Association between indoor air pollution, tobacco smoke and tuberculosis: an updated systematic review and meta-analysis

Obore, Nathan; Kawuki, Joseph; Guan, Jianming; Papabathini, Shireen Salome; Wang, Liang

doi:10.1016/j.puhe.2020.07.031

Cited by 38 publications

(16 citation statements)

References 54 publications

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“…Exposure to air pollution can reduce individuals' defense capability against pathogens. Previous studies showed that fuel-induced indoor air pollution had a strong connection with increased risk of tuberculosis infection [6][7][8][9]. Some epidemiological studies have explored the relations between air pollution exposure and TB risk, and the study results are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Association of Daily Exposure to Air Pollutants with the Risk of Tuberculosis in Xuhui District of Shanghai, China

Xiong

Yang

Wang

et al. 2022

IJERPH

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Previous studies have suggested that air pollutant exposure is related to tuberculosis (TB) risk, but results have not been consistent. This study evaluated the relation between daily air pollutant exposure and TB incidence in Shanghai from 2014 to 2019. Overall, there were four pollutants that were positively related to the risk of new TB cases. After a 5 μg/m3 increase, the maximum lag-specific and cumulative relative risk (RR) of SO2 were 1.081, (95% CI: 1.035–1.129, lag: 3 days) and 1.616 (95% CI: 1.119–2.333, lag: 0–13 days), while for NO2, they were 1.061 (95% CI: 1.015–1.11, lag: 4 days) and 1.8 (95% CI: 1.113–2.91, lag: 0–15 days). As for PM2.5, with a 50 μg/m3 increase, the lag-specific and cumulative RR were 1.064 (95% CI: 1–1.132, lag: 6 days) and 3.101 (95% CI: 1.096–8.777, lag: 0–21 days), while for CO, the lag-specific RR was 1.03 (95% CI: 1.005–1.057, lag: 8 days) and the cumulative RR was 1.436 (95% CI: 1.004–2.053, lag: 0–16 days) with a 100 μg/m3 increase. The associations tended to be stronger in male and elderly patients and differed with seasons. Air pollutant exposure may be a risk factor for TB incidence.

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Section: Introductionmentioning

confidence: 99%

Association of Daily Exposure to Air Pollutants with the Risk of Tuberculosis in Xuhui District of Shanghai, China

Xiong

Yang

Wang

et al. 2022

IJERPH

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“…Another meta-analysis concluded that the risk of active TB depends on the type of fuel used, with the highest risk (43% increased risk) being associated with burning solid fuels [ 25 ]. A recent meta-analysis reported that IAP is associated with the risk of contracting TB (relative risk: 1.68; 95%, CI: 1.108–2.542; p < 0.014) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

Dorjravdan

Kouda

Boldoo

et al. 2021

Environ Health Prev Med

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Background Tuberculosis (TB) and indoor air pollution (IAP) are equally critical public health issues in the developing world. Mongolia is experiencing the double burden of TB and IAP due to solid fuel combustion. However, no study has assessed the relationship between household solid fuel use and TB in Mongolia. The present study aimed to assess the association between household solid fuel use and TB based on data from the Mongolian National Tuberculosis Prevalence Survey (MNTP Survey). Method The MNTP Survey was a nationally representative population-based cross-sectional survey targeting households in Mongolia from 2014 to 2015, with the aim of evaluating the prevalence of TB. The survey adopted a multistage cluster sampling design in accordance with the World Health Organization prevalence survey guidelines. Clusters with at least 500 residents were selected by random sampling. A sample size of 98 clusters with 54,100 participants was estimated to be required for the survey, and 41,450 participants were included in the final analysis of the present study. A structured questionnaire was used to collect information on environmental and individual factors related to TB. Physical examination, chest X-ray, and sputum examinations were also performed to diagnose TB. Results The use of solid fuels for heating (adjusted odds ratio (aOR): 1.5; 95% confidence interval (CI): 1.1–2.1), male gender (aOR: 2.2; 95% CI: 1.6–3.2), divorced or widowed (aOR: 2.6; 95% CI: 1.7–3.8), daily smoker (aOR: 1.8; 95% CI: 1.3–2.5), contact with an active TB case (aOR: 1.7; 95% CI: 1.2–2.3), being underweight (aOR: 3.7; 95% CI: 2.4–5.7), and previous history of TB (aOR: 4.3; 95% CI: 3.0–6.1) were significantly associated with bacteriologically confirmed TB after adjusting for confounding variables. Conclusion The use of solid fuels for heating was significantly associated with active TB in Mongolian adults. Increased public awareness is needed on the use of household solid fuels, a source of IAP.

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“…The absence of data prevented a separate analysis of its effect on relapse and reinfection. Still, smoking and alcohol consumption are known to be associated to the risk of TB as such26 27 and could be addressed by TB programme interventions.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pulmonary tuberculosis recurrence, relapse and reinfection: a systematic review and meta-analysis

Vega,

Cabrera-Sanchez,

Rodríguez

et al. 2024

BMJ Open Resp Res

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BackgroundThe rate of pulmonary tuberculosis (TB) recurrence is substantial. Identifying risk factors can support the development of prevention strategies.MethodsWe retrieved studies published between 1 January 1980 and 31 December 2022 that assessed factors associated with undifferentiated TB recurrence, relapse or reinfection. For factors reported in at least four studies, we performed random-effects meta-analysis to estimate a pooled relative risk (RR). We assessed heterogeneity, risk of publication bias and certainty of evidence.ResultsWe included 85 studies in the review; 81 documented risk factors for undifferentiated recurrence, 17 for relapse and 10 for reinfection. The scope for meta-analyses was limited given the wide variety of factors studied, inconsistency in control for confounding and the fact that only few studies employed molecular genotyping. Factors that significantly contributed to moderately or strongly increased pooled risk and scored at least moderate certainty of evidence were: for undifferentiated recurrence, multidrug resistance (MDR) (RR 3.49; 95% CI 1.86 to 6.53) and fixed-dose combination TB drugs (RR 2.29; 95% CI 1.10 to 4.75) in the previous episode; for relapse, none; and for reinfection, HIV infection (RR 4.65; 95% CI 1.71 to 12.65). Low adherence to treatment increased the pooled risk of recurrence 3.3-fold (95% CI 2.37 to 4.62), but the certainty of evidence was weak.ConclusionThis review emphasises the need for standardising methods for TB recurrence research. Actively pursuing MDR prevention, facilitating retention in treatment and providing integrated care for patients with HIV could curb recurrence rates. The use of fixed-dose combinations of TB drugs under field conditions merits further attention.PROSPERO registration numberCRD42018077867.

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Association between indoor air pollution, tobacco smoke and tuberculosis: an updated systematic review and meta-analysis

Cited by 38 publications

References 54 publications

Association of Daily Exposure to Air Pollutants with the Risk of Tuberculosis in Xuhui District of Shanghai, China

Association of Daily Exposure to Air Pollutants with the Risk of Tuberculosis in Xuhui District of Shanghai, China

Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

Risk factors for pulmonary tuberculosis recurrence, relapse and reinfection: a systematic review and meta-analysis

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