Use of biomass fuel in households is not a risk factor for pulmonary tuberculosis in South Ethiopia

Woldesemayat, Endrias Markos; Datiko, Daniel Gemechu; Lindtjørn, Bernt

doi:10.5588/ijtld.12.0980

Cited by 14 publications

(21 citation statements)

References 19 publications

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“…A recent systematic review and previous reports have shown that history of TB contact was associated with a high risk of TB [30, 46–48]. Findings by the current study are in line with those of a systematic review and large epidemiological surveys that have established the association between history of TB contact and higher risk of TB [47, 49, 50].…”

Section: Discussionsupporting

confidence: 91%

Prevalence and Incidence of Smear-Positive Pulmonary Tuberculosis in the Hetosa District of Arsi Zone, Oromia Regional State of Central Ethiopia

et al. 2017

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BackgroundThe real burden of smear-positive (PTB+) and bacteriologically confirmed tuberculosis (BCTB) in Ethiopia is not known. Thus, the aim of this community-based study was to measure the prevalence and incidence of tuberculosis in the Hetosa District of Oromia Region, Ethiopia.MethodsFirst, a population-based cross-sectional survey was conducted on a total of 33,073 individuals aged ≥ 15 years to determine the prevalence of PTB+ and BCTB cases. Then, in order to determine the incidence, a prospective follow-up was carried out on 32,800 individuals found to be either free from symptoms suggestive of TB (SSTB) during the baseline survey or had symptoms suggestive of TB but yielded negative bacteriological examination results. We identified 1,041 presumptive TB cases at the baseline survey, and 1,468 in the follow-up study. Each participants with cough of more than two weeks were provided spot and morning sputum samples for acid-fast bacilli sputum microscopy and culture.ResultsAt the baseline survey, 43 BCTB cases were identified. Thirty six of these were both smear- and culture-positive while seven were only culture-positive. In the follow-up study, however, 76 BCTB cases were diagnosed and 70 of these were found to be both smear- and culture-positive while six were culture-positive only. The adjusted prevalence of PTB+ and BCTB in the study area was 109 and 132/100,000 persons, respectively. Moreover, the incidences of PTB+ and BCTB were 214 and 232/100,000 persons per year (py), respectively. The ratio of the passive to active case finding was 1:0.96 (45/43). For every TB case identified through the existing passive case diagnosis, there was an almost equal number (0.96) of undiagnosed infectious TB cases in the community. A family history of TB contact was independently associated with a high risk of TB (TB prevalence, AOR, 13; 95% CI: 6.55–15.33) and (TB incidence, aIRR 4.11, 95% CI: 2.18–7.77).Conclusions and recommendationsThe prevalence and incidence of smear-positive and bacteriologically confirmed TB cases were high in the study area. For every case of smear-positive TB receiving treatment, there was an almost equal (0.96) number of undetected infectious bacteriologically confirmed TB case in the community. The high proportion of undetected infectious TB cases in the community could possibly be due to the sub-optimal performance of Directly Observed Treatment Short-course (DOTS) in detecting 70% of infectious TB cases, as well as attaining a cure rate of 85% in the study area. Family history of TB contact has substantaially increased the risk of developing the disease, and there is a need to improve ways of identifying TB cases and intensify mechanisms of tracing contacts among household members of PTB+ cases.

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Section: Discussionsupporting

confidence: 91%

Prevalence and Incidence of Smear-Positive Pulmonary Tuberculosis in the Hetosa District of Arsi Zone, Oromia Regional State of Central Ethiopia

et al. 2017

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“…One limitation of this study was selection of tuberculosis cases from a regional tuberculosis centre, whereas controls were recruited from a nearby hospital. By contrast, Lakshmi and colleagues42 reported no association between tuberculosis and kerosene stove use in a study in India, and Woldesemayat and colleagues43 also showed no association between tuberculosis and kerosene lamp use in Ethiopia. In summary, the relationship between HAP and tuberculosis in adults is not established.…”

Section: Respiratory Infectionsmentioning

confidence: 93%

“…They reported a summary OR for all participants of 1·30 (95% CI 1·04–1·62) and 1·70 for women (1·10–8·20), although there was heterogeneity among study results. A study by Woldesemayat and colleagues,43 published after the meta-analysis, showed no association between tuberculosis and use of solid fuels for cooking, but nearly all participants used solid fuels, so there was insufficient exposure variation for useful analysis 43…”

Section: Respiratory Infectionsmentioning

confidence: 99%

Respiratory risks from household air pollution in low and middle income countries

Gordon¹,

Bruce²,

Grigg³

et al. 2014

The Lancet Respiratory Medicine

756

592

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A third of the world’s population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5–4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.

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“…Taken in Nepal and India that investigated the relationship between tuberculosis (TB) and indoor biomass, evidence was provided that linked exposure to smoke from kerosene fuel combustion, either in stoves or in lamps to TB [46,47]. Interestingly, similar studies conducted recently in Southern Ethiopia found no evidence of an association between the use of biomass fuel and TB [48]. The authors cited low statistical power due to the selection of neighbourhood controls as a likely contributor to these negative findings.…”

Section: Pulmonary System Effectsmentioning

confidence: 93%

Effects and mechanisms of kerosene use-related toxicity

Maiyoh¹,

Njoroge²,

Tuei³

2015

Environmental Toxicology and Pharmacology

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Use of biomass fuel in households is not a risk factor for pulmonary tuberculosis in South Ethiopia

Cited by 14 publications

References 19 publications

Prevalence and Incidence of Smear-Positive Pulmonary Tuberculosis in the Hetosa District of Arsi Zone, Oromia Regional State of Central Ethiopia

Prevalence and Incidence of Smear-Positive Pulmonary Tuberculosis in the Hetosa District of Arsi Zone, Oromia Regional State of Central Ethiopia

Respiratory risks from household air pollution in low and middle income countries

Effects and mechanisms of kerosene use-related toxicity

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