Cooking fuel and respiratory symptoms among people living with HIV in rural Uganda

Abstract

Household air pollution (HAP) and chronic HIV infection are each associated with significant respiratory morbidity. Little is known about relationships between HAP and respiratory symptoms among people living with HIV. The objective of this study was to investigate the relationship between cooking fuel type and chronic respiratory symptoms in study participants from the Uganda AIDS Rural Treatment Outcomes Study.Study participants were enrolled at the time of antiretroviral therapy initiation and seen quarterly from 2005 to 2014 for health-focused questionnaires, CD4 count and HIV viral load. We used multivariable logistic regression and generalised estimating equations, with each study visit as a unit of observation, to investigate relationships between cooking fuel type and chronic respiratory symptoms.We observed an association between cooking with firewood (versus charcoal) and chronic cough among HIV-infected females in rural Uganda (adjusted OR 1.41, 95% CI 1.00–1.99; p=0.047). We did not observe an association between cooking fuel type and respiratory symptoms among males (adjusted OR 0.88, 95% CI 0.47–1.63; p=0.658).Associations between cooking fuel and chronic cough in this HIV-infected cohort may be influenced by sex-based roles in meal preparation. This study raises important questions about relationships between household air pollution, HIV infection and respiratory morbidity.

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“…Finally, we also found that having an adequately ventilated kitchen had an independent, inverse association with probable dementia. Air pollution is a growing problem globally [17] and has been linked, in studies from Uganda, to other health problems like respiratory symptoms [18,19]. One population-based study from Taiwan found that higher levels of carbon monoxide exposure were significantly associated with an increased risk of dementia [20].…”

Association of Gut Intestinal Integrity and Inflammation with Insulin Resistance in Adults Living with HIV in Uganda

“…Second, we acknowledge that the results should only be generalized to rural East African populations, characterized by subsistence farming, and high rates of food insecurity and biomass cooking fuel exposure. 58,59 Third, since many potentially important factors, including data on specific comorbidities, alcohol consumption, waist circumference, and adipose tissue parameters, were not included in the regression analyses, we are unable to rule out confounding by these factors. Further, we did not perform duplicate testing of inflammatory assays.…”

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