American journal of respiratory and critical care medicine | 2021
Indoor Air Pollution and Susceptibility to Tuberculosis Infection in Urban Vietnamese Children.
Abstract
RATIONALE\nThe Southeast Asian tuberculosis burden is high, and it remains unclear if urban indoor air pollution in this setting is exacerbating the epidemic.\n\n\nOBJECTIVES\nTo determine the associations of latent tuberculosis with common urban indoor air pollution sources (secondhand smoke, indoor motorcycle emissions, and cooking) in Southeast Asia.\n\n\nMETHODS\nWe enrolled child household contacts of patients with microbiologically confirmed active tuberculosis in Vietnam, July 2017-December 2019. We tested children for latent tuberculosis and evaluated air pollution exposures with questionnaires and personal aerosol sampling. We tested hypotheses using generalized estimating equations.\n\n\nMEASUREMENTS AND MAIN RESULTS\nWe enrolled 72 tuberculosis patients (27% with cavitary disease) and 109 of their child household contacts. Of household contacts, 58 (53%) were diagnosed with latent tuberculosis at baseline visit. Children experienced a 2.56-fold increased odds of latent tuberculosis for each additional household member who smoked (95%CI 1.27-5.16). Odds were highest among children exposed to indoor smokers and children under five years old exposed to household smokers. Each residential floor above street-level pollution decreased the odds of latent tuberculosis by 36% (aOR 0.64, 95%CI 0.42-0.96). Motorcycles parked inside children s homes and cooking with liquid petroleum gas compared to electricity increased the odds of latent tuberculosis while kitchen ventilation decreased the effect, but these findings were not statistically significant.\n\n\nCONCLUSION\nCommon urban indoor air pollution sources were associated with increased odds of latent tuberculosis infection in child household contacts of active tuberculosis patients.