Tuberculosis (TB), caused by mycobacterium tuberculosis (M tb), is the second most prevalent infectious disease 1,2 and accounts for about 1.5 million deaths annually. 3 Low-and middle-income countries (LMIC) bear disproportionately higher burden of TB mortality and morbidity. 4 Among LMIC, India has the highest incidence and prevalence rates of TB in the world. 5 Many factors are shown to increase the risk of activation from latent TB infection to clinically manifested active TB and its severity, including host immunity, exposure to smear-positive pulmonary TB patients, malnutrition, and socioeconomic and environmental exposure and risk behavior (eg, smoking, alcohol consumption, sexual behavior). [6][7][8] Among environmental risk factors, air pollution is of particular interest not only because air pollutants, such as particulate matter (PM), can serve as carriers of airborne M.tb but also because it affects lung immunity by inducing oxidative stress and inflammation, and impairs the host's immunity. 9,10 Literature shows epidemiological associations between air pollution exposure and tuberculosis, including in India. 8,[11][12][13] Although the mechanism of TB activation from air pollution is not fully understood, 14 it has been proposed that air pollution affects TB activation through altering lung immunity of the host due to chronic

No abstract