Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults
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Published:2024-01-17
Issue:1
Volume:23
Page:
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ISSN:1476-069X
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Container-title:Environmental Health
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language:en
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Short-container-title:Environ Health
Author:
Katoto Patrick D.M.C.,Bihehe Dieudonné,Brand Amanda,Mushi Raymond,Kusinza Aline,Alwood Brian W.,van Zyl-Smit Richard N.,Tamuzi Jacques L.,Sam-Agudu Nadia A.,Yotebieng Marcel,Metcalfe John,Theron Grant,Godri Pollitt Krystal J.,Lesosky Maia,Vanoirbeek Jeroen,Mortimer Kevin,Nawrot Tim,Nemery Benoit,Nachega Jean B.
Abstract
Abstract
Background
In low- and middle-income countries countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection.
Methods
We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 – March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB.
Results
We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/week were more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm].
Conclusion
Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women.
Publisher
Springer Science and Business Media LLC
Subject
Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health
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