Indoor household fuel combustion is said to be responsible for more than 4 million premature deaths per
year. More than 50% of premature deaths among children under the age of 5 years are likely caused by
inhalation of particulate matter from domestic indoor air pollution. Collecting household data on indoor
fuel use and respiratory health outcomes requires careful planning and consideration of limitations. In a
cross-sectional survey of 1 360 households, 397 in Mozambique (Massingir) and 963 in South African
(Hoedspruit), informed adult household representatives were asked to report on their main energy carrier.
No households in Mozambican homes use electricity and 98% relied on wood. Around 15% of South
Africa homes used electricity and 85% relied on wood for cooking. Prevalence of diagnosed upper
respiratory infections from the preceding 2 weeks of (1) hay fever, (2) ear infection and (3) sinusitis was
relatively low in both country samples, but was higher among Mozambicans (prevalence of 14%, 1% and
9%, respectively) compared to South Africans (prevalence of 0.8%, 0.6% and 0.6%, respectively). These
results were surprising given the reliance on wood as main energy carrier. Here, we discuss possible
reasons for relatively low prevalence of respiratory infections including timing of the study, questionnaire
design, under-reporting, use of alternative medical treatment and lack of understanding.