Feasibility Intervention Trial of Two Types of Improved Cookstoves in Three Developing Countries
Condition: Poisoning by Carbon Monoxide From Domestic Fuels; Respiratory Conditions Due to Other External Agents
MeSH terms: Poisoning; Carbon Monoxide Poisoning
Study type: Interventional

Summary: 
      The underlying concept behind this feasibility trial is to achieve a reduction in indoor
      smoke from biomass fuels and minimize changes in cooking practices such that it prompts one
      of the two improved, ventilated cookstoves to be the selection of choice. Typical fuel
      sources used in developing countries include wood, dried dung, and agricultural waste. The
      investigators propose to reduce indoor air pollution by replacing the household traditional
      cookstove with an improved design that incorporates the following key elements:

        -  Burner openings customized to the size and shape of the cooking vessels in the home.

        -  Flue designed to draw air into the fire box under the cooking pots and pass it out
           through a chimney.

        -  A chimney with adequate height to create a draft and vented to the exterior.

        -  An exterior port that has bidirectional openings to prevent backflow of smoke.

        -  An access port for the chimney that permits cleaning of soot.

      The investigators propose to use two types of improved cookstoves that meet these criteria.
      As part of piloting activities, the investigators will test several different types of
      commercially-available cookstoves with a chimney, and we may also want to test a locally-made
      improved cookstove. The investigators want to evaluate those designs by comparing their
      ability to reduce indoor air pollution, the reliability between cookstoves of the same type,
      the functioning over time, the logistics of import/build locally, preferences and cultural
      compatibility, and costs. The investigators will select two types of improved cookstoves to
      use in the feasibility trial.

      The study design will be a crossover intervention trial in which all patients will first have
      a run-in observational period of 4 months with the traditional cookstove prior to
      randomization. At baseline, the investigators will obtain sociodemographic information for
      each household, respiratory outcomes and other health data for the participating women, and
      cooking times and practices including the types of fuels used. All 40 patients at each site
      will receive the two types of improved cookstoves, one after the other: 20 will be randomized
      to receive the first type of cookstove with a chimney and the other 20 to first receive the
      second type of improved cookstove with a chimney. The patients will be followed for 4 months
      before the crossover. The investigators will assess cooking behavioral practices and
      compliance with cookstove use monthly, and respiratory and environmental measures at the
      mid-point of the 4 month period to minimize carry-over effects. At the end of second 4 month
      period, the investigators will switch the order of the improved cookstoves and follow all
      participants for another 4 months. The investigators will assess behavior, compliance,
      respiratory and environmental measures as above. The study is expected to require 12 months
      to complete.
    


Intervention name(s): Improved, ventilated cookstove
Intervention type(s): Device
Intervention description(s): An improved, ventilated cookstove incorporates the following key elements: burner openings customized to the size and shape of the cooking utensils; a flue designed to draw air into the fire box and pass it out through a chimney; a chimney, vented to the exterior, of adequate height to create a draft; an exterior port that has bidirectional openings to prevent the backflow of smoke and an access port for the chimney that permits cleaning.
The investigators piloted cookstoves prior to the trial and compared their ability to reduce indoor air pollution, the reliability between cookstoves of the same type, the functionality over time, preferences and cultural compatibility, and cost. The investigators selected the the Envirofit G-3300/3355, a modified Stovetec cookstove with a chimney and a locally-made improved, ventilated cookstove for use in the trial.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: improved cookstove; ventilated cookstove; behavior change; adoption; indoor air pollution; DLCO; spirometry; biomass fuel