Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

Munkhjargal Dorjravdan; Katsuyasu Kouda; Tsolmon Boldoo; Naranzul Dambaa; Tugsdelger Sovd; Chikako Nakama; Toshimasa Nishiyama

doi:10.1186/s12199-021-00996-4

Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

Environ Health Prev Med. 2021 Aug 9;26(1):76. doi: 10.1186/s12199-021-00996-4.

Authors

Munkhjargal Dorjravdan¹, Katsuyasu Kouda², Tsolmon Boldoo³, Naranzul Dambaa³, Tugsdelger Sovd⁴, Chikako Nakama¹, Toshimasa Nishiyama¹

Affiliations

¹ Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
² Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan. koudakat@hirakata.kmu.ac.jp.
³ Tuberculosis Surveillance and Research Department, National Center for Communicable Disease, Nam Yan Ju Street, Bayanzurkh district, Ulaanbaatar, 13701, Mongolia.
⁴ Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4051, Basel, Switzerland.

Abstract

Background: Tuberculosis (TB) and indoor air pollution (IAP) are equally critical public health issues in the developing world. Mongolia is experiencing the double burden of TB and IAP due to solid fuel combustion. However, no study has assessed the relationship between household solid fuel use and TB in Mongolia. The present study aimed to assess the association between household solid fuel use and TB based on data from the Mongolian National Tuberculosis Prevalence Survey (MNTP Survey).

Method: The MNTP Survey was a nationally representative population-based cross-sectional survey targeting households in Mongolia from 2014 to 2015, with the aim of evaluating the prevalence of TB. The survey adopted a multistage cluster sampling design in accordance with the World Health Organization prevalence survey guidelines. Clusters with at least 500 residents were selected by random sampling. A sample size of 98 clusters with 54,100 participants was estimated to be required for the survey, and 41,450 participants were included in the final analysis of the present study. A structured questionnaire was used to collect information on environmental and individual factors related to TB. Physical examination, chest X-ray, and sputum examinations were also performed to diagnose TB.

Results: The use of solid fuels for heating (adjusted odds ratio (aOR): 1.5; 95% confidence interval (CI): 1.1-2.1), male gender (aOR: 2.2; 95% CI: 1.6-3.2), divorced or widowed (aOR: 2.6; 95% CI: 1.7-3.8), daily smoker (aOR: 1.8; 95% CI: 1.3-2.5), contact with an active TB case (aOR: 1.7; 95% CI: 1.2-2.3), being underweight (aOR: 3.7; 95% CI: 2.4-5.7), and previous history of TB (aOR: 4.3; 95% CI: 3.0-6.1) were significantly associated with bacteriologically confirmed TB after adjusting for confounding variables.

Conclusion: The use of solid fuels for heating was significantly associated with active TB in Mongolian adults. Increased public awareness is needed on the use of household solid fuels, a source of IAP.

Keywords: Epidemiology; Household air pollution; Indoor air pollution; Solid fuel; Tuberculosis.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Air Pollution, Indoor / adverse effects*
Cooking*
Cross-Sectional Studies
Female
Heating / adverse effects*
Humans
Male
Middle Aged
Mongolia / epidemiology
Prevalence
Tuberculosis / chemically induced
Tuberculosis / epidemiology*
Young Adult