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Title: | Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults | Authors: | Katoto, Patrick D. M. C. Bihehe, Dieudonne 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 Pollitt, Krystal J. Godri Lesosky, Maia Vanoirbeek, Jeroen Mortimer, Kevin NAWROT, Tim Nemery, Benoit Nachega, Jean B. |
Issue Date: | 2024 | Publisher: | BMC | Source: | Environmental Health, 23 (1) (Art N° 6) | 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<middle dot>36; 95%CI 1<middle dot>06-1<middle dot>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<middle dot>64 (95%CI 1<middle dot>1-20<middle dot>7) for the highest quintile [12<middle dot>3-76<middle dot>2 ppm] compared to the lowest quintile [0<middle dot>1-1<middle dot>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. | Notes: | Katoto, PDMC (corresponding author), Stellenbosch Univ, Fac Med & Hlth Sci, Dept Global Hlth, Div Epidemiol & Biostat, Cape Town, South Africa.; Katoto, PDMC (corresponding author), South African Med Res Council, Off President & CEO, Cape Town, South Africa.; Katoto, PDMC (corresponding author), Catholic Univ Bukavu, Ctr Trop Dis & Global Hlth, Bukavu, DEM REP CONGO.; Katoto, PDMC (corresponding author), Katholieke Univ Leuven, Ctr Environm & Hlth, Dept Publ Hlth & Primary Care, Leuven, Belgium.; Nachega, JB (corresponding author), Albert Einstein Coll Med, Dept Med, New York, NY 10461 USA.; Nachega, JB (corresponding author), Univ Pittsburgh Grad Sch Publ Hlth, Dept Epidemiol, 130 Desoto St,Room A522,Crabtree Hall, Pittsburgh, PA 15260 USA.; Nachega, JB (corresponding author), Univ Pittsburgh, Grad Sch Publ Hlth, Ctr Global Hlth Infect Dis & Microbiol, 130 Desoto St,Room A522,Crabtree Hall, Pittsburgh, PA 15260 USA. katoto.chimusa@ucbukavu.ac.cd; jbn16@pitt.edu |
Keywords: | Africa;Indoor pollution;Charcoal;Gender;Health equity | Document URI: | http://hdl.handle.net/1942/42324 | e-ISSN: | 1476-069X | DOI: | 10.1186/s12940-023-01044-0 | ISI #: | 001144631700001 | Rights: | The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecom‑ mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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