Association of Pulmonary Tuberculosis with Biomass Smoke Exposure in a Rural Setting of South-West Nigeria: A Case Control Study

RationaleApproximately half of the world population use of biomass fuel (BMF) for cooking or heating and TB is one of 10 the leading causes of death and remains the leading infectious killer worldwide. Biomass fuel use has been associated with couples of respiratory health outcomes, however, its association with TB has not been clearly established, with null result or positive in previous studies. We therefore aim to investigate the association between exposure to biomass fuel smoke and tuberculosis (TB) in rural settings of Osun state in south-west Nigeria. Methods In a matched case control study, adult diagnosed with smear-positive pulmonary tuberculosis (PTB) and treated in rural DOTS-treatment center in Iwo, Osun state of Nigeria were compared with age and sex match healthy controls in the same community. Exposure to biomass fuel was assessed standardized questionnaire and logistic regression was used to estimate the association between exposure to biomass fuel smoke, other covariates and PTB.Results Of the 616 participants, 201 were cases [median age of 45 years (IQR 36-57 years); female 45%] and 415 were controls [median age of 43 years (IQR 33-55 years); female 50%]. Of 201 cases, 33 (16.5%) use biomass fuel for cooking, compared to 201/415 (48.4%) controls. In multivariate model adjusted for socioeconomic status, cooking with BMF in rooms that have open doors and windows, family member with TB, Cigarette use, alcohol use and HIV status, patients with tuberculosis were less likely to have use biomass with adjusted OR of 0.84 (95% CI: 0.71-1.02) p=0.071 as compared with healthy controls, however this was not statistically significant. Conclusion PTB was not associated with exposure to the biomass in this population, more studies are needed to determine the association between BMF use and tuberculosis