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Background: Several studies have assessed the association between biomass fuel use and respiratory infection morbidity and mortality but very limited studies have investigated the practices involved in the use of these biomass fuels in relation to the acquisition of acute respiratory infections (ARI) among under-five children in Nigeria. This study was therefore designed to assess the association between household cooking practices and ARI among under-five children in Ibadan. Methods: A hospital based case-control study was undertaken. Two hundred and twenty (220) under-5 children with ARI (cases) and 220 without ARI (controls) were selected consecutively from children visiting OniMemorial Children Hospital and University College Hospital, Ibadan. A semi-structured questionnaire was administered to 220 mothers of recruited cases and controls to elicit vital information on household cooking practices and other factors that predispose children under-five to ARIs. Sixty-six consented cases and controls each were followed-up for household survey using an observational checklist. Data were analysed using descriptive statistics, Chi-square and logistic regression at p < 0.05. 8Results: The mean age of mothers of cases was 28.7 ± 5.6 years as compared to 30.3 ± 6.6 years for mothers of controls. Mean ages of cases and controls were 20.4 ± 14.7 and 20.3 ± 15.0 months respectively. More cases than controls belong to households with a household size greater than 5 persons (OR = 2.5; 95% CI = 1.6– 3.6). A large proportion of household of cases than controls engage in inadequate cooking practices (OR = 2.4; 95% CI = 1.6–3.5). Under-five children carried on the back while cooking were found to be thrice more likely to develop ARIs than children whose mothers do not carry while cooking. The odds ratios of acute respiratory infection were 8.2 (95% CI: 3.7-18.0) and 3.0 (95% CI: 1.3-6.9) in households using firewood and charcoal for cooking respectively. Children whose household cook in the same room where the child sleeps were found to have a 3-fold greater risk of ARIs than children belonging to household that has its separate kitchen. Conclusions: Inadequate household cooking practices play an important role in the acquisition of acute respiratory infections among under-five children. Increase awareness on the importance of good cooking practices with regard to prevention and control of ARIs among under-5 children is therefore recommended.

Household Cooking Practices as Risk Factor for Acute Respiratory Infections among Hospitalized Under-5 Children in Ibadan, Nigeria