The effect of biomass smoke exposure on quality-of-life among Ugandan patients treated for tuberculosis: A cross-sectional analysis
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Date
2024-02
Authors
Wennemann, Sophie
Mudarshiru, Bbuye
Zawedde-Muyanja, Stella
Siddharthan, Trishul
Jackson, Peter D
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
Abstract
More than half the global population burns biomass fuels for cooking and home heating,
especially in low-middle income countries. This practice is a prominent source of indoor air
pollution and has been linked to the development of a variety of cardiopulmonary diseases,
including Tuberculosis (TB). The purpose of this cross-sectional study was to investigate
the association between current biomass smoke exposure and self-reported quality of life
scores in a cohort of previous TB patients in Uganda. We reviewed medical records from six
TB clinics from 9/2019-9/2020 and conducted phone interviews to obtain information about
biomass smoke exposure. A random sample of these patients were asked to complete
three validated quality-of-life surveys including the St. Georges Respiratory Questionnaire
(SGRQ), the EuroQol 5 Dimension 3 Level system (EQ-5D-3L) which includes the EuroQol
Visual Analog Scale (EQ-VAS), and the Patient Health Questionnaire 9 (PHQ-9). The cohort
was divided up into 3 levels based on years of smoke exposure–no-reported smoke exposure (0 years), light exposure (1–19 years), and heavy exposure (20+ years), and independent-samples-Kruskal-Wallis testing was performed with post-hoc pairwise comparison and
the Bonferroni correction. The results of this testing indicated significant increases in survey
scores for patients with current biomass exposure and a heavy smoke exposure history (20
+ years) compared to no reported smoke exposure in the SGRQ activity scores (adj. p =
0.018) and EQ-5D-3L usual activity scores (adj. p = 0.002), indicating worse activity related
symptoms. There was a decrease in EQ-VAS scores for heavy (adj. p = 0.007) and light
(adj. p = 0.017) exposure groups compared to no reported exposure, indicating lower perceptions of overall health. These results may suggest worse outcomes or baseline health for
TB patients exposed to biomass smoke at the time of treatment and recovery, however further research is needed to characterize the effect of indoor air pollution on TB treatment
outcomes.
Description
Keywords
Tuberculosis; Smoking habits ; Smoking related disorders; Quality of life
Citation
Wennemann, Sophie, Bbuye Mudarshiru, Stella Zawedde-Muyanja, et al. 'The Effect of Biomass Smoke Exposure on Quality-of-Life among Ugandan Patients Treated for Tuberculosis: A Cross-Sectional Analysis', PLOS Global Public Health, vol. 4/no. 2, (2024), pp. e0002892.