuel use was positively associated with an increased number of individual morbidity conditions, with an adjusted beta coefficient of 0.46 (IRR = 1.58, 95% CI [1.17-2.13], p = 0.003). Conclusion: Solid fuel use was an independent predictor of childhood morbidity risk. Efficient policies and strategies, such as the integration of environmental regulation policies into the healthcare system aimed at the reduction of harmful air pollutants and their adverse health effects on children, need to be implemented.