Environmental Risk Factors and Social Determinants of Pulmonary Tuberculosis in Pakistan

Abstract

Objective: To evaluate the role of potential environmental risk factors and social determinants associated with pulmonary tuberculosis in Pakistan. Methods: Newly diagnosed pulmonary TB patients from August 2011-August 2014 from Gulab Devi Chest Hospital, Lahore, were recruited for this study. Two types of controls, house hold and community healthy controls (n=800 each) were selected. Multivariate analysis was performed to calculate odd ratios (OR) and observe the association of these factors with the disease. Results: For host-related factors, TB was found to be significantly associated with male gender, married individuals, smoking, drinking, personal and family history of TB, asthma and diabetes (OR: 1.08, 1.96, 1.21, 4.26, 2.07, 3.16, 3.43 and 3.67) respectively with P-value <0.001. For environmental and socio economic factors TB was found to be associated with adult crowding, increased family size, poor ventilation and use of biofuels (OR: 4.60, 1.75, 3.29 and 3.90) illiteracy, unawareness of the disease, migration and presence of animals in the house (OR: 1.74, 0.07, 1.83 and 1.60) respectively with p-values of <0.005. Conclusion: Information related to environmental and host related risk factors are very important to control the spread of infection and disease. Smoking, exposure to TB infected individuals, crowding ventilation and use of biofuels can be controlled by proper planning which are the risk factors of high potential found in this study. Proper health care facilities and education of people is also very important to control the disease.