Tuberculosis and indoor biomass and kerosene use in Nepal

A Case-Control study

Amod K. Pokhrel, Michael N. Bates, Sharat C. Verma, Hari S. Joshi, Chandrashekhar T. Sreeramareddy, Kirk R. Smith

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Background: In Nepal, tuberculosis (TB) is a major problem. Worldwide, six previous epidemiologic studies have investigated whether indoor cooking with biomass fuel such as wood or agricultural wastes is associated with TB with inconsistent results. Objectives: Using detailed information on potential confounders, we investigated the associations between TB and the use of biomass and kerosene fuels. Methods: A hospital-based case-control study was conducted in Pokhara, Nepal. Cases (n = 125) were women, 20-65 years old, with a confirmed diagnosis of TB. Age-matched controls (n = 250) were female patients without TB. Detailed exposure histories were collected with a standardized questionnaire. Results: Compared with using a clean-burning fuel stove (liquefied petroleum gas, biogas), the adjusted odds ratio (OR) for using a biomass-fuel stove was 1.21 [95% confidence interval (CI), 0.48-3.05], whereas use of a kerosene-fuel stove had an OR of 3.36 (95% CI, 1.01-11.22). The OR for use of biomass fuel for heating was 3.45 (95% CI, 1.44-8.27) and for use of kerosene lamps for lighting was 9.43 (95% CI, 1.45-61.32). Conclusions: This study provides evidence that the use of indoor biomass fuel, particularly as a source of heating, is associated with TB in women. It also provides the first evidence that using kerosene stoves and wick lamps is associated with TB. These associations require confirmation in other studies. If using kerosene lamps is a risk factor for TB, it would provide strong justification for promoting clean lighting sources, such as solar lamps.

Original languageEnglish
Pages (from-to)558-564
Number of pages7
JournalEnvironmental Health Perspectives
Volume118
Issue number4
DOIs
Publication statusPublished - 01-04-2010
Externally publishedYes

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Kerosene
Nepal
Biomass
Case-Control Studies
Tuberculosis
Confidence Intervals
Odds Ratio
Lighting
Heating
Capillary Action
Biofuels
Petroleum
Cooking
Epidemiologic Studies
Gases

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Pokhrel, A. K., Bates, M. N., Verma, S. C., Joshi, H. S., Sreeramareddy, C. T., & Smith, K. R. (2010). Tuberculosis and indoor biomass and kerosene use in Nepal: A Case-Control study. Environmental Health Perspectives, 118(4), 558-564. https://doi.org/10.1289/ehp.0901032
Pokhrel, Amod K. ; Bates, Michael N. ; Verma, Sharat C. ; Joshi, Hari S. ; Sreeramareddy, Chandrashekhar T. ; Smith, Kirk R. / Tuberculosis and indoor biomass and kerosene use in Nepal : A Case-Control study. In: Environmental Health Perspectives. 2010 ; Vol. 118, No. 4. pp. 558-564.
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Pokhrel, AK, Bates, MN, Verma, SC, Joshi, HS, Sreeramareddy, CT & Smith, KR 2010, 'Tuberculosis and indoor biomass and kerosene use in Nepal: A Case-Control study', Environmental Health Perspectives, vol. 118, no. 4, pp. 558-564. https://doi.org/10.1289/ehp.0901032

Tuberculosis and indoor biomass and kerosene use in Nepal : A Case-Control study. / Pokhrel, Amod K.; Bates, Michael N.; Verma, Sharat C.; Joshi, Hari S.; Sreeramareddy, Chandrashekhar T.; Smith, Kirk R.

In: Environmental Health Perspectives, Vol. 118, No. 4, 01.04.2010, p. 558-564.

Research output: Contribution to journalArticle

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T1 - Tuberculosis and indoor biomass and kerosene use in Nepal

T2 - A Case-Control study

AU - Pokhrel, Amod K.

AU - Bates, Michael N.

AU - Verma, Sharat C.

AU - Joshi, Hari S.

AU - Sreeramareddy, Chandrashekhar T.

AU - Smith, Kirk R.

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Background: In Nepal, tuberculosis (TB) is a major problem. Worldwide, six previous epidemiologic studies have investigated whether indoor cooking with biomass fuel such as wood or agricultural wastes is associated with TB with inconsistent results. Objectives: Using detailed information on potential confounders, we investigated the associations between TB and the use of biomass and kerosene fuels. Methods: A hospital-based case-control study was conducted in Pokhara, Nepal. Cases (n = 125) were women, 20-65 years old, with a confirmed diagnosis of TB. Age-matched controls (n = 250) were female patients without TB. Detailed exposure histories were collected with a standardized questionnaire. Results: Compared with using a clean-burning fuel stove (liquefied petroleum gas, biogas), the adjusted odds ratio (OR) for using a biomass-fuel stove was 1.21 [95% confidence interval (CI), 0.48-3.05], whereas use of a kerosene-fuel stove had an OR of 3.36 (95% CI, 1.01-11.22). The OR for use of biomass fuel for heating was 3.45 (95% CI, 1.44-8.27) and for use of kerosene lamps for lighting was 9.43 (95% CI, 1.45-61.32). Conclusions: This study provides evidence that the use of indoor biomass fuel, particularly as a source of heating, is associated with TB in women. It also provides the first evidence that using kerosene stoves and wick lamps is associated with TB. These associations require confirmation in other studies. If using kerosene lamps is a risk factor for TB, it would provide strong justification for promoting clean lighting sources, such as solar lamps.

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Pokhrel AK, Bates MN, Verma SC, Joshi HS, Sreeramareddy CT, Smith KR. Tuberculosis and indoor biomass and kerosene use in Nepal: A Case-Control study. Environmental Health Perspectives. 2010 Apr 1;118(4):558-564. https://doi.org/10.1289/ehp.0901032