Abstract
Background: The association between biomass fuel use and pulmonary tuberculosis (TB) is unclear.
Objective: To determine the association between biomass fuel use by women for cooking and pulmonary TB.
Methods: Age and residential area matched case-control study was conducted in a rural health facility situated in Sindh, Pakistan. Women aged 20-65 years diagnosed with TB by sputum test or chest X-Ray and clinical examinationwere enrolled as cases and those without pulmonary TB were recruited as controls. Multivariate conditional logistic regression was applied and population attributable fraction was also calculated.
Results: A total of 178 cases and 178 controls were included. Women who were present users of biomass were at higher risk of pulmonary TB (Adj mOR 3.0; 95% CI: 1.08-4.9) compared to those using other fuels. A separate model for assessing exposure over lifetime found a dose-response relationship where women who were former users of biomass were 2.8 (Adj mOR 2.8, 95% CI: 0.94-8.2) times more likely and those who were current users of biomass were 3.9 (Adj mOR 3.9, 95% CI: 1.4-10.7) times more likely to have TB as compared to non-biomass users. Both the models were adjusted for potential confounders including educational status, income, construction of house, environmental tobacco smoke, crowding, family history of TB, type of kitchen, and type of fuel for cooking and heating. Population attributable fraction (PAF) for TB related to biomass fuel use was 40.6% (95% CI: 35.47% - 45.73%).
Conclusions: This study strengthens the evidence that biomass fuel used for cooking is associated with pulmonary TB and shows that risk increases with duration of exposure.
- Copyright ©ERS 2015
