ABS 124: Assessing the Environmental Impact of Household Air Quality on Tuberculosis Transmission Among Women in Rural India: Developing the Household Ventilation and Biomass Exposure Index (HVBEI) as a Modern Composite Indicator

Soumya Shukla ¹ , Avi Kumar Bansal ² , Umesh Datta Gupta ³

¹ New York University
² World Health Organization (WHO) TB Division of India
³ Indian Council of Medical Research

Van Wickle (2025) Volume 1, ABS 124

Abstract: This study investigates the insidious interplay of household ventilation and air quality, biomass fuel use, and TB transmission in women in rural India, a nation accounting for 26% of the global TB burden. In these communities, environmental factors including reliance on biomass fuels for cooking, poor ventilation, and overcrowding significantly increase the risk of tuberculosis transmission. In this study, we create a novel composite metric, the Household Ventilation and Biomass Exposure Index (HVBEI), to quantify environmental risk factors for TB transmission in the household setting. The HVBEI incorporated comprehensive quantitative data including air quality metrics (PM2.5, PM10, carbon monoxide), household density, and fuel type. Using principal component analysis and multivariate regression, our findings revealed that households with PM2.5 levels exceeding safety thresholds experienced 2-3 times higher TB rates, while homes with fewer than two windows or inadequate air exchanges showed significantly elevated transmission rates. Higher HVBEI scores were associated with a 40-50% increased risk of TB transmission. Multi-generational households with high occupancy density showed elevated TB rates, with socioeconomic status significantly influencing both housing conditions and TB risk. Preliminary findings suggest that traditional cooking practices involving specific biomass fuels correlate strongly with increased TB incidence. However, as this research is ongoing, these associations require further investigation to confirm and refine the findings. While the research focused on women's exposure patterns, the findings provide valuable insights for policymakers and healthcare professionals to establish more focused and equitable tuberculosis prevention strategies. This contributes at the programme level to India's Revised National Tuberculosis Control Programme (RNTCP) and WHO strategies, providing a data-driven framework for intervention in India.

Methods: Not published.

Conclusion: Not published.

Discussion: Not published.