Indoor Air Pollution and Treatment Outcomes in Tb Patients of a Hiily District in North India.

Abstract

Background: India carries the highest burden of Tuberculosis in the world. For progression towards the goal of global elimination, it is imperative to understand the factors which influence the treatment outcomes. The objectives were to study the socio-demographic characteristics of the subjects and to study the factors influencing treatment outcomes in the TB patients. Methods: A Cross-sectional study design was employed and all patients (n=117) who were registered for Category I DOTS during the last quarter of 2015 were included after obtaining written informed consent. Patients were visited at their homes for interviews to note socio-demographic and environmental characteristics and secondary data analysis was done to note the outcomes. Univariate and binary logistic regression models were employed. Results: The overall treatment success rate was 93.2% (Cure rate= 87%, treatment completion rate= 100%). Default, death, failure and lost to follow up rates were 2.6%, 2.6%, 0.8% and 0.8% respectively. Those with a history of indoor air pollution [OR: 7.89 (1.10-62.13); p=0.02], tobacco smoking [OR: 6 (1.27-28.37); p=0.02], alcohol use [OR: 6.13 (1.57-23.93); p=0.01] and second hand smoke ); p=0.02] had higher odds of developing unfavourable treatment outcomes. The commonest cause of indoor air pollution was smoke surfacing out of fire-wood used for cooking and tobacco. Conclusion: The study observed air pollution due to firewood and tobacco smoke and alcohol intake to be associated with adverse outcomes. Health education regarding the ill effects of indoor air pollution and alcohol with regards to the disease preventability and curability needs to be further intensified. Larger studies are highly recommended to determine the effect of indoor air pollution as a risk factor and its impact on treatment outcomes by contemporary scientific methods.