Abstract
Background: Overcrowded housing and poor ventilation increase the risk of tuberculosis (TB) by facilitating contact with Mycobacterium tuberculosis (MTB) and accelerating disease progression. Key environmental factors influencing TB risk include humidity and household density.
Aim: This study aimed to assess TB prevalence, explore environmental risk factors and association between environmental risk factors and TB among South African adults under varying living conditions, using the nationally representative General Household Survey (GHS) 2022 dataset.
Methodology: A quantitative retrospective design was employed. Secondary data from the South African GHS 2022 was analyzed, focusing on 43 082 from the 66 144 households surveyed after dropping those who are less than 18 years of age, excluding non-residential institutions. Data were analyzed using Stata 18 (Logit regression model) to examine the associations between TB prevalence and environmental risk factors.
Results: The study found a TB prevalence of 0.6% among South African adults’ respondents. The risk of TB increased if houses were traditionally built or were built with mud-brick and if the floor was made of earth/soil and if the energy source used were coal and animal dung for space heating. The association between TB prevalence and environmental risk factors was not significant.
Conclusion: TB prevalence is high among adults in this high-burden country. Environmental risk factors and poor living conditions significantly contribute to TB prevalence. The study highlights that TB remains a disease of poverty, with higher prevalence linked to inadequate housing and limited access to healthcare. Improving living conditions and healthcare access can help reduce TB prevalence and mortality.
Recommendations: Key recommendations include 1) the improvement of TB control with the identification of specific targets, such as enhanced health education on TB, 2) dealing with environmental risk factors for TB, and 3) Improved case-finding activities within the families of TB cases and appropriate treatment.