Lack of an Association Between Household Air Pollution Exposure and Previous Pulmonary Tuberculosis

SIDDHARTHAN, TRISHUL; GRIGSBY, MATTHEW R.; RUBINSTEIN, ADOLFO; MIRANDA, J. JAIME; KIRENGA, BRUCE; CHECKLEY, WILLIAM; MORGAN, BROOKS; GOODMAN, DINA; IRAZOLA, VILMA; BERNABE-ORTIZ, ANTONIO; JONES, RUPERT; EMURON, DENNIS; POLLARD, SUZANNE L.; CHOWDHURY, MUHAMMAD; GUTIERREZ, LAURA; ALAM, DEWAN; VAN GEMERT, FREDERIK

LUNG.

SPRINGER

Lugar: Berlin; Año: 2019 vol. 197 p. 793 - 801

0341-2040

Context: Observational studies investigating household air pollution (HAP) exposure to biomass fuel smoke as a risk factor for pulmonary tuberculosis have reported inconsistent results.Objective: To evaluate the association between HAP exposure and the prevalence of self-reported previous pulmonary tuberculosis.Design: 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.Results: 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).Conclusions: There was no association between HAP exposure and self-reported previous pulmonary tuberculosis in five population-based studies conducted worldwide.Keywords: Biomass fuel; Cross-sectional study; Tuberculosis burden.