Household air pollution and health: a Multi-country LPG Intervention Trial-Core
Location(s): Rwanda; India; Guatemala; Peru
This study is a randomized controlled trial of liquefied petroleum gas (LPG) stove and fuel distribution in 3,200 households in four countries (India, Guatemala, Peru, and Rwanda). Following a common protocol, each intervention site will recruit 800 pregnant women (aged 18-34 years, <20 weeks gestation), and will randomly assign half their households to receive LPG stoves and a 30-month supply of LPG. Controls will receive the same cookstoves and LPG supply at the end of the study. The mother will be followed along with her child until the child is 2 years old. The researchers estimate that 25% of households will have a second, non-pregnant older adult woman (aged 35-64 years) who will also be enrolled at baseline and followed during the 30-month follow-up period. To optimize intervention use, the researchers will implement behavior change strategies informed by previous experiences and formative research in Year 1. This study will assess cookstove use, conduct repeated personal exposure assessments of household air pollution, and collect dried blood spots and urinary samples for biomarker analysis and biospecimen storage. The primary outcomes are low birthweight, pneumonia incidence, and linear growth in the child, and blood pressure in the older adult woman. Secondary outcomes include preterm birth and gross motor development in the child, maternal blood pressure during pregnancy, and endothelial function, respiratory impairment, carcinogenic metabolites, and quality of life in the older adult woman.