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International Journal of Infectious Diseases: Volume 3, Number 3
Biomass Cooking Fuels and Prevalence of Tuberculosis in India
Vinod K. Mishra, PhD, MPH; Robert D. Retherford, PhD; and Kirk R. Smith, PhD, MPH

Int J Infect Dis 1999; 3:119-129.

Objectives: To examine the relation between use of biomass cooking fuels (wood or dung) and prevalence of active tuberculosis in India. Methods: The analysis is based on 260,162 persons age 20 and over in India's 1992-93 National Family Health Survey. Logistic regression is used to estimate the effects of biomass fuel use on prevalence of active tuberculosis, as reported by household heads, after controlling for a number of potentially confounding variables. Results: Persons living in households that primarily use biomass for cooking fuel have substantially higher prevalence of active tuberculosis than persons living in households that use cleaner fuels (odds ratio [OR] = 3.56; 95% confidence interval [CI] = 2.82-4.50). This effect is reduced somewhat when availability of a separate kitchen, house type, indoor crowding, age, gender, urban or rural residence, education, religion, caste or tribe, and geographic region are statistically controlled (OR = 2.58; 95% CI = 1.98-3.37). Fuel type also has a large effect when the analysis is done separately for men (OR = 2.46; 95% CI = 1.79-3.39) and women (OR = 2.74; 95% CI = 1.86-4.05) and separately for urban areas (OR = 2.29; 95% CI = 1.61-3.23) and rural areas (OR = 2.65; 95% CI = 1.74-4.03). The analysis also indicates that, among persons age 20 years and over, 51% of the prevalence of active tuberculosis is attributable to cooking smoke. Conclusions: Results strongly suggest that use of biomass fuels for cooking substantially increases the risk of tuberculosis in India.

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