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1. Effects of a liquefied petroleum gas stove intervention on stillbirth, congenital anomalies and neonatal mortality: A multi-country household air pollution intervention network trial

Author

Younger, Ashley, Ye, Wenlu, Alkon, Abbey, Harknett, Kristen, Kirby, Miles A, Elon, Lisa, Lovvorn, Amy E, Wang, Jiantong, Diaz-Artiga, Anaité, McCracken, John P, Gonzalez, Adly Castañaza, Alarcon, Libny Monroy, Mukeshimana, Alexie, Rosa, Ghislaine, Chiang, Marilu, Balakrishnan, Kalpana, Garg, Sarada S, Pillarisetti, Ajay, Piedrahita, Ricardo, Johnson, Michael A, Craik, Rachel, Papageorghiou, Aris T, Toenjes, Ashley, Williams, Kendra N, Underhill, Lindsay J, Hartinger, Stella M, Nicolaou, Laura, Chang, Howard H, Naeher, Luke P, Rosenthal, Joshua, Checkley, William, Peel, Jennifer L, Clasen, Thomas F, Thompson, Lisa M, and Investigators, Household Air Pollution Intervention Network

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Health Sciences, Perinatal Period - Conditions Originating in Perinatal Period, Pediatric, Preterm, Low Birth Weight and Health of the Newborn, Prevention, Health Effects of Household Energy Combustion, Climate-Related Exposures and Conditions, Conditions Affecting the Embryonic and Fetal Periods, Clinical Trials and Supportive Activities, Infant Mortality, Health Effects of Indoor Air Pollution, Clinical Research, Reproductive health and childbirth, Good Health and Well Being, Household Air Pollution Intervention Network (HAPIN) Investigators, Birth outcomes, Congenital anomaly, Cooking fuel, Low- and middle-income countries, Neonatal mortality, Stillbirth, Environmental Sciences
Abstract

Household air pollution (HAP) from cooking with solid fuels used during pregnancy has been associated with adverse pregnancy outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial that assessed the impact of a liquefied petroleum gas (LPG) stove and fuel intervention on health in Guatemala, India, Peru, and Rwanda. Here we investigated the effects of the LPG stove and fuel intervention on stillbirth, congenital anomalies and neonatal mortality and characterized exposure-response relationships between personal exposures to fine particulate matter (PM2.5), black carbon (BC) and carbon monoxide (CO) and these outcomes. Pregnant women (18 to

Published
2024

2. Effects of a LPG stove and fuel intervention on adverse maternal outcomes: A multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)

Author

Younger, Ashley, Alkon, Abbey, Harknett, Kristen, Kirby, Miles A, Elon, Lisa, Lovvorn, Amy E, Wang, Jiantong, Ye, Wenlu, Diaz-Artiga, Anaité, McCracken, John P, Gonzalez, Adly Castañaza, Alarcon, Libny Monroy, Mukeshimana, Alexie, Rosa, Ghislaine, Chiang, Marilu, Balakrishnan, Kalpana, Garg, Sarada S, Pillarisetti, Ajay, Piedrahita, Ricardo, Johnson, Michael, Craik, Rachel, Papageorghiou, Aris T, Toenjes, Ashley, Quinn, Ashlinn, Williams, Kendra N, Underhill, Lindsay, Chang, Howard H, Naeher, Luke P, Rosenthal, Joshua, Checkley, William, Peel, Jennifer L, Clasen, Thomas F, Thompson, Lisa M, and investigators, HAPIN

Subjects
Infant Mortality, Health Effects of Household Energy Combustion, Perinatal Period - Conditions Originating in Perinatal Period, Contraception/Reproduction, Pediatric, Clinical Research, Clinical Trials and Supportive Activities, Prevention, Health Effects of Indoor Air Pollution, Behavioral and Social Science, Reproductive health and childbirth, Good Health and Well Being, HAPIN investigators, Birth outcomes, Cooking fuel, Household air pollution, Hypertensive disorders of pregnancy, Low- and middle-income countries, Postpartum hemorrhage and maternal mortality, Spontaneous abortion, Environmental Sciences
Abstract

Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid cooking fuels. Pregnant women (18-34 years of age; gestation confirmed by ultrasound at 9-19 weeks) were randomly assigned to an intervention (n = 1593) or control (n = 1607) arm. Intention-to-treat analyses compared outcomes between the two arms using log-binomial models. Among the 3195 pregnant women in the study, there were 10 spontaneous abortions (7 intervention, 3 control), 93 hypertensive disorders of pregnancy (47 intervention, 46 control), 11 post postpartum hemorrhage (5 intervention, 6 control) and 4 maternal deaths (3 intervention, 1 control). Compared to the control arm, the relative risk of spontaneous abortion among women randomized to the intervention was 2.32 (95% confidence interval (CI): 0.60, 8.96), hypertensive disorders of pregnancy 1.02 (95% CI: 0.68, 1.52), postpartum hemorrhage 0.83 (95% CI: 0.25, 2.71) and 2.98 (95% CI: 0.31, 28.66) for maternal mortality. In this study, we found that adverse maternal outcomes did not differ based on randomized stove type across four country research sites.

Published
2023

3. Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomised controlled trial

Author

Bankundiye, Gloriose, Boyd Barr, Dana, Burrowes, Vanessa, Bussalleu, Alejandra, Campbell, Devan, Canuz, Eduardo, Castañaza, Adly, Clark, Maggie, Crocker, Mary, De León, Oscar, Dusabimana, Ephrem, Elon, Lisa, Espinoza, Juan G, Pineda Fuentes, Irma, Ghosh, Ahana, Goodman, Dina, Gupton, Savannah, Hamid, Sarah, Harvey, Steven, Hengstermann, Mayari, Hennessee, Ian, Herrera, Phabiola, Howard, Marjorie, Howards, Penelope P., Jaacks, Lindsay, Kearns, Katherine, Kremer, Jacob, Laws, Margaret A., Lenzen, Pattie, Liao, Jiawen, Lovvorn, Amy, Mbabazi, Jane, McPeek, Julia N., Meyers, Rachel, Miranda, J. Jaime, Mollinedo, Erick, Monroy, Libny, Mukhopadhyay, Krishnendu, Mutariyani, Bernard, Naeher, Luke P., Nambajimana, Abidan, Natesan, Durairaj, Nizam, Azhar, Ntivuguruzwa, Jean de Dieu, Piedrahita, Ricardo, Puttaswamy, Naveen, Puzzolo, Elisa, Quinn, Ashlinn, Rajamani, Karthikeyan D., Rajkumar, Sarah, Ramasami, Rengaraj, Ramirez, Alexander, Ryan, P. Barry, Saidam, Sudhakar, Sakas, Zoe, Sambandam, Sankar, Sarnat, Jeremy, Smith, Kirk, Swearing, Damien, Toenjes, Ashley, Underhill, Lindsay, Uwizeyimana, Jean D, Valdes, Viviane, Verma, Amit, Warnock, Megan, Ye, Wenlu, Young, Bonnie, Younger, Ashley, Monroy-Alarcón, Libny Y., Castañaza Gonzalez de Durante, Adly, López-Ortega, Claudia, Gonzalez, Maria F., Sowrirajan, Lakshminarayanan, Paramanandam, Shanthi P., Shanmugavadivu, K, Sudharsanan, V, Seshadri, Suresh, Yupanqui-Fredes, Adhemir E., Hancco-Gomez, Mario, Apaza, Ronald, Persivale-Calle, Juan F., Quispe, Elizabeth, Leon-Ponce, Carlos, Villar-Gonzales, Victor, Andrade-Salas, Rebeca, Herrera, Jhon E., Ramos-Mamani, Luzdelia, Lopez, Yessica, Quiza, Giovanna, Hinojosa, Yadel, Gomez-Quispe, Madeluz, Frisancho-Parada, Gery, Mendoza-Apaza, Danielle I., Quispe-Flores, Luz R., Xavier, Niyitegeka F, Utfimana, Grace, Tuzayisenga, Elie, Nkurunziza, Valens, Checkley, William, Thompson, Lisa M, Hossen, Shakir, Nicolaou, Laura, Williams, Kendra N, Hartinger, Stella M, Chiang, Marilu, Balakrishnan, Kalpana, Garg, Sarada S, Thangavel, Gurusamy, Aravindalochanan, Vigneswari, Rosa, Ghislaine, Mukeshimana, Alexie, Ndagijimana, Florien, McCracken, John P, Diaz-Artiga, Anaité, Sinharoy, Sheela S, Waller, Lance, Wang, Jiantong, Jabbarzadeh, Shirin, Chen, Yunyun, Steenland, Kyle, Kirby, Miles A, Ramakrishnan, Usha, Johnson, Michael, Pillarisetti, Ajay, McCollum, Eric D, Craik, Rachel, Ohuma, Eric O, Dávila-Román, Victor G, de las Fuentes, Lisa, Simkovich, Suzanne M, Peel, Jennifer L, Clasen, Thomas F, and Papageorghiou, Aris T

Published
2024
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4. Lung Ultrasound Protocol and Quality Control of Image Interpretation Using an Adjudication Panel in the Household Air Pollution Intervention Network (HAPIN) Trial

Author

Simkovich, Suzanne M., Hossen, Shakir, McCollum, Eric D., Toenjes, Ashley K., McCracken, John P., Thompson, Lisa M., Castañaza, Adly, Diaz, Anaite, Rosa, Ghislaine, Kirby, Miles A., Mukeshimana, Alexie, Myers, Rachel, Lenzen, Patricia M., Craik, Rachel, Jabbarzadeh, Shirin, Elon, Lisa, Garg, Sarada S., Balakrishnan, Kalpana, Thangavel, Gurusamy, Peel, Jennifer L., Clasen, Thomas F., Dávila-Román, Victor G., Papageorghiou, Aris T., de las Fuentes, Lisa, and Checkley, William

Published
2023
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5. Effects of a LPG stove and fuel intervention on adverse maternal outcomes: A multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)

Author

Ashley Younger, Abbey Alkon, Kristen Harknett, Miles A. Kirby, Lisa Elon, Amy E. Lovvorn, Jiantong Wang, Wenlu Ye, Anaité Diaz-Artiga, John P. McCracken, Adly Castañaza Gonzalez, Libny Monroy Alarcon, Alexie Mukeshimana, Ghislaine Rosa, Marilu Chiang, Kalpana Balakrishnan, Sarada S. Garg, Ajay Pillarisetti, Ricardo Piedrahita, Michael Johnson, Rachel Craik, Aris T. Papageorghiou, Ashley Toenjes, Ashlinn Quinn, Kendra N. Williams, Lindsay Underhill, Howard H. Chang, Luke P. Naeher, Joshua Rosenthal, William Checkley, Jennifer L. Peel, Thomas F. Clasen, and Lisa M. Thompson

Subjects
Cooking fuel, Birth outcomes, Household air pollution, Low- and middle-income countries, Spontaneous abortion, Hypertensive disorders of pregnancy, Environmental sciences, GE1-350
Abstract

Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid cooking fuels. Pregnant women (18–34 years of age; gestation confirmed by ultrasound at 9–19 weeks) were randomly assigned to an intervention (n = 1593) or control (n = 1607) arm. Intention-to-treat analyses compared outcomes between the two arms using log-binomial models. Among the 3195 pregnant women in the study, there were 10 spontaneous abortions (7 intervention, 3 control), 93 hypertensive disorders of pregnancy (47 intervention, 46 control), 11 post postpartum hemorrhage (5 intervention, 6 control) and 4 maternal deaths (3 intervention, 1 control). Compared to the control arm, the relative risk of spontaneous abortion among women randomized to the intervention was 2.32 (95% confidence interval (CI): 0.60, 8.96), hypertensive disorders of pregnancy 1.02 (95% CI: 0.68, 1.52), postpartum hemorrhage 0.83 (95% CI: 0.25, 2.71) and 2.98 (95% CI: 0.31, 28.66) for maternal mortality. In this study, we found that adverse maternal outcomes did not differ based on randomized stove type across four country research sites.

Published
2023
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6. Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomised controlled trial

Author

Checkley, William, primary, Thompson, Lisa M, additional, Hossen, Shakir, additional, Nicolaou, Laura, additional, Williams, Kendra N, additional, Hartinger, Stella M, additional, Chiang, Marilu, additional, Balakrishnan, Kalpana, additional, Garg, Sarada S, additional, Thangavel, Gurusamy, additional, Aravindalochanan, Vigneswari, additional, Rosa, Ghislaine, additional, Mukeshimana, Alexie, additional, Ndagijimana, Florien, additional, McCracken, John P, additional, Diaz-Artiga, Anaité, additional, Sinharoy, Sheela S, additional, Waller, Lance, additional, Wang, Jiantong, additional, Jabbarzadeh, Shirin, additional, Chen, Yunyun, additional, Steenland, Kyle, additional, Kirby, Miles A, additional, Ramakrishnan, Usha, additional, Johnson, Michael, additional, Pillarisetti, Ajay, additional, McCollum, Eric D, additional, Craik, Rachel, additional, Ohuma, Eric O, additional, Dávila-Román, Victor G, additional, de las Fuentes, Lisa, additional, Simkovich, Suzanne M, additional, Peel, Jennifer L, additional, Clasen, Thomas F, additional, Papageorghiou, Aris T, additional, Bankundiye, Gloriose, additional, Boyd Barr, Dana, additional, Burrowes, Vanessa, additional, Bussalleu, Alejandra, additional, Campbell, Devan, additional, Canuz, Eduardo, additional, Castañaza, Adly, additional, Clark, Maggie, additional, Crocker, Mary, additional, De León, Oscar, additional, Dusabimana, Ephrem, additional, Elon, Lisa, additional, Espinoza, Juan G, additional, Pineda Fuentes, Irma, additional, Ghosh, Ahana, additional, Goodman, Dina, additional, Gupton, Savannah, additional, Hamid, Sarah, additional, Harvey, Steven, additional, Hengstermann, Mayari, additional, Hennessee, Ian, additional, Herrera, Phabiola, additional, Howard, Marjorie, additional, Howards, Penelope P., additional, Jaacks, Lindsay, additional, Kearns, Katherine, additional, Kremer, Jacob, additional, Laws, Margaret A., additional, Lenzen, Pattie, additional, Liao, Jiawen, additional, Lovvorn, Amy, additional, Mbabazi, Jane, additional, McPeek, Julia N., additional, Meyers, Rachel, additional, Miranda, J. Jaime, additional, Mollinedo, Erick, additional, Monroy, Libny, additional, Mukhopadhyay, Krishnendu, additional, Mutariyani, Bernard, additional, Naeher, Luke P., additional, Nambajimana, Abidan, additional, Natesan, Durairaj, additional, Nizam, Azhar, additional, Ntivuguruzwa, Jean de Dieu, additional, Piedrahita, Ricardo, additional, Puttaswamy, Naveen, additional, Puzzolo, Elisa, additional, Quinn, Ashlinn, additional, Rajamani, Karthikeyan D., additional, Rajkumar, Sarah, additional, Ramasami, Rengaraj, additional, Ramirez, Alexander, additional, Ryan, P. Barry, additional, Saidam, Sudhakar, additional, Sakas, Zoe, additional, Sambandam, Sankar, additional, Sarnat, Jeremy, additional, Smith, Kirk, additional, Swearing, Damien, additional, Toenjes, Ashley, additional, Underhill, Lindsay, additional, Uwizeyimana, Jean D, additional, Valdes, Viviane, additional, Verma, Amit, additional, Warnock, Megan, additional, Ye, Wenlu, additional, Young, Bonnie, additional, Younger, Ashley, additional, Monroy-Alarcón, Libny Y., additional, Castañaza Gonzalez de Durante, Adly, additional, López-Ortega, Claudia, additional, Gonzalez, Maria F., additional, Sowrirajan, Lakshminarayanan, additional, Paramanandam, Shanthi P., additional, Shanmugavadivu, K, additional, Sudharsanan, V, additional, Seshadri, Suresh, additional, Yupanqui-Fredes, Adhemir E., additional, Hancco-Gomez, Mario, additional, Apaza, Ronald, additional, Persivale-Calle, Juan F., additional, Quispe, Elizabeth, additional, Leon-Ponce, Carlos, additional, Villar-Gonzales, Victor, additional, Andrade-Salas, Rebeca, additional, Herrera, Jhon E., additional, Ramos-Mamani, Luzdelia, additional, Lopez, Yessica, additional, Quiza, Giovanna, additional, Hinojosa, Yadel, additional, Gomez-Quispe, Madeluz, additional, Frisancho-Parada, Gery, additional, Mendoza-Apaza, Danielle I., additional, Quispe-Flores, Luz R., additional, Xavier, Niyitegeka F, additional, Utfimana, Grace, additional, Tuzayisenga, Elie, additional, and Nkurunziza, Valens, additional

Published
2024
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9. LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

Author

Aravindalochanan, Vigneswari, Bankundiye, Gloriose, Barr, Dana Boyd, Bussalleu, Alejandra, Canuz, Eduardo, Castañaza, Adly, Chen, Yunyun, Chiang, Marilú, Craik, Rachel, Davila-Roman, Victor G., de las Fuentes, Lisa, Elon, Lisa, Espinoza, Juan Gabriel, Garg, Sarada, Hamid, Sarah, Hartinger, Stella, Harvey, Steven A., Hengstermann, Mayari, Hennessee, Ian, Herrera, Phabiola M., Hossen, Shakir, Howards, Penelope P., Jaacks, Lindsay, Jabbarzadeh, Shirin, Lenzen, Pattie, Lovvorn, Amy E., Mbabazi, Jane, McCollum, Eric, Meyers, Rachel, Moulton, Lawrence, Mukeshimana, Alexie, Mutariyani, Bernard, Natesan, Durairaj, Nizam, Azhar, Ntivuguruzwa, Jean de Dieu, Papageorghiou, Aris, Puttaswamy, Naveen, Puzzolo, Elisa, Quinn, Ashlinn, Rajamani, Karthikeyan Dharmapuri, Ramakrishnan, Usha, Ramasami, Rengaraj, Ramirez, Alexander, Ryan, P. Barry, Saidam, Sudhakar, Sarnat, Jeremy A., Simkovich, Suzanne, Sinharoy, Sheela S., Smith, Kirk R., Swearing, Damien, Thangavel, Gurusamy, Toenjes, Ashley, Valdes, Viviane, Williams, Kendra N., Ye, Wenlu, Young, Bonnie N., Liao, Jiawen, Kirby, Miles A., Pillarisetti, Ajay, Piedrahita, Ricardo, Balakrishnan, Kalpana, Sambandam, Sankar, Mukhopadhyay, Krishnendu, Rosa, Ghislaine, Majorin, Fiona, Dusabimana, Ephrem, Ndagijimana, Florien, McCracken, John P., Mollinedo, Erick, de Leon, Oscar, Díaz-Artiga, Anaité, Thompson, Lisa M., Kearns, Katherine A., Naeher, Luke, Rosenthal, Joshua, Clark, Maggie L., Steenland, Kyle, Waller, Lance A., Checkley, William, Peel, Jennifer L., Clasen, Thomas, and Johnson, Michael

Published
2021
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10. Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia

Author

McCollum, Eric D., primary, McCracken, John P., additional, Kirby, Miles A., additional, Grajeda, Laura M., additional, Hossen, Shakir, additional, Moulton, Lawrence H., additional, Simkovich, Suzanne M., additional, Goodman-Palmer, Dina, additional, Rosa, Ghislaine, additional, Mukeshimana, Alexie, additional, Balakrishnan, Kalpana, additional, Thangavel, Gurusamy, additional, Garg, Sarada S., additional, Castañaza, Adly, additional, Thompson, Lisa M., additional, Diaz-Artiga, Anaite, additional, Papageorghiou, Aris T., additional, Davila-Roman, Victor G., additional, Underhill, Lindsay J., additional, Hartinger, Stella M., additional, Williams, Kendra N., additional, Nicolaou, Laura, additional, Chang, Howard H., additional, Lovvorn, Amy E., additional, Rosenthal, Joshua P., additional, Pillarisetti, Ajay, additional, Ye, Wenlu, additional, Naeher, Luke P., additional, Johnson, Michael A., additional, Waller, Lance A., additional, Jabbarzadeh, Shirin, additional, Wang, Jiantong, additional, Chen, Yunyun, additional, Steenland, Kyle, additional, Clasen, Thomas F., additional, Peel, Jennifer L., additional, and Checkley, William, additional

Published
2024
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11. Lung Ultrasound Protocol and Quality Control of Image Interpretation Using an Adjudication Panel in the Household Air Pollution Intervention Network (HAPIN) Trial

Author

Suzanne M. Simkovich, Shakir Hossen, Eric D. McCollum, Ashley K. Toenjes, John P. McCracken, Lisa M. Thompson, Adly Castañaza, Anaite Diaz, Ghislaine Rosa, Miles A. Kirby, Alexie Mukeshimana, Rachel Myers, Patricia M. Lenzen, Rachel Craik, Shirin Jabbarzadeh, Lisa Elon, Sarada S. Garg, Kalpana Balakrishnan, Gurusamy Thangavel, Jennifer L. Peel, Thomas F. Clasen, Victor G. Dávila-Román, Aris T. Papageorghiou, Lisa de las Fuentes, and William Checkley

Subjects
Acoustics and Ultrasonics, Radiological and Ultrasound Technology, Biophysics, Radiology, Nuclear Medicine and imaging
Published
2023
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12. Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial

Author

J Jaime Miranda, Kyle Steenland, Vanessa Burrowes, Kirk R Smith, Aris Papageorghiou, Abigail Jones, Ghislaine Rosa, Anaité Díaz-Artiga, Gurusamy Thangavel, Kalpana Balakrishnan, Joshua P Rosenthal, Thomas F Clasen, Steven A Harvey, Amit Verma, Kendra N. Williams, Lisa M. Thompson, Zoe Sakas, Mayari Hengstermann, Ashlinn Quinn, Elisa Puzzolo, Jennifer Peel, Vigneswari Aravindalochanan, Dana Boyd Barr, Alejandra Bussalleu, Devan Campbell, Eduardo Canuz, Adly Castañaza, Howard Chang, Yunyun Chen, Marilú Chiang, Maggie L Clark, Rachel Craik, Mary Crocker, Victor Davila-Roman, Lisa de las Fuentes, Oscar De León, Ephrem Dusabimana, Lisa Elon, Juan Gabriel Espinoza, Irma Sayury Pineda Fuentes, Sarada Garg, Dina Goodman, Savannah Gupton, Meghan Hardison, Stella Hartinger, Phabiola M Herrera, Shakir Hossen, Penelope Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A Johnson, Katherine Kearns, Miles Kirby, Jacob Kremer, Margaret A Laws, Pattie Lenzen, Jiawen Liao, Amy E Lovvorn, Fiona Majorin, Eric McCollum, John McCracken, Julia N McPeek, Rachel Meyers, Erick Mollinedo, Lawrence Moulton, Krishnendu Mukhopadhyay, Luke Naeher, Abidan Nambajimana, Durairaj Natesan, Florien Ndagijimana, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Sarah Rajkumar, Usha Ramakrishnan, Rengaraj Ramasami, Davis Reardon, Barry Ryan, Sudhakar Saidam, Sankar Sambandam, Jeremy A Sarnat, Suzanne Simkovich, Sheela S Sinharoy, Damien Swearing, Ashley Toenjes, Lindsay Underhill, Jean Damascene Uwizeyimana, Viviane Valdes, Kayla Valentine, Lance Waller, Megan Warnock, Wenlu Ye, and Bonnie Young

Subjects
Medicine
Abstract

Introduction Increasing use of cleaner fuels, such as liquefied petroleum gas (LPG), and abandonment of solid fuels is key to reducing household air pollution and realising potential health improvements in low-income countries. However, achieving exclusive LPG use in households unaccustomed to this type of fuel, used in combination with a new stove technology, requires substantial behaviour change. We conducted theory-grounded formative research to identify contextual factors influencing cooking fuel choice to guide the development of behavioural strategies for the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial will assess the impact of exclusive LPG use on air pollution exposure and health of pregnant women, older adult women, and infants under 1 year of age in Guatemala, India, Peru, and Rwanda.Methods Using the Capability, Opportunity, Motivation–Behaviour (COM–B) framework and Behaviour Change Wheel (BCW) to guide formative research, we conducted in-depth interviews, focus group discussions, observations, key informant interviews and pilot studies to identify key influencers of cooking behaviours in the four countries. We used these findings to develop behavioural strategies likely to achieve exclusive LPG use in the HAPIN trial.Results We identified nine potential influencers of exclusive LPG use, including perceived disadvantages of solid fuels, family preferences, cookware, traditional foods, non-food-related cooking, heating needs, LPG awareness, safety and cost and availability of fuel. Mapping formative findings onto the theoretical frameworks, behavioural strategies for achieving exclusive LPG use in each research site included free fuel deliveries, locally acceptable stoves and equipment, hands-on training and printed materials and videos emphasising relevant messages. In the HAPIN trial, we will monitor and reinforce exclusive LPG use through temperature data loggers, LPG fuel delivery tracking, in-home observations and behavioural reinforcement visits.Conclusion Our formative research and behavioural strategies can inform the development, implementation, monitoring and evaluation of theory-informed strategies to promote exclusive LPG use in future stove programmes and research studies.Trial registration number NCT02944682, Pre-results.

Published
2020
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13. Effects of a LPG stove and fuel intervention on adverse maternal outcomes: A multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)

Author

Younger, Ashley, primary, Alkon, Abbey, additional, Harknett, Kristen, additional, Kirby, Miles A., additional, Elon, Lisa, additional, Lovvorn, Amy E., additional, Wang, Jiantong, additional, Ye, Wenlu, additional, Diaz-Artiga, Anaité, additional, McCracken, John P., additional, Castañaza Gonzalez, Adly, additional, Monroy Alarcon, Libny, additional, Mukeshimana, Alexie, additional, Rosa, Ghislaine, additional, Chiang, Marilu, additional, Balakrishnan, Kalpana, additional, Garg, Sarada S., additional, Pillarisetti, Ajay, additional, Piedrahita, Ricardo, additional, Johnson, Michael, additional, Craik, Rachel, additional, Papageorghiou, Aris T., additional, Toenjes, Ashley, additional, Quinn, Ashlinn, additional, Williams, Kendra N., additional, Underhill, Lindsay, additional, Chang, Howard H., additional, Naeher, Luke P., additional, Rosenthal, Joshua, additional, Checkley, William, additional, Peel, Jennifer L., additional, Clasen, Thomas F., additional, and Thompson, Lisa M., additional

Published
2023
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14. Effects of a Multi-component Liquefied Petroleum Gas Stove Intervention on Severe Pneumonia Incidence During Infancy: HAPIN Randomized Controlled Trial

Author

Mccollum, E.D., primary, McCracken, J.P., additional, Kirby, M.A., additional, Hossen, S., additional, Grajeda, L., additional, Moulton, L.H., additional, Simkovich, S.M., additional, Goodman, D., additional, Rosa, G., additional, Balakrishnan, K., additional, Thangavel, G., additional, Garg, S.S., additional, Castañaza, A., additional, Thompson, L.M.M., additional, Diaz-Artiga, A., additional, Papageorghiou, A.T., additional, Davila-Roman, V., additional, Underhill, L.J., additional, Hartinger, S., additional, Chang, H.H., additional, Lovvorn, A.E., additional, Rosenthal, J.P., additional, Pillarisetti, A., additional, Johnnson, M.A., additional, Waller, L.A., additional, Jabbarzadeh, S., additional, Wang, J., additional, Chen, Y., additional, Steenland, K., additional, Clasen, T.F., additional, Peel, J.L., additional, and Checkley, W., additional

Published
2023
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15. Effects of a Multi-component Liquefied Petroleum Gas Stove Intervention on Severe Pneumonia Incidence During Infancy: HAPIN Randomized Controlled Trial

Author

E.D. Mccollum, J.P. McCracken, M.A. Kirby, S. Hossen, L. Grajeda, L.H. Moulton, S.M. Simkovich, D. Goodman, G. Rosa, K. Balakrishnan, G. Thangavel, S.S. Garg, A. Castañaza, L.M.M. Thompson, A. Diaz-Artiga, A.T. Papageorghiou, V. Davila-Roman, L.J. Underhill, S. Hartinger, H.H. Chang, A.E. Lovvorn, J.P. Rosenthal, A. Pillarisetti, M.A. Johnnson, L.A. Waller, S. Jabbarzadeh, J. Wang, Y. Chen, K. Steenland, T.F. Clasen, J.L. Peel, and W. Checkley

Published
2023
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16. Resources and Geographic Access to Care for Severe Pediatric Pneumonia in Four Resource-limited Settings

Author

Suzanne M. Simkovich, Lindsay J. Underhill, Miles A. Kirby, Mary E. Crocker, Dina Goodman, John P. McCracken, Lisa M. Thompson, Anaité Diaz-Artiga, Adly Castañaza-Gonzalez, Sarada S. Garg, Kalpana Balakrishnan, Gurusamy Thangavel, Ghislaine Rosa, Jennifer L. Peel, Thomas F. Clasen, Eric D. McCollum, William Checkley, Vigneswari Aravindalochanan, Dana B. Barr, Vanessa Burrowes, Devan Campbell, Eduardo Canuz, Howard Chang, Yunyun Chen, Marilú Chiang, Maggie L. Clark, Rachel Craik, Victor Dávila-Román, Lisa de las Fuentes, Oscar De Léon, Ephrem Dusabimana, Lisa Elon, Juan Gabriel Espinoza, Irma S. Pineda Fuentes, Savannah Gupton, Meghan Hardison, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Phabiola Herrera, Shakir Hossen, Penelope Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A. Johnson, Abigail Jones, Katherine Kearns, Jacob Kremer, Margaret Laws, Patricia M. Lenzen, Jiawen Liao, Amy Lovvorn, Fiona Majorin, Julia McPeek, Rachel M. Meyers, J. Jaime Miranda, Erick Mollinedo, Lawrence Moulton, Krishnendu Mukhopadhyay, Luke Naeher, Abidan Nambajimana, Florien Ndagijimana, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Sarah Rajkumar, Usha Ramakrishnan, Davis Reardon, Joshua Rosenthal, P. Barry Ryan, Zoe Sakas, Sankar Sambandam, Jeremy Sarnat, Sheela Sinharoy, Kirk R. Smith, Kyle Steenland, Damien Swearing, Ashley K. Toenjes, Jean Damascene Uwizeyimana, Viviane Valdes, Amit Verma, Lance Waller, Megan Warnock, Kendra Williams, Wenlu Ye, and Bonnie Young

Subjects
Pulmonary and Respiratory Medicine, Referral, business.industry, Creative commons, Original Articles, low- and middle-income country, Critical Care and Intensive Care Medicine, medicine.disease, Environmental and Occupational Lung Disease/Pediatrics and Lung Development, pulse oximetry, health service accessibility, Pneumonia, Intervention (counseling), Health care, medicine, pneumonia, Humans, Medical emergency, Healthcare Disparities, business, Child, License, Limited resources, Cause of death
Abstract

RATIONALE: Pneumonia is the leading cause of death in children worldwide. Identifying and appropriately managing severe pneumonia in a timely manner improves outcomes. Little is known about the readiness of healthcare facilities to manage severe pediatric pneumonia in low-resource settings. OBJECTIVES: As part of the Household Air Pollution Intervention Network (HAPIN) trial, we sought to identify healthcare facilities that were adequately resourced to manage severe pediatric pneumonia in Jalapa, Guatemala (J-GUA); Puno, Peru (P-PER); Kayonza, Rwanda (K-RWA); and Tamil Nadu, India (T-IND). We conducted a facility-based survey of available infrastructure, staff, equipment, and medical consumables. Facilities were georeferenced and a road network analysis was performed. MEASUREMENTS AND MAIN RESULTS: Of the 350 healthcare facilities surveyed, 13% had adequate resources to manage severe pneumonia, 37% had pulse oximeters, and 44% had supplemental oxygen. Mean (±SD) travel time to an adequately-resourced facility was 41±19 minutes in J-GUA, 99±64 minutes in P-PER, 40±19 minutes in K-RWA, and 31±19 minutes in T-IND. Expanding pulse oximetry coverage to all facilities reduced travel time by 44% in J-GUA, 29% in P-PER, 29% in K-RWA, and 11% in T-IND (all p

Published
2021

17. Revolucionando la enseñanza en caries dental a través de investigación y acción

Author

Ligia Nicté Castañaza Guzmán

Abstract

OBJETIVO: compartir la experiencia de investigación y ejecución de un plan de acción en la enseñanza de caries dental en la Facultad de Odontología de la Universidad de San Carlos de Guatemala. MÉTODO:la investigación se basó en el paradigma Socio Crítico, con un enfoque de tipo mixto, el diseño es anidado o incrustado concurrente de modelo dominante (DIAC) y en la fase cuantitativa el diseño es no experimental transeccional, la experiencia investigativa tiene predominio de investigación acción. RESULTADOS: la implementación de la acción demostró resultados satisfactorios y fortalecimiento del conocimiento, análisis y diagnóstico de lesiones de caries dental en los estudiantes, también aportó la implementación de una plataforma para el manejo del contenido, incorporación de metodología de resolución de casos clínicos, trabajo colaborativo, realización de proyectos y la aplicación de diferentes tipos de evaluación. CONCLUSIÓN: la investigación contribuyó a mejorar el entrenamiento en el diagnóstico de caries y manejo de la enfermedad en los estudiantes de cuarto año de la carrera de Cirujano Dentista de la Universidad de San Carlos de Guatemala. Se evidenció que la educación virtual y el uso de la tecnología favorece el desarrollo de actividades que cumplen los objetivos de aprendizaje. Cambió el rol del estudiante a un papel activo y el del docente al de facilitador, se incorporaron metodologías activas de la educación con éxito que no se tenían contempladas y que actualmente forman parte de la planificación docente del curso.

Published
2022
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18. Liquefied Petroleum Gas or Biomass for Cooking and Effects on Birth Weight

Author

Clasen, Thomas F., primary, Chang, Howard H., additional, Thompson, Lisa M., additional, Kirby, Miles A., additional, Balakrishnan, Kalpana, additional, Díaz-Artiga, Anaité, additional, McCracken, John P., additional, Rosa, Ghislaine, additional, Steenland, Kyle, additional, Younger, Ashley, additional, Aravindalochanan, Vigneswari, additional, Barr, Dana B., additional, Castañaza, Adly, additional, Chen, Yunyun, additional, Chiang, Marilú, additional, Clark, Maggie L., additional, Garg, Sarada, additional, Hartinger, Stella, additional, Jabbarzadeh, Shirin, additional, Johnson, Michael A., additional, Kim, Dong-Yun, additional, Lovvorn, Amy E., additional, McCollum, Eric D., additional, Monroy, Libny, additional, Moulton, Lawrence H., additional, Mukeshimana, Alexie, additional, Mukhopadhyay, Krishnendu, additional, Naeher, Luke P., additional, Ndagijimana, Florien, additional, Papageorghiou, Aris, additional, Piedrahita, Ricardo, additional, Pillarisetti, Ajay, additional, Puttaswamy, Naveen, additional, Quinn, Ashlinn, additional, Ramakrishnan, Usha, additional, Sambandam, Sankar, additional, Sinharoy, Sheela S., additional, Thangavel, Gurusamy, additional, Underhill, Lindsay J., additional, Waller, Lance A., additional, Wang, Jiantong, additional, Williams, Kendra N., additional, Rosenthal, Joshua P., additional, Checkley, William, additional, and Peel, Jennifer L., additional

Published
2022
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19. Effects of a liquefied petroleum gas cookstove and fuel intervention on fetal and neonatal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN) trial

Author

Ashley Younger, Abbey Alkon, Kristen Harknett, Miles A Kirby, Amy E. Lovvorn, Jiantong Wang, Anaité Diaz-Artiga, John P. McCracken, Ghislaine Rosa, Kalpana Balakrishnan, Adly Castañaza-Gonzalez, Libny Monroy-Alarcon, Alexie Mukeshimana, Sarada S. Garg, Lindsay Underhill, Howard H. Chang, Joshua Rosenthal, Aris Papageorghiou, William Checkley, Jennifer L. Peel, Thomas F. Clasen, and Lisa Thompson

Subjects
General Earth and Planetary Sciences, General Environmental Science
Published
2022
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20. Effects of a Liquefied Petroleum Gas Stove and Continuous Fuel Distribution Intervention on Anthropometric Outcomes at Birth

Author

Hina Raheel, Ashley Younger, Sheela Sinharoy, Jiantong Wang, Shirin Jabbarzadeh, Marilu Chiang, Adly Castañaza, Anaite Diaz-Artiga, Sarada Garg, Florien Ndagijimana, Gloriose Bankundiye, Miles A. Kirby, Kalpana Balakrishnan, John P. McCracken, Ghislaine Rosa, Aris Papageorghiou, Thomas F. Clasen, Jennifer Peel, William Checkley, and Lisa M. Thompson

Subjects
General Earth and Planetary Sciences, General Environmental Science
Published
2022
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21. Effects of a liquefied petroleum gas cookstove and fuel intervention on preterm birth and gestational duration: the multi-country Household Air Pollution Intervention Network (HAPIN) trial

Author

Miles A. Kirby, Lisa Thompson, Ashley Toenjes, Aris Papageorghiou, Rachel Craik, Lisa Elon, Ashley Younger, Penelope P. Howards, Usha Ramakrishnan, John P. McCracken, Anaite Diaz-Artiga, Adly Castañaza-Gonzalez, Libny Monroy-Alarcon, Ghislaine Rose, Alexie Mukeshimana, Kalpana Balakrishnan, Sarada S. Garg, Lindsay J. Underhill, Michael Johnson, Ajay Pillarisetti, Ricardo Piedrahita, Joshua Rosenthal, Ashlinn Quinn, Lance Waller, Shirin Jabbarzadeh, Jiantong Wang, Kyle Steenland, Luke P. Naeher, Howard Chang, William Checkley, Thomas F. Clasen, and Jennifer L. Peel

Subjects
General Earth and Planetary Sciences, General Environmental Science
Published
2022
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22. Effects of a liquefied petroleum gas cookstove and fuel intervention on fetal and neonatal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN) trial

Author

Younger, Ashley, primary, Alkon, Abbey, additional, Harknett, Kristen, additional, Kirby, Miles A, additional, Lovvorn, Amy E., additional, Wang, Jiantong, additional, Diaz-Artiga, Anaité, additional, McCracken, John P., additional, Rosa, Ghislaine, additional, Balakrishnan, Kalpana, additional, Castañaza-Gonzalez, Adly, additional, Monroy-Alarcon, Libny, additional, Mukeshimana, Alexie, additional, Garg, Sarada S., additional, Underhill, Lindsay, additional, Chang, Howard H., additional, Rosenthal, Joshua, additional, Papageorghiou, Aris, additional, Checkley, William, additional, Peel, Jennifer L., additional, Clasen, Thomas F., additional, and Thompson, Lisa, additional

Published
2022
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23. Effects of a Liquefied Petroleum Gas Stove and Continuous Fuel Distribution Intervention on Anthropometric Outcomes at Birth

Author

Raheel, Hina, primary, Younger, Ashley, additional, Sinharoy, Sheela, additional, Wang, Jiantong, additional, Jabbarzadeh, Shirin, additional, Chiang, Marilu, additional, Castañaza, Adly, additional, Diaz-Artiga, Anaite, additional, Garg, Sarada, additional, Ndagijimana, Florien, additional, Bankundiye, Gloriose, additional, Kirby, Miles A., additional, Balakrishnan, Kalpana, additional, McCracken, John P., additional, Rosa, Ghislaine, additional, Papageorghiou, Aris, additional, Clasen, Thomas F., additional, Peel, Jennifer, additional, Checkley, William, additional, and Thompson, Lisa M., additional

Published
2022
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24. Effects of a liquefied petroleum gas cookstove and fuel intervention on preterm birth and gestational duration: the multi-country Household Air Pollution Intervention Network (HAPIN) trial

Author

Kirby, Miles A., primary, Thompson, Lisa, additional, Toenjes, Ashley, additional, Papageorghiou, Aris, additional, Craik, Rachel, additional, Elon, Lisa, additional, Younger, Ashley, additional, Howards, Penelope P., additional, Ramakrishnan, Usha, additional, McCracken, John P., additional, Diaz-Artiga, Anaite, additional, Castañaza-Gonzalez, Adly, additional, Monroy-Alarcon, Libny, additional, Rose, Ghislaine, additional, Mukeshimana, Alexie, additional, Balakrishnan, Kalpana, additional, Garg, Sarada S., additional, Underhill, Lindsay J., additional, Johnson, Michael, additional, Pillarisetti, Ajay, additional, Piedrahita, Ricardo, additional, Rosenthal, Joshua, additional, Quinn, Ashlinn, additional, Waller, Lance, additional, Jabbarzadeh, Shirin, additional, Wang, Jiantong, additional, Steenland, Kyle, additional, Naeher, Luke P., additional, Chang, Howard, additional, Checkley, William, additional, Clasen, Thomas F., additional, and Peel, Jennifer L., additional

Published
2022
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25. Resources and Geographic Access to Care for Severe Pediatric Pneumonia in Four Resource-limited Settings

Author

Simkovich, Suzanne M, Underhill, Lindsay J, Kirby, Miles A, Crocker, Mary E, Goodman, Dina, McCracken, John P, Thompson, Lisa M, Diaz-Artiga, Anaité, Castañaza-Gonzalez, Adly, Garg, Sarada S, Balakrishnan, Kalpana, Thangavel, Gurusamy, Rosa, Ghislaine, Peel, Jennifer L, Clasen, Thomas F, McCollum, Eric D, Checkley, William, and HAPIN Investigators

Abstract

Rationale: Pneumonia is the leading cause of death in children worldwide. Identifying and appropriately managing severe pneumonia in a timely manner improves outcomes. Little is known about the readiness of healthcare facilities to manage severe pediatric pneumonia in low-resource settings.\ud Objectives: As part of the HAPIN (Household Air Pollution Intervention Network) trial, we sought to identify healthcare facilities that were adequately resourced to manage severe pediatric pneumonia in Jalapa, Guatemala (J-GUA); Puno, Peru (P-PER); Kayonza, Rwanda (K-RWA); and Tamil Nadu, India (T-IND). We conducted a facility-based survey of available infrastructure, staff, equipment, and medical consumables. Facilities were georeferenced, and a road network analysis was performed. Measurements and Main Results: Of the 350 healthcare facilities surveyed, 13% had adequate resources to manage severe pneumonia, 37% had pulse oximeters, and 44% had supplemental oxygen. Mean (±SD) travel time to an adequately resourced facility was 41 ± 19 minutes in J-GUA, 99 ± 64 minutes in P-PER, 40 ± 19 minutes in K-RWA, and 31 ± 19 minutes in T-IND. Expanding pulse oximetry coverage to all facilities reduced travel time by 44% in J-GUA, 29% in P-PER, 29% in K-RWA, and 11% in T-IND (all P

Published
2022

26. Developing visual messages to support liquefied petroleum gas use in intervention homes in the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala

Author

Mayarí Hengstermann, Anaité Díaz-Artiga, Roberto Otzóy-Sucúc, Ana Laura Maria Ruiz-Aguilar, Lisa M. Thompson, Vigneswari Aravindalochanan, Kalpana Balakrishnan, Dana Boyd Barr, Vanessa Burrowes, Devan Campbell, Julia McPeek Campbell, Eduardo Canuz, Adly Castañaza, Howard Chang, William Checkley, Yunyun Chen, Marilú Chiang, Maggie L. Clark, Thomas Clasen, Rachel Craik, Mary Crocker, Victor Davila-Roman, Lisa de las Fuentes, Oscar De Léon, Anaité Diaz-Artiga, Ephrem Dusabimana, Lisa Elon, Juan Gabriel Espinoza, Irma Sayury Pineda Fuentes, Sarada Garg, Dina Goodman, Savannah Gupton, Meghan Hardison, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Phabiola Herrera, Shakir Hossen, Penelope Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A. Johnson, Abigail Jones, Katherine Kearns, Miles Kirby, Jacob Kremer, Margaret Laws, Jiawen Liao, Amy Lovvorn, Fiona Majorin, Eric McCollum, John McCracken, Rachel Meyers, J. Jaime Miranda, Erick Mollinedo, Lawrence Moulton, Krishnendu Mukhopadhyay, Luke Naeher, Abidan Nambajimana, Florien Ndagijimana, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Jennifer Peel, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Sarah Rajkumar, Usha Ramakrishnan, Davis Reardon, Ghislaine Rosa, Joshua Rosenthal, P. Barry Ryan, Zoe Sakas, Sankar Sambandam, Jeremy Sarnat, Suzanne Simkovich, Sheela Sinharoy, Kirk R. Smith, Kyle Steenland, Damien Swearing, Gurusamy Thangavel, Ashley Toenjes, Lindsay Underhill, Jean Damascene Uwizeyimana, Viviane Valdes, Amit Verma, Lance Waller, Megan Warnock, Kendra Williams, Wenlu Ye, and Bonnie Young

Subjects
Rural Population, Public Health, Environmental and Occupational Health, Air pollution, Health literacy, Pilot Projects, medicine.disease_cause, Guatemala, Audiovisual Aids, Liquefied petroleum gas, Human health, Intervention (law), Petroleum, Arts and Humanities (miscellaneous), Environmental health, Air Pollution, Air Pollution, Indoor, medicine, Humans, Business, Cooking
Abstract

Background Household air pollution adversely affects human health and the environment, yet more than 40% of the world still depends on solid cooking fuels. The House Air Pollution Intervention Network (HAPIN) randomized controlled trial is assessing the health effects of a liquefied petroleum gas (LPG) stove and 18-month supply of free fuel in 3,200 households in rural Guatemala, India, Peru, and Rwanda. Aims We conducted formative research in Guatemala to create visual messages that support the sustained, exclusive use of LPG in HAPIN intervention households. Method We conducted ethnographic research, including direct observation ( n = 36), in-depth ( n = 18), and semistructured ( n = 6) interviews, and 24 focus group discussions ( n = 96) to understand participants’ experience with LPG. Sixty participants were selected from a pilot study of LPG stove and 2-months of free fuel to assess the acceptability and use of LPG. Emergent themes were used to create visual messages based on observations and interviews in 40 households; messages were tested and revised in focus group discussions with 20 households. Results We identified 50 codes related to household air pollution and stoves; these were reduced into 24 themes relevant to LPG stoves, prioritizing 12 for calendars. Messages addressed fear and reluctance to use LPG; preference of wood stoves for cooking traditional foods; sustainability and accessibility of fuel; association between health outcomes and household air pollution; and the need for inspirational and aspirational messages. Discussion We created a flip chart and calendar illustrating themes to promote exclusive LPG use in HAPIN intervention households.

Published
2021
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27. LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

Author

Liao, Jiawen, primary, Kirby, Miles A., additional, Pillarisetti, Ajay, additional, Piedrahita, Ricardo, additional, Balakrishnan, Kalpana, additional, Sambandam, Sankar, additional, Mukhopadhyay, Krishnendu, additional, Ye, Wenlu, additional, Rosa, Ghislaine, additional, Majorin, Fiona, additional, Dusabimana, Ephrem, additional, Ndagijimana, Florien, additional, McCracken, John P., additional, Mollinedo, Erick, additional, de Leon, Oscar, additional, Díaz-Artiga, Anaité, additional, Thompson, Lisa M., additional, Kearns, Katherine A., additional, Naeher, Luke, additional, Rosenthal, Joshua, additional, Clark, Maggie L., additional, Steenland, Kyle, additional, Waller, Lance A., additional, Checkley, William, additional, Peel, Jennifer L., additional, Clasen, Thomas, additional, Johnson, Michael, additional, Aravindalochanan, Vigneswari, additional, Bankundiye, Gloriose, additional, Barr, Dana Boyd, additional, Bussalleu, Alejandra, additional, Canuz, Eduardo, additional, Castañaza, Adly, additional, Chen, Yunyun, additional, Chiang, Marilú, additional, Craik, Rachel, additional, Davila-Roman, Victor G., additional, de las Fuentes, Lisa, additional, Elon, Lisa, additional, Espinoza, Juan Gabriel, additional, Garg, Sarada, additional, Hamid, Sarah, additional, Hartinger, Stella, additional, Harvey, Steven A., additional, Hengstermann, Mayari, additional, Hennessee, Ian, additional, Herrera, Phabiola M., additional, Hossen, Shakir, additional, Howards, Penelope P., additional, Jaacks, Lindsay, additional, Jabbarzadeh, Shirin, additional, Lenzen, Pattie, additional, Lovvorn, Amy E., additional, Mbabazi, Jane, additional, McCollum, Eric, additional, Meyers, Rachel, additional, Moulton, Lawrence, additional, Mukeshimana, Alexie, additional, Mutariyani, Bernard, additional, Natesan, Durairaj, additional, Nizam, Azhar, additional, Ntivuguruzwa, Jean de Dieu, additional, Papageorghiou, Aris, additional, Puttaswamy, Naveen, additional, Puzzolo, Elisa, additional, Quinn, Ashlinn, additional, Rajamani, Karthikeyan Dharmapuri, additional, Ramakrishnan, Usha, additional, Ramasami, Rengaraj, additional, Ramirez, Alexander, additional, Ryan, P. Barry, additional, Saidam, Sudhakar, additional, Sarnat, Jeremy A., additional, Simkovich, Suzanne, additional, Sinharoy, Sheela S., additional, Smith, Kirk R., additional, Swearing, Damien, additional, Thangavel, Gurusamy, additional, Toenjes, Ashley, additional, Valdes, Viviane, additional, Williams, Kendra N., additional, and Young, Bonnie N., additional

Published
2021
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28. LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

Author

Usha Ramakrishnan, Shirin Jabbarzadeh, Pattie Lenzen, Erick Mollinedo, Rachel Meyers, Penelope P. Howards, Anaite Diaz-Artiga, Ajay Pillarisetti, Kyle Steenland, Krishnendu Mukhopadhyay, Jiawen Liao, Kalpana Balakrishnan, Eduardo Canuz, Jean de Dieu Ntivuguruzwa, Fiona Majorin, Sheela S. Sinharoy, Ashlinn Quinn, Thomas Clasen, Miles A. Kirby, Eric D. McCollum, Jane Mbabazi, Ghislaine Rosa, Marilu Chiang, Bonnie N. Young, John P. McCracken, Viviane Valdes, Bernard Mutariyani, Florien Ndagijimana, Amy Lovvorn, Alejandra Bussalleu, Gloriose Bankundiye, Maggie L. Clark, Luke P. Naeher, Dana B. Barr, Suzanne M. Simkovich, Elisa Puzzolo, Steven A. Harvey, Gurusamy Thangavel, Naveen Puttaswamy, Jeremy A. Sarnat, Kendra N. Williams, Lisa M. Thompson, Wenlu Ye, Damien Swearing, Kirk R. Smith, Sankar Sambandam, Sarada S. Garg, Katherine A. Kearns, Lawrence H. Moulton, Rengaraj Ramasami, Yunyun Chen, Vigneswari Aravindalochanan, Marvin Johnson, Lisa de las Fuentes, Alexander Ramirez, Ian Hennessee, William Checkley, Ashley Toenjes, Shakir Hossen, Ricardo Piedrahita, P. Barry Ryan, Karthikeyan Rajamani, Joshua P. Rosenthal, Lisa Elon, Lindsay M. Jaacks, Ephrem Dusabimana, Jennifer L. Peel, Durairaj Natesan, Mayari Hengstermann, Lance A. Waller, Rachel Craik, Oscar de Leon, Victor G. Davila-Roman, Azhar Nizam, Aris T. Papageorghiou, Alexie Mukeshimana, Juan Gabriel Espinoza, Sudhakar Saidam, Adly Castañaza, Sarah Hamid, Phabiola Herrera, and Stella Hartinger

Subjects
Rural Population, Fine particulate, Health, Toxicology and Mutagenesis, Psychological intervention, Air pollution, Intervention, PM2.5, Health benefits, Toxicology, medicine.disease_cause, complex mixtures, Article, Interquartile range, Pregnancy, Environmental health, Intervention (counseling), Air Pollution, medicine, Humans, Cooking, Child, Air Pollutants, Clean cooking fuel, business.industry, Child Health, General Medicine, Pollution, Confidence interval, Personal exposure, Household air pollution, Petroleum, Stove, Air Pollution, Indoor, Women's Health, Cookstove, Female, Particulate Matter, Pregnant Women, business
Abstract

The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries. As formative research in 2017, we recruited pregnant women and characterized the impact of the intervention on personal exposures and kitchen levels of fine particulate matter (PM2.5) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM2.5 for 24 or 48 h using gravimetric-based PM2.5 samplers at baseline and two follow-ups over two months after delivery of an LPG cookstove and free fuel supply. Mixed models were used to estimate PM2.5 reductions. Median kitchen PM2.5 concentrations were 296 μg/m3 at baseline (interquartile range, IQR: 158–507), 24 μg/m3 at first follow-up (IQR: 18–37), and 23 μg/m3 at second follow-up (IQR: 14–37). Median personal exposures to PM2.5 were 134 μg/m3 at baseline (IQR: 71–224), 35 μg/m3 at first follow-up (IQR: 23–51), and 32 μg/m3 at second follow-up (IQR: 23–47). Overall, the LPG intervention was associated with a 92% (95% confidence interval (CI): 90–94%) reduction in kitchen PM2.5 concentrations and a 74% (95% CI: 70–79%) reduction in personal PM2.5 exposures. Results were similar for each site. Conclusions The intervention was associated with substantial reductions in kitchen and personal PM2.5 overall and in all sites. Results suggest LPG interventions in these rural settings may lower exposures to the WHO annual interim target-1 of 35 μg/m3. The range of exposure contrasts falls on steep sections of estimated exposure-response curves for birthweight, blood pressure, and acute lower respiratory infections, implying potentially important health benefits when transitioning from solid fuels to LPG., Highlights • There was high uptake of an LPG stove and fuel intervention in 3 rural settings. • The LPG intervention was associated with a 92% reduction in kitchen PM2.5 levels. • The intervention was associated with a 74% reduction in personal exposure to PM2.5 • Maternal PM2.5 exposure was reduced to the WHO annual interim target-1 of 35 μg/m3. • Results from 3 countries indicate switching to clean fuel could improve health., Capsule summary: LPG stove and fuel intervention can reduce kitchen area and personal PM2.5 exposure levels in a pilot study of clean cookstove intervention trial. This strongly suggests switching to clean cook can improve health.

Published
2020

29. The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

Author

Liao, J., McCracken, J.P., Piedrahita, R., Thompson, L., Mollinedo, E., Canuz, E., De Léon, O., Díaz-Artiga, A., Johnson, M., Clark, M., Pillarisetti, A., Kearns, K., Naeher, L., Steenland, K., Checkley, W., Peel, J., Clasen, T.F., Aravindalochanan, V., Balakrishnan, K., Barr, D.B., Burrowes, V., Campbell, D., Campbell, J.M.P., Castañaza, A., Chang, H., Chen, Y., Chiang, M., Craik, R., Crocker, M., Davila-Roman, V., de las Fuentes, L., Dusabimana, E., Elon, L., Espinoza, J.G., Fuentes, I.S.P., Garg, S., Goodman, D., Gupton, S., Hartinger Peña, Stella Maria, Harvey, S., Hengstermann, M., Herrera, Phabiola, Hossen, S., Howards, P., Jaacks, L., Jabbarzadeh, S., Jones, A., Kirby, M., Kremer, J., Laws, M., Lovvorn, A., Majorin, F., McCollum, E., Meyers, R., Miranda, J. Jaime, Moulton, L., Mukhopadhyay, K., Nambajimana, A., Ndagijimana, F., Nizam, A., Ntivuguruzwa, J.D., Papageorghiou, A., Puttaswamy, N., Puzzolo, E., Quinn, A., Rajkumar, S., Ramakrishnan, U., Reardon, D., Rosa, G., Rosenthal, J., Ryan, P.B., Sakas, Z., Sambandam, S., Sarnat, J., Simkovich, S., Sinharoy, S., Smith, K.R., Swearing, D., Thangavel, G., Toenjes, A., Underhill, L., Uwizeyimana, J.D., Valdes, V., Verma, A., Waller, L., Warnock, M., Williams, K., Ye, W., Young, B., HAPIN investigators, Craik, RH, investigators, HAPIN, and Papageorghiou, A

Subjects
Microenvironment, purl.org/pe-repo/ocde/ford#3.03.05 [https], Epidemiology, computer.internet_protocol, Air pollution, 030501 epidemiology, Toxicology, medicine.disease_cause, purl.org/pe-repo/ocde/ford#3.03.09 [https], Liquefied petroleum gas, Article, law.invention, Bluetooth, 03 medical and health sciences, law, Environmental health, medicine, Exposure measurement, Fine particulate matters (PM2.5), Exposure assessment, Bluetooth Low Energy, Public Health, Environmental and Occupational Health, Pollution, LPG Intervention, Household air pollution, Indirect exposure, Stove, Environmental science, Patio, 0305 other medical science, computer
Abstract

Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM(2.5) monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual’s time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM(2.5) exposures for women and children during two 24-hour periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM(2.5) monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM(2.5) concentration range: 5–528 μg/m(3)). Indirect exposure had better agreement with direct exposure measurements (bias: −17 μg/m(3)) than did kitchen area measurements (bias: −89 μg/m(3)). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.

Published
2020

30. Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala

Author

Hengstermann, Mayarí, primary, Díaz-Artiga, Anaité, additional, Otzóy-Sucúc, Roberto, additional, Laura Maria Ruiz-Aguilar, Ana, additional, Thompson, Lisa M., additional, Aravindalochanan, Vigneswari, additional, Balakrishnan, Kalpana, additional, Barr, Dana Boyd, additional, Burrowes, Vanessa, additional, Campbell, Devan, additional, Campbell, Julia McPeek, additional, Canuz, Eduardo, additional, Castañaza, Adly, additional, Chang, Howard, additional, Checkley, William, additional, Chen, Yunyun, additional, Chiang, Marilú, additional, Clark, Maggie L., additional, Clasen, Thomas, additional, Craik, Rachel, additional, Crocker, Mary, additional, Davila-Roman, Victor, additional, de las Fuentes, Lisa, additional, De Léon, Oscar, additional, Diaz-Artiga, Anaité, additional, Dusabimana, Ephrem, additional, Elon, Lisa, additional, Espinoza, Juan Gabriel, additional, Fuentes, Irma Sayury Pineda, additional, Garg, Sarada, additional, Goodman, Dina, additional, Gupton, Savannah, additional, Hardison, Meghan, additional, Hartinger, Stella, additional, Harvey, Steven A., additional, Hengstermann, Mayari, additional, Herrera, Phabiola, additional, Hossen, Shakir, additional, Howards, Penelope, additional, Jaacks, Lindsay, additional, Jabbarzadeh, Shirin, additional, Johnson, Michael A., additional, Jones, Abigail, additional, Kearns, Katherine, additional, Kirby, Miles, additional, Kremer, Jacob, additional, Laws, Margaret, additional, Liao, Jiawen, additional, Lovvorn, Amy, additional, Majorin, Fiona, additional, McCollum, Eric, additional, McCracken, John, additional, Meyers, Rachel, additional, Miranda, J. Jaime, additional, Mollinedo, Erick, additional, Moulton, Lawrence, additional, Mukhopadhyay, Krishnendu, additional, Naeher, Luke, additional, Nambajimana, Abidan, additional, Ndagijimana, Florien, additional, Nizam, Azhar, additional, de Dieu Ntivuguruzwa, Jean, additional, Papageorghiou, Aris, additional, Peel, Jennifer, additional, Piedrahita, Ricardo, additional, Pillarisetti, Ajay, additional, Puttaswamy, Naveen, additional, Puzzolo, Elisa, additional, Quinn, Ashlinn, additional, Rajkumar, Sarah, additional, Ramakrishnan, Usha, additional, Reardon, Davis, additional, Rosa, Ghislaine, additional, Rosenthal, Joshua, additional, Ryan, P. Barry, additional, Sakas, Zoe, additional, Sambandam, Sankar, additional, Sarnat, Jeremy, additional, Simkovich, Suzanne, additional, Sinharoy, Sheela, additional, Smith, Kirk R., additional, Steenland, Kyle, additional, Swearing, Damien, additional, Thangavel, Gurusamy, additional, Toenjes, Ashley, additional, Underhill, Lindsay, additional, Uwizeyimana, Jean Damascene, additional, Valdes, Viviane, additional, Verma, Amit, additional, Waller, Lance, additional, Warnock, Megan, additional, Williams, Kendra, additional, Ye, Wenlu, additional, and Young, Bonnie, additional

Published
2021
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31. Effect of temperature on an enzyme assay to detect fenitrothion resistance in Anopheles albimanus mosquitos

Author

R F, Beach, W G, Brogdon, L A, Castañaza, C, Cordón-Rosales, and M, Calderón

Subjects
Insecticide Resistance, Hot Temperature, Anopheles, Animals, Female, Fenitrothion, Carboxylic Ester Hydrolases, Carboxylesterase, Research Article
Abstract

A laboratory strain of Anopheles albimanus Wiedemann of known fenitrothion resistance was used in the field to compare the results of the WHO test for determining fenitrothion resistance in mosquitos with those of an enzyme microplate assay. The level of resistance obtained with the enzyme assay increased with the ambient temperature, and in order to compensate for this temperature effect, the incubation time was reduced. With the adjusted incubation times, the results for the microassay from 23 degrees C to 32 degrees C were the same as those found with the WHO test. The fenitrothion resistance of a field population of A. albimanus mosquitos determined between 27 degrees C and 31 degrees C using the adjusted enzyme microassay or the WHO test did not differ in a statistically significant way.

Published
1989

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