Research on Emissions, Air Quality, Climate and Cooking Technologies in Northern Ghana (REACCTING)

REACCTING (Research on Emissions, Air quality, Climate, and Cooking Technologies in Northern Ghana) is an interdisciplinary randomized cookstove intervention study in the Kassena-Nankana District of Northern Ghana. The study tests two types of biomass burning stoves that have the potential to meet local cooking needs and represent different "rungs" in the cookstove technology ladder: a locally-made, low-tech Gyapa rocket stove and the imported, highly efficient Philips gasifier stove. Intervention households were randomized into four different groups, three of which received different combinations of two improved stoves, while the fourth group serves as a control for the duration of the study. Diverse measurements assess different points along the causal chain linking the intervention to final outcomes of interest. The investigators assess stove use and cooking behavior, cooking emissions, household air pollution and personal exposure, health burden, and local to regional air quality. Integrated analysis and modeling will tackle a range of interdisciplinary science questions, including examining ambient exposures among the regional population, assessing how those exposures might change with different technologies and behaviors, and estimating the comparative impact of local behavior and technological changes versus regional climate variability and change on local air quality and health outcomes.

Study Overview

• Status: Completed
• Conditions: Inflammation; Growth Retardation
• Intervention / Treatment: Device: Gyapa stove; Device: Philips stove

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 51 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion

Individual Participants:

• Classified as "rural"
• Uses biofuel as main cooking fuel source (firewood, animal waste, crop residue/sawdust)
• Uses borehole as main water source (to facilitate social network analysis linking household's knowledge and attitudes toward stoves to experience of social contacts);
• Does not have electricity (to permit possible addition of lighting intervention at a later date);
• Has a woman in household aged 18-55 and at least one child under five (since women and children are the most vulnerable to cookstove smoke and are thus the main focus of our health measures).

Clusters:

• No more than 25% classified as urban
• Accessible year-round (determined by field staff)
• Having at least 10 eligible households (in line with the participant criteria above)

Exclusion:

• Household could not be located
• Household declined to participate

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Households enrolled in the control arm of the study did not receive either improved cookstove
Experimental: Gyapa/Gyapa; Households enrolled in the Gyapa/Gyapa arm of the study received two Gyapa stoves for free	Device: Gyapa stove; Wood stove made in Ghana; Other Names: Rocket stove
Experimental: Gyapa/Philips; Households enrolled in the Gyapa/Philips arm of the study received one Gyapa stove and one Philips stove for free	Device: Gyapa stove; Wood stove made in Ghana; Other Names: Rocket stove; Device: Philips stove; Philips Smokeless stove HD4012LS; Other Names: Gasifier stove
Experimental: Philips/Philips; Households enrolled in the Philips/Philips arm of the study received two Philips stoves for free	Device: Philips stove; Philips Smokeless stove HD4012LS; Other Names: Gasifier stove

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health (Biomarkers of inflammation)	Health indicators from blood spot samples (C-Reactive Protein, Sicam, sVCAM, serum amyloid A, Interleukin-1b, Interleukin-6, Interleukin-8, tumor necrosis factor alpha).	At baseline
Health (Biomarkers of inflammation)	Health indicators from blood spot samples (C-Reactive Protein, Sicam, sVCAM, serum amyloid A, Interleukin-1b, Interleukin-6, Interleukin-8, tumor necrosis factor alpha).	At 6 months
Health (Biomarkers of inflammation)	Health indicators from blood spot samples (C-Reactive Protein, Sicam, sVCAM, serum amyloid A, Interleukin-1b, Interleukin-6, Interleukin-8, tumor necrosis factor alpha).	At 12 months
Health (Biomarkers of inflammation)	Health indicators from blood spot samples (C-Reactive Protein, Sicam, sVCAM, serum amyloid A, Interleukin-1b, Interleukin-6, Interleukin-8, tumor necrosis factor alpha).	At 18 months
Height	Height of participants	At baseline
Height	Height of participants	At 6 months
Height	Height of participants	At 12 months
Height	Height of participants	At 18 months
Weight	Weight of participants	At baseline
Weight	Weight of participants	At 6 months
Weight	Weight of participants	At 12 months
Weight	Weight of participants	At 18 months
Mid-arm circumference	Measurement of mid-upper arm circumference of participants	At baseline
Mid-arm circumference	Measurement of mid-upper arm circumference of participants	At 6 months
Mid-arm circumference	Measurement of mid-upper arm circumference of participants	At 12 months
Mid-arm circumference	Measurement of mid-upper arm circumference of participants	At 18 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Personal exposure to fine particulate matter (PM2.5)	48 hour integrated personal PM2.5 concentrations from filter measurements	48 hour deployment periods
Personal exposure to carbon monoxide (CO)	Daily average and integrated personal CO concentrations	48 hour deployment periods
Kitchen area concentrations of carbon monoxide (CO)	Daily average and integrated kitchen area CO concentrations	48 hour deployment periods
Kitchen area concentrations of fine particulate matter (PM2.5)	48 hour integrated kitchen area PM2.5 concentrations from filter measurements	48 hour deployment periods
Self-reported stove usage	Surveys administered to respondents (primary cooks)	At baseline
Self-reported stove usage	Surveys administered to respondents (primary cooks)	At 6 months
Self-reported stove usage	Surveys administered to respondents (primary cooks)	At 12 months
Self-reported stove usage	Surveys administered to respondents (primary cooks)	At 18 months
Stove usage as measured by devices	Continuous stove usage indicators as measured by temperature loggers on stoves	Throughout data collection period, approximately 2 years.

Collaborators and Investigators

• Sponsor: University of Colorado, Boulder
• Collaborators: U.S. National Science Foundation; Environmental Protection Agency (EPA)

Publications and helpful links

General Publications

• Dickinson KL, Kanyomse E, Piedrahita R, Coffey E, Rivera IJ, Adoctor J, Alirigia R, Muvandimwe D, Dove M, Dukic V, Hayden MH, Diaz-Sanchez D, Abisiba AV, Anaseba D, Hagar Y, Masson N, Monaghan A, Titiati A, Steinhoff DF, Hsu YY, Kaspar R, Brooks B, Hodgson A, Hannigan M, Oduro AR, Wiedinmyer C. Research on Emissions, Air quality, Climate, and Cooking Technologies in Northern Ghana (REACCTING): study rationale and protocol. BMC Public Health. 2015 Feb 12;15:126. doi: 10.1186/s12889-015-1414-1.
• Abdo M, Kanyomse E, Alirigia R, Coffey ER, Piedrahita R, Diaz-Sanchez D, Hagar Y, Naumenko DJ, Wiedinmyer C, Hannigan MP, Oduro AR, Dickinson KL. Health impacts of a randomized biomass cookstove intervention in northern Ghana. BMC Public Health. 2021 Dec 4;21(1):2211. doi: 10.1186/s12889-021-12164-y.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2012
• Primary Completion (Actual): December 31, 2016
• Study Completion (Actual): December 31, 2017

Study Registration Dates

• First Submitted: September 14, 2020
• First Submitted That Met QC Criteria: November 11, 2020
• First Posted (Actual): November 18, 2020

Study Record Updates

• Last Update Posted (Actual): November 18, 2020
• Last Update Submitted That Met QC Criteria: November 11, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Inflammation
• Other Study ID Numbers: REACCTING; GEO-1211668 (Other Grant/Funding Number: NSF); RD-8354201 (Other Grant/Funding Number: EPA)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: De-identified data are available upon request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No