Abstract
The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default.ltr.aspx. Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel.
Highlights
Air pollution is still the most important environmental factor that has adverse effects on human health
The rate of diagnosis based on culture and smear positivity [48.4% [31]] was significantly higher than that in the clinic [10.9% [7]] among patients who used stove for warming (Fisher’s exact test p=0.019; Bonferroni subgroup analysis was used)
The rate of diagnosis based on culture and smear positivity [52.1% [25]] was significantly higher than that in the clinic [8.3% [4]] among patients who were exposed to biomass
Summary
Air pollution is still the most important environmental factor that has adverse effects on human health. Extensive research has demonstrated an increase in the rates of morbidity and mortality due to diseases with an increase in air pollution [1]. In 2015, air pollution affected more than one billion people, and it has been estimated that this number will increase to four billion in 2050 [2, 3]. Tuberculosis (TB) is an airborne disease caused by Mycobacterium tuberculosis, and one-third of people in the world are known to be infected with this disease [4]. TB generally affects the lungs, but it can affect all other organs. TB still remains one of the major causes for mortality and morbidity worldwide [5]
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