EFFECT OF BIOMASS SMOKE EXPOSURE ON QUALITY OF LIFE IN UGANDAN PATIENTS TREATED FOR TB

Abstract

SESSION TITLE: Late Breaking Chest Infections PostersSESSION TYPE: Original Investigation PostersPRESENTED ON: 10/18/2022 01:30 pm - 02:30 pmPURPOSE: Over half the global population, particularly those in low-middle income countries, are exposed to indoor air pollution from combustion of biomass fuels. Indoor air pollution is linked to numerous diseases; the WHO estimates biomass smoke contributes to two million deaths yearly. Studies suggest biomass smoke increases tuberculosis (TB) risk, however, the effect of biomass smoke on TB patients’ quality of life (QOL) is unknown. In this study of TB patients in Uganda, we assessed the association of biomass smoke exposure with QOL.METHODS: Medical records for TB patients from 9/2019-9/2020 at a network of six TB clinics in Uganda were reviewed. Biomass exposure, including type and years exposed, was collected by phone. A random sample of patients recruited completed the EQ-5D-3L, a validated tool consisting of five health dimensions, and the St. Georges Respiratory Questionnaire (SGRQ) measuring respiratory QOL. Patients with no biomass exposure (0 years), light exposure (1-19 years) and heavy exposure (20+ years) were compared by independent-samples-Kruskal-Wallis test with post hoc pairwise tests. Confounding by age and income level was examined with linear regression (p<0.05 considered significant).RESULTS: SGRQ was completed by 157 patients; median age 33 (IQR 25.5-41.5); 66.2% male. Kruskal-Wallis testing showed significant differences in total SGRQ between exposure groups in the initial test (H=6.118, p=.047) but not the pairwise comparison (adj. p=.057). SGRQ activity domain score (H=8.357, p=.015) indicated worse symptoms for patients with heavy vs. no exposure (adj. p=.018) without confounding by age and income.EQ-5D-3L was completed by 173 patients; median age 33 (IQR 26-42); 64.7% male. There were significant increases in EQ-5D-3L activity scores (H=12.022, p=.002), which indicates limited activity performance, in high exposure vs. no exposure (adj. p=.002) and light exposure (adj. p=.041) groups, without confounding by age and income. There was a significant decrease in scores for the EQ-Visual Assessment Scale (H=14.355, p<.001), which ranks health overall, for both heavy (adj. p=.004) and light (adj. p=.020) exposure groups vs. no exposure without confounding by age and income.CONCLUSIONS: TB patients with heavy biomass exposure report more activity limitations on SGRQ and EQ-5D-3L. Those with any biomass exposure report lower overall health on EQ-VAS compared to those with no exposure. Our results indicate that more research is needed to determine the effect of indoor air pollution on TB treatment outcomes.CLINICAL IMPLICATIONS: Our results indicate that biomass smoke exposure is associated with lower QOL scores on two validated QOL questionnaires in Ugandan TB patients. This may suggest poor baseline health or worse treatment response for TB patients exposed to biomass smoke. Additional prospective research is needed to better characterize the effect of biomass smoke on TB outcomes.DISCLOSURES:No relevant relationships by Peter Jacksonno disclosure on file for Bbuye Mudarshiru;no disclosure on file for Trishul Siddharthan;No relevant relationships by Sophie WennemannNo relevant relationships by Stella Zawedde-Muyanja SESSION TITLE: Late Breaking Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Over half the global population, particularly those in low-middle income countries, are exposed to indoor air pollution from combustion of biomass fuels. Indoor air pollution is linked to numerous diseases; the WHO estimates biomass smoke contributes to two million deaths yearly. Studies suggest biomass smoke increases tuberculosis (TB) risk, however, the effect of biomass smoke on TB patients’ quality of life (QOL) is unknown. In this study of TB patients in Uganda, we assessed the association of biomass smoke exposure with QOL. METHODS: Medical records for TB patients from 9/2019-9/2020 at a network of six TB clinics in Uganda were reviewed. Biomass exposure, including type and years exposed, was collected by phone. A random sample of patients recruited completed the EQ-5D-3L, a validated tool consisting of five health dimensions, and the St. Georges Respiratory Questionnaire (SGRQ) measuring respiratory QOL. Patients with no biomass exposure (0 years), light exposure (1-19 years) and heavy exposure (20+ years) were compared by independent-samples-Kruskal-Wallis test with post hoc pairwise tests. Confounding by age and income level was examined with linear regression (p<0.05 considered significant). RESULTS: SGRQ was completed by 157 patients; median age 33 (IQR 25.5-41.5); 66.2% male. Kruskal-Wallis testing showed significant differences in total SGRQ between exposure groups in the initial test (H=6.118, p=.047) but not the pairwise comparison (adj. p=.057). SGRQ activity domain score (H=8.357, p=.015) indicated worse symptoms for patients with heavy vs. no exposure (adj. p=.018) without confounding by age and income. EQ-5D-3L was completed by 173 patients; median age 33 (IQR 26-42); 64.7% male. There were significant increases in EQ-5D-3L activity scores (H=12.022, p=.002), which indicates limited activity performance, in high exposure vs. no exposure (adj. p=.002) and light exposure (adj. p=.041) groups, without confounding by age and income. There was a significant decrease in scores for the EQ-Visual Assessment Scale (H=14.355, p<.001), which ranks health overall, for both heavy (adj. p=.004) and light (adj. p=.020) exposure groups vs. no exposure without confounding by age and income. CONCLUSIONS: TB patients with heavy biomass exposure report more activity limitations on SGRQ and EQ-5D-3L. Those with any biomass exposure report lower overall health on EQ-VAS compared to those with no exposure. Our results indicate that more research is needed to determine the effect of indoor air pollution on TB treatment outcomes. CLINICAL IMPLICATIONS: Our results indicate that biomass smoke exposure is associated with lower QOL scores on two validated QOL questionnaires in Ugandan TB patients. This may suggest poor baseline health or worse treatment response for TB patients exposed to biomass smoke. Additional prospective research is needed to better characterize the effect of biomass smoke on TB outcomes. DISCLOSURES: No relevant relationships by Peter Jackson no disclosure on file for Bbuye Mudarshiru; no disclosure on file for Trishul Siddharthan; No relevant relationships by Sophie Wennemann No relevant relationships by Stella Zawedde-Muyanja