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How Indoor and Outdoor Air Pollution Raises the Risk of Death and Hospitalisation in African Kids under Five

Table of Contents

Introduction

Air pollution is often seen as an urban problem, but in much of sub-Saharan Africa, the air inside homes can be just as dangerous as outdoor smog. Smoke from traditional cooking fuels like wood, charcoal, or coal can linger indoors, while tiny airborne particles (PM₂.₅) from traffic and industry drift through cities and villages. For children under five, these invisible pollutants can be deadly, increasing the risk of respiratory infections, hospitalization, and even death.

This article explores a major new systematic review and meta-analysis that examined how indoor and outdoor air pollution affects young children across sub-Saharan Africa, highlighting the real-world risks and what can be done to protect kids.

How the Study Worked

The researchers conducted a systematic review and meta-analysis, which means they collected and analyzed data from many previous studies to find overall trends. They reviewed 31 studies encompassing over 2 million children under five from sub-Saharan Africa. The focus was on two main sources of pollution:

  • Indoor air pollution: Smoke from solid cooking fuels such as wood, coal, and charcoal used in households.
  • Outdoor air pollution: Particulate matter (PM₂.₅) from vehicles, industry, and other ambient sources.

By combining results from multiple studies, the authors were able to estimate how these exposures influence the risk of death and hospitalisation due to respiratory problems. They also looked at exposure to second-hand tobacco smoke, although the evidence here was less consistent.

Key Findings

  • Children under five exposed to indoor solid fuel smoke had significantly higher odds of dying before age five compared to unexposed children — in some cases, risk increased by more than 30%.
  • Outdoor air pollution (PM₂.₅) also likely contributes to increased mortality, although fewer studies measured it directly.
  • Exposure to second-hand tobacco smoke was linked to higher odds of respiratory hospitalisations, such as pneumonia, but evidence was less consistent.
  • Large gaps exist in standardized exposure and health outcome data, which limits how confidently we can quantify some risks.

What We Still Don’t Know

  • Different studies used varied methods to measure pollution and health outcomes, making comparisons challenging.
  • High-quality data on outdoor PM₂.₅ is limited, especially in rural sub-Saharan Africa.
  • Few longitudinal studies exist to track children over time and understand chronic exposure effects.
  • Evidence linking second-hand tobacco smoke directly to mortality is still weak.
  • Interventions like clean cooking fuels need testing in large-scale, real-world settings to evaluate both effectiveness and feasibility.

Why It Matters

For parents and communities: Smoke from cooking fuels isn’t just unpleasant — it can be life-threatening for young children. Reducing indoor pollution and improving ventilation can make a real difference.

For health professionals and policymakers: The findings underline the need for urgent interventions. Promoting access to clean energy, safer cookstoves, and reducing outdoor air pollution should be public health priorities.

For African health systems and global health advocates: Protecting children from air pollution is an essential component of reducing infant and child mortality. Investments in cleaner fuels, regulatory policies, and standardized research can save thousands of lives across the region.

For researchers: Future studies need standardized measurement tools, longitudinal designs, and evaluations of interventions to close the knowledge gaps and guide effective policy.

Consider how indoor air quality affects children in your community. Supporting policies, programs, or technologies that reduce household smoke and outdoor pollution could be transformative for child health. Awareness, education, and cleaner energy solutions are key steps toward saving young lives.

Disclaimer

>This blog post is an educational summary based on published scientific research. Full credit belongs to the original authors. Always consult the original study for full details.

Acknowledgements

This article is based on the original research study:

Title: The effect of air pollution on morbidity and mortality among children aged under five in sub Saharan Africa: Systematic review and meta-analysis

Authors: Lake, R., Kinyanjui, T., et al.

Journal: Open-access systematic review & meta-analysis

Year: 2025

DOI: 10.1093/xxxxxxx

Access Full Paper: Click here to read the full study

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