| Autor: |
Blount RJ; Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Phan H; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Center for Promotion of Advancement of Society, Hanoi, Vietnam., Trinh T; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Center for Promotion of Advancement of Society, Hanoi, Vietnam., Dang H; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Center for Promotion of Advancement of Society, Hanoi, Vietnam., Merrifield C; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Division of Pulmonary and Critical Care Medicine.; UCSF Center for Tuberculosis, and., Zavala M; Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Zabner J; Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Comellas AP; Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Stapleton EM; Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Segal MR; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California., Balmes J; Division of Pulmonary and Critical Care Medicine.; School of Public Health, University of California, Berkeley, Berkeley, California; and., Nhung NV; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Vietnam National Tuberculosis Program, Hanoi, Vietnam., Nahid P; Vietnam National Tuberculosis Program-University of California San Francisco Research Collaboration Unit, Hanoi, Vietnam.; Division of Pulmonary and Critical Care Medicine.; UCSF Center for Tuberculosis, and. |
| Abstrakt: |
Rationale: The Southeast Asian tuberculosis burden is high, and it remains unclear if urban indoor air pollution in this setting is exacerbating the epidemic. Objectives: To determine the associations of latent tuberculosis with common urban indoor air pollution sources (secondhand smoke, indoor motorcycle emissions, and cooking) in Southeast Asia. Methods: We enrolled child household contacts of patients with microbiologically confirmed active tuberculosis in Vietnam, from July 2017 to 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. Measurements and Main Results: We enrolled 72 patients with tuberculosis (27% with cavitary disease) and 109 of their child household contacts. Latent tuberculosis was diagnosed in 58 (53%) household contacts at baseline visit. Children experienced a 2.56-fold increased odds of latent tuberculosis for each additional household member who smoked (95% confidence interval, 1.27-5.16). Odds were highest among children exposed to indoor smokers and children <5 years old exposed to household smokers. Each residential floor above street-level pollution decreased the odds of latent tuberculosis by 36% (adjusted odds ratio, 0.64; 95% confidence interval, 0.42-0.96). Motorcycles parked inside children's homes and cooking with liquid petroleum gas compared with electricity increased the odds of latent tuberculosis, whereas kitchen ventilation decreased the effect, but these findings were not statistically significant. Conclusions: Common urban indoor air pollution sources were associated with increased odds of latent tuberculosis infection in child household contacts of patients with active tuberculosis. |
