Household ventilation and tuberculosis transmission in Kampala, Uganda

Area of Science:

• Environmental Health
• Infectious Disease Epidemiology
• Respiratory Health

Background:

• Tuberculosis (TB) transmission is influenced by household environments.
• Understanding household ventilation is crucial for controlling TB.
• Limited data exists on measuring ventilation in homes in low-resource settings.

Purpose of the Study:

• To assess the feasibility of measuring household ventilation in Kampala, Uganda.
• To investigate the association between household ventilation and TB transmission among contacts.

Main Methods:

• A carbon dioxide (CO₂) decay method was adapted to measure ventilation in air changes per hour (ACH).
• Home visits were conducted to enroll participants and collect data on household characteristics.
• Ventilation was compared between households with and without co-prevalent TB.

Main Results:

• The CO₂ decay method for measuring ventilation was successfully implemented in 92% of approached households.
• Median household ventilation was 14 ACH.
• While not statistically significant, lower median ventilation (11-12 ACH) was observed in sleeping rooms of index TB cases in households with co-prevalent TB compared to those without (15-17 ACH).

Conclusions:

• A CO₂ decay method is a viable tool for measuring home ventilation in clinical research.
• Ventilation is a potentially significant, yet often overlooked, factor in household TB transmission.
• Further research is warranted to confirm the association between ventilation and TB transmission.