Respiratory symptoms associated with mothers among biogas user and non-user in Wondogenet District, Sidama Region southern Ethiopia

Abstract Household air pollution remains a major public health concern in Ethiopia, where many households still rely on inefficient and polluting fuels for cooking. Despite national efforts to introduce cleaner energy sources such as biogas, evidence on its impact on respiratory health, particularly among women who are most exposed, remains limited. This study assessed respiratory symptoms among mothers using biogas compared with non-users in Wondo Genet District, Sidama, Ethiopia. A comparative cross-sectional design was employed, and data were collected in April 2023 from 422 mothers (211 biogas users and 211 non-users). Data collection included face-to-face interviews, observation checklists, and particulate matter (PM₂.₅) measurements in 20% of households. The overall prevalence of respiratory symptoms was 48.8%, with a higher prevalence among non-users (63.5%) compared with biogas users (34.1%). Average particulate matter (PM₂.₅) concentrations were significantly lower in biogas-using households (54.2 µg/m 3 ) than in non-user households (152.7 µg/m 3 ). Factors significantly associated with respiratory symptoms included poor attitude [AOR = 1.75, 95% CI 1.02–3.00], poor knowledge [AOR = 2.03, 95% CI 1.15–3.56], cooking inside the house [AOR = 2.71, 95% CI 1.55–4.73], having a smoker in the family [AOR = 4.46, 95% CI 2.50–7.94], and a history of respiratory symptoms [AOR = 1.98, 95% CI 1.11–3.54]. The study recommends strengthening biogas adoption programs, enforcing household air quality control measures, and implementing community-based education to improve knowledge and attitudes toward respiratory health and reduce indoor pollution-related diseases.