Using objective measures of stove use and indoor air quality to evaluate a cookstove intervention in rural Uganda

Exposure to combustion byproducts from cooking is a major health concern globally. Alternative stoves may reduce the burden of disease associated with exposure to household air pollution. We subsidized Ugastove-brand rocket stoves to 54 households in six rural Ugandan villages. We monitored kitchen concentrations of fine particles (PM_2.5) and carbon monoxide (CO) before and one month after introduction of the Ugastove. Temperature data-loggers were affixed to each Ugastove and to the traditional stove (three-stone fire) during the 1-month Ugastove acclimation period to record temporal patterns in stove use and adoption. Household surveys were administered to collect household information that may impact stove use or indoor air quality. PM_2.5 kitchen concentrations were 37% lower after introduction of the Ugastove (mean reduction: 0.68mg/m³; 95% confidence interval [CI]: 0.2-1.2; p<0.01). Changes in CO concentrations were small (8% lower; mean reduction: 1.4ppm, 95% CI: -5.2-7.9) and not statistically significant. During the 1-month acclimation period, 47% of households used primarily the Ugastove, 12% used primarily the three stone fire, and 41% used both stoves in tandem. PM_2.5 concentrations were generally lowest in households that used primarily the Ugastove, followed by households that used stoves in tandem and that primarily used a three-stone fire. In summary, introduction of the Ugastove in 54 rural Ugandan households was associated with modest reductions in kitchen concentrations of PM_2.5 but not CO. Objective measures of stove use reveal that short-term stove use varied by household.