SUMMARY

INTRODUCTION: Air pollution is a major environmental health threat and an important determinant of child health globally. It has long been regarded as a silent killer responsible for causing a variety of chronic and infectious diseases, and disorders. The study is aimed at assessing the influence of indoor and outdoor air pollution on malnutrition (stunting) in children less than five years.

METHODS: This is a community based cross sectional study of children less than five, which will be surveyed from households selected using multistage randomised cluster sampling. A well-structured questionnaire will be used to get the following information; socio-demographics information, household dermographics,infant measurement and air quality measurements. A descriptive and influential statistics will be used for analysis.

EXCPECTED RESULTS: to determine the influence of indoor air pollutants amongst households with children less than five years and stunting in Buea and Tiko health district and to determine the influence of outdoor air pollutants and stunting in children less than five years in Buea and Tiko health district

Key words; air pollution, malnutrition, stunting, particulate matter,indoor air pollution, outdoor air pollution.

CHAPTER ONE

INTRODUCTION

1.1 Background

Air pollution is a major environmental health threat and an important determinant of child health globally. It has long been regarded as a silent killer responsible for causing a variety of chronic and infectious diseases. The World Health Organization (WHO) recognizes air pollution as “an overlooked health emergency for children around the world,” noting that the issue can be especially severe for children living in low- or middle-income countries (LMICs) [1]. Exposure to air pollution was the second leading risk factor for premature death among children under 5 in 2019, resulting in over 691,000 deaths, two-thirds of which was from household air pollution exposure[2].

Unlike many more prominent risk factors, air pollution is pervasive 93% of children and teens ≤ 15 years globally are exposed to ambient Particulate matter less than 2.5 µm in diameter (PM2.5) levels higher than 10 μg/m3 [1], the health-based limit in WHO’s Air Quality Guidelines. Burning or combustion is the main source of health damaging air pollutants, including PM2.5. One specific combustion source heating or cooking with dirty fuels can result in smoky indoor concentrations of PM2.5 and other pollutants five or six times the levels in ambient air, posing significant health risks to women and children in these households while contributing substantially to ambient air pollution levels [1]. While P.M 2.5 at high concentrations is visible as smoke or haze, even concentrations too low to be visible can have health effects.

Although air pollution is a global problem, the burden of disease attributable to particulate matter in air is heaviest in LMICs, particularly in the WHO African, South-East Asia, Eastern Mediterranean and Western Pacific regions [3]. LMICs in these regions especially the African Region have the highest levels of exposure to household air pollution due to the widespread use of polluting fuels and technologies for basic daily needs, such as cooking, heating and lighting [4].

1.2 Statement of Problem

Pollution inside and outside the home is affecting the development of millions of young children and killing hundreds of thousands of them every year. From studies done in Nepal which showed that air pollution has been a huge burden to the residents of Kathmandu, threatening the lives of thousands of people of every year[5]. In a population-based, cross-sectional study of half a million children in low- and middle-income countries, it was found out that solid cook fuel used is associated with childhood stunting in LMICs [6].In another study carried out in Ghana, it was noted that households using dirty cooking fuels are facing the risk of having stunted children by exposing mothers especially expectant ones to Hazardous Air pollutants (HAP). It also points out that children of mothers with more years of schooling tend to have higher heights for age[7]. Together with other related research on the association of air pollution on malnutrition (stunting).

As air pollution keeps increasing, many studies have reported it effects and challenges it causes on human health. It can cause premature death, stunting which can lead to other things. Many persons are exposed to these air pollutants unknowingly. Since little or no work has been done or published for the Buea, Tiko health districts, this has prompted the initiative to do this research in this area.

1.3 Research questions

1. What is the level of indoor air pollution amongst households with children less than five in Buea and Tiko health district?
2. What is the level of outdoor air pollution in Buea and Tiko health district?

• What is the relationship between indoor air pollution and stunting amongst children less than five years in Buea and Tiko health district?

1. What is the relationship between outdoor air pollution and stunting amongst children less than five years in Buea and Tiko health district?

1.4 Research Hypothesis

1. There is no significant level of indoor air pollution amongst households with children less than five years.
2. There is no significant level of outdoor air pollution in Buea and Tiko health district.

• There is no significant association between indoor air pollution and stunting amongst children less than five years.

1. There is no significant association between outdoor air pollution and stunting in children less than five years.

1.5 Objectives

1.5.1 General Objective

The aim of this study is to measure the influence of indoor air pollution amongst households and outdoor air pollution on stunting among children aged less than five years.

1.5.2 Specific objectives

1. To assess the influence of indoor air pollutants amongst household with children less than five years in Buea and Tiko health district.
2. To assess the level of outdoor air pollutants in Buea and Tiko health district.

• To assess the influence of indoor air pollutants amongst households with children less than five years and stunting in Buea and Tiko health district.

1. To assess the influence of outdoor air pollutants and stunting in children less than five years in Buea and Tiko health district.