Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults

被引:0
作者
Katoto, Patrick D. M. C. [1 ,2 ,3 ,4 ]
Bihehe, Dieudonne [5 ]
Brand, Amanda [6 ]
Mushi, Raymond [1 ]
Kusinza, Aline [7 ]
Alwood, Brian W. [7 ]
van Zyl-Smit, Richard N. [8 ,9 ]
Tamuzi, Jacques L. [1 ]
Sam-Agudu, Nadia A. [10 ,11 ]
Yotebieng, Marcel [12 ]
Metcalfe, John [13 ]
Theron, Grant [14 ]
Pollitt, Krystal J. Godri [15 ]
Lesosky, Maia [16 ]
Vanoirbeek, Jeroen [4 ]
Mortimer, Kevin [17 ]
Nawrot, Tim [4 ,18 ]
Nemery, Benoit [4 ]
Nachega, Jean B. [12 ,19 ,20 ]
机构
[1] Stellenbosch Univ, Fac Med & Hlth Sci, Dept Global Hlth, Div Epidemiol & Biostat, Cape Town, South Africa
[2] South African Med Res Council, Off President & CEO, Cape Town, South Africa
[3] Catholic Univ Bukavu, Ctr Trop Dis & Global Hlth, Bukavu, DEM REP CONGO
[4] Katholieke Univ Leuven, Ctr Environm & Hlth, Dept Publ Hlth & Primary Care, Leuven, Belgium
[5] Univ Evangel Afrique, Dept Internal Med, Brazzaville, DEM REP CONGO
[6] Stellenbosch Univ, Ctr Evidence based Hlth Care, Dept Global Hlth, Ctr Evidence Based Hlth Care, Cape Town, South Africa
[7] Stellenbosch Univ, Fac Med & Hlth Sci, Dept Med, Div Pulmonol, Cape Town, South Africa
[8] Univ Cape Town, Div Pulmonol, Cape Town, South Africa
[9] Univ Cape Town, UCT Lung Inst, Dept Med, Cape Town, South Africa
[10] Inst Human Virol Nigeria, Int Res Ctr Excellence, Abuja, Nigeria
[11] Univ Maryland, Sch Med, Inst Human Virol, Div Epidemiol & Prevent, Baltimore, MD USA
[12] Albert Einstein Coll Med, Dept Med, New York, NY 10461 USA
[13] Univ Calif San Francisco, Zuckerberg San Francisco Gen Hosp & Trauma Ctr, Div Pulm & Crit Care Med, Trauma Ctr, San Francisco, CA USA
[14] Stellenbosch Univ, NRF DST Ctr Excellence Biomed TB Res, South African Med Res Council Ctr TB Res, Div Mol Biol & Human Genet,Fac Med & Hlth Sci, Cape Town, South Africa
[15] Yale Univ, Sch Publ Hlth, Dept Environm Hlth Sci, New Haven, CT USA
[16] Univ Cape Town, Div Epidemiol & Biostat, Rondebosch, Western Cape, South Africa
[17] Univ Liverpool Liverpool Sch Trop Med, Liverpool L3 5QA, England
[18] Stellenbosch Univ, Ctr Environm Sci, B-3500 Hasselt, Belgium
[19] Univ Pittsburgh Grad Sch Publ Hlth, Dept Epidemiol, 130 Desoto St,Room A522,Crabtree Hall, Pittsburgh, PA 15260 USA
[20] Univ Pittsburgh, Grad Sch Publ Hlth, Ctr Global Hlth Infect Dis & Microbiol, 130 Desoto St,Room A522,Crabtree Hall, Pittsburgh, PA 15260 USA
关键词
Africa; Indoor pollution; Charcoal; Gender; Health equity; SOCIETIES ENVIRONMENTAL COMMITTEE; SOLID-FUEL; NONCOMMUNICABLE DISEASES; TOBACCO-SMOKE; LUNG HEALTH; EXPOSURE; INCOME; ASSOCIATIONS; METAANALYSIS; COMBUSTION;
D O I
10.1186/s12940-023-01044-0
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
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.
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页数:16
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