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. 2024 Jan 23;24(1):121.
doi: 10.1186/s12879-024-09011-x.

Associations between air pollutants and acute exacerbation of drug-resistant tuberculosis: evidence from a prospective cohort study

Chan-Na Zhao #  1 , Zhiwei Xu #  2 , Peng Wang  3 , Jie Liu  4 , Rong Wang  4 , Hai-Feng Pan  5 , Fangjin Bao  6
Affiliations

Associations between air pollutants and acute exacerbation of drug-resistant tuberculosis: evidence from a prospective cohort study

Chan-Na Zhao et al. BMC Infect Dis. .

Abstract

Background: Short-term exposure to air pollution may trigger symptoms of drug-resistant tuberculosis (DR-TB) through stimulating lung tissue, damaging tracheobronchial mucosa, the key anti-mycobacterium T cell immune function, and production and release of inflammatory cytokines.

Objective: To investigate the association between acute exacerbations of DR-TB and short-term residential exposure to air pollutants (PM10, PM2.5, SO2, NO2, CO and O3) based on a large prospective cohort in Anhui Province, China.

Method: Patients were derived from a prospective cohort study of DR-TB in Anhui Province. All DR-TB patients underwent drug-susceptibility testing and prefecture-level reference laboratories confirmed their microbiologies. The case-crossover design was performed to evaluate the association between the risk of acute exacerbations of DR-TB and short-term residential exposure to air pollution.

Results: Short-term NO2 exposure was significantly related to an elevated risk of first-time outpatient visit due to acute exacerbations of DR-TB(relative risk:1.159, 95% confidence interval:1.011 ~ 1.329). Stratification analyses revealed that the relationship between the risk of acute exacerbations and NO2 exposure was stronger in the elderly (age ≥ 65) DR-TB patients, and in individuals with a history of TB treatment.

Conclusions: NO2 Exposure was significantly associated with an elevated risk of acute exacerbation of DR-TB in Anhui Province, China.

Keywords: Air pollutants; Drug-resistant tuberculosis; NO2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Spatial distributions of 2522 DR-TB cases’ residential addresses in Anhui province, China DR-TB, drug resistant tuberculosis
Fig. 2
Fig. 2
RR (95% CIs) for the association between first-time outpatient visits due to acute exacerbation of DR-TB and air pollutants concentrations with each IQR increase based on single-pollutant models DR-TB, drug resistant tuberculosis; RR, Relative risks; CIs, confidence intervals
See this image and copyright information in PMC

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