Impact of a Clean Cookstove Intervention on Acute Respiratory Infection Incidence in Children Under Five in Nyarugusu Refugee Camp, Tanzania

Household air pollution from traditional biomass cooking is a significant environmental health risk in humanitarian settings. Acute respiratory infections (ARIs) are a major cause of mortality in children under five. Nyarugusu Refugee Camp in Tanzania relies predominantly on biomass fuels, creating a high-risk environment for paediatric ARI. This study evaluated the impact of a clean cookstove intervention on the incidence of ARIs in children under five residing in Nyarugusu Refugee Camp. A quasi-experimental design was employed. Households with a child under five were allocated to an intervention group receiving a clean cookstove or a control group using traditional three-stone fires. Primary caregivers reported child health symptoms weekly for six months. ARI incidence was defined using WHO integrated management of childhood illness criteria. Data were analysed using Poisson regression. The intervention group experienced a statistically significant reduction in ARI incidence. The incidence rate ratio was 0.72 (95% CI: 0.65–0.80), indicating a 28% lower incidence of ARI in the clean cookstove group compared to the control group. The introduction of clean cookstoves was associated with a substantial reduction in ARI incidence among children under five in a refugee camp setting. This supports clean cooking interventions as an important public health measure to protect child respiratory health in humanitarian contexts. Programmatic scale-up of clean cookstove distribution in Nyarugusu and similar refugee settings is recommended. This should be integrated with comprehensive health promotion on stove use and maintenance. Further research should assess long-term adherence and health impacts. household air pollution, clean cookstove, acute respiratory infection, refugee health, child health, humanitarian setting, Tanzania This study provides evidence on the effectiveness of a clean cookstove intervention for reducing ARI incidence in young children within a large, protracted refugee camp setting, informing public health policy and programming.