Lack of an Association Between Household Air Pollution Exposure and Previous Pulmonary Tuberculosis
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Observational studies investigating household air pollution (HAP) exposure to biomass fuel smoke as a risk factor for pulmonary tuberculosis have reported inconsistent results.
To evaluate the association between HAP exposure and the prevalence of self-reported previous pulmonary tuberculosis.
We analyzed pooled data including 12,592 individuals from five population-based studies conducted in Latin America, East Africa, and Southeast Asia from 2010 to 2015. We used multivariable logistic regression to model the association between HAP exposure and self-reported previous pulmonary tuberculosis adjusted for age, sex, tobacco smoking, body mass index, secondary education, site and country of residence.
Mean age was 54.6 years (range of mean age across settings 43.8–59.6 years) and 48.6% were women (range of % women 38.3–54.5%). The proportion of participants reporting HAP exposure was 38.8% (range in % HAP exposure 0.48–99.4%). Prevalence of previous pulmonary tuberculosis was 2.7% (range of prevalence 0.6–6.9%). While participants with previous pulmonary tuberculosis had a lower pre-bronchodilator FEV1 (mean − 0.7 SDs, 95% CI − 0.92 to − 0.57), FVC (− 0.52 SDs, 95% CI − 0.69 to − 0.33) and FEV1/FVC (− 0.59 SDs, 95% CI − 0.76 to − 0.43) as compared to those who did not, we did not find an association between HAP exposure and previous pulmonary tuberculosis (adjusted odds ratio = 0.86; 95% CI 0.56–1.32).
There was no association between HAP exposure and self-reported previous pulmonary tuberculosis in five population-based studies conducted worldwide.
KeywordsBiomass fuel Tuberculosis burden Cross-sectional study
We would like to thank Dr. Shakir Hossen for his independent review of the statistics and development of figures. These studies were sponsored and funded by the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institute of Health in the United States, under contracts HHSN268200900029C, HHSN268200900032C, and HHSN26820900033C. FRESH AIR Uganda was done by the University Medical Centre Groningen (Netherlands) in close collaboration with Makerere University (Uganda) and the Leiden University Medical Centre (Netherlands). It was funded by the International Primary Care Respiratory Group (UK), supported by an unrestricted grant from Mundipharma International. WC is additionally supported under UM1HL134590. TS was supported by a National Research Service Award through the National Institute of Environmental Health Sciences of the National Institutes of Health (1F32ES028577). AR was supported by the National Institutes of Health Office of the Director, Fogarty International Centre and National Heart, Blood, and Lung Institute through the International Clinical Research Fellows Program at Vanderbilt University (R24TW007988) and the American Relief and Recovery Act. RJ was supported by the Applied Research Collaboration South West Peninsula.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
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