Tuberculosis and Indoor Biomass and Kerosene Use in Nepal: A Case–Control Study

BackgroundIn Nepal, tuberculosis (TB) is a major problem. Worldwide, six previous epidemiologic studies have investigated whether indoor cooking with biomass fuel such as wood or agricultural wastes is associated with TB with inconsistent results.ObjectivesUsing detailed information on potential confounders, we investigated the associations between TB and the use of biomass and kerosene fuels.MethodsA hospital-based case-control study was conducted in Pokhara, Nepal. Cases (n = 125) were women, 20-65 years old, with a confirmed diagnosis of TB. Age-matched controls (n = 250) were female patients without TB. Detailed exposure histories were collected with a standardized questionnaire.ResultsCompared with using a clean-burning fuel stove (liquefied petroleum gas, biogas), the adjusted odds ratio (OR) for using a biomass-fuel stove was 1.21 [95% confidence interval (CI), 0.48-3.05], whereas use of a kerosene-fuel stove had an OR of 3.36 (95% CI, 1.01-11.22). The OR for use of biomass fuel for heating was 3.45 (95% CI, 1.44-8.27) and for use of kerosene lamps for lighting was 9.43 (95% CI, 1.45-61.32).ConclusionsThis study provides evidence that the use of indoor biomass fuel, particularly as a source of heating, is associated with TB in women. It also provides the first evidence that using kerosene stoves and wick lamps is associated with TB. These associations require confirmation in other studies. If using kerosene lamps is a risk factor for TB, it would provide strong justification for promoting clean lighting sources, such as solar lamps

Solar greenhouse technology for food security: A case study from Humla District, NW Nepal

Food security is a significant issue for many people who live in remote mountain areas around the world. Most of these people are also poor because of the lack of opportunity to earn cash. Malnutrition is common because the harsh climate restricts production and access to fresh food. Simple conventional greenhouses can provide some improvement of growing conditions, but the benefits are limited because of the high heat losses from these structures. Solar greenhouses, however, which are designed to store some of the heat generated within the structure can overcome these limitations. This article describes the experiences of a nongovernmental organization that has been introducing community and family-owned solar greenhouses into the remote villages of Humla, a mountainous district of northwest Nepal prone to food insecurity. The overall result has been positive. Family-owned greenhouses, which avoid the issues of community ownership and operation, have been more successful. A validated computer model based on the first solar greenhouse has been used to predict the thermal performance of a new family-sized design. Training and education are vital to the success of solar greenhouse technology in remote mountain areas