Scientists focus on role of ventilation in preventing tuberculosis transmission

Despite biomedical improvements to treat tuberculosis (TB), the incidence in South Africa continues to increase. TB spreads through the air, and children attending school may be particularly vulnerable to the disease because they are required to spend large amounts of time indoors in classrooms. Over one school year in a high school in Cape Town, South Africa, scientists assessed the role of schools and 'air hygiene' in TB spread or prevention by monitoring CO₂ in classrooms -- using sensors carried around by students.

In the study, the authors first calculated 1000ppm as the indoor CO₂ concentration threshold above which indicates a high amount of rebreathed air and increased risk of TB transmission. This level falls in line with regulations in other industrialized nations.

During the monitoring study, the authors found that students may spend up to 60% of their time in classrooms with CO₂ levels above the 1000 ppm threshold, at risk for TB transmission. The classrooms with the highest levels of CO₂ had windows on only one side of the room. Although calculating the CO₂ threshold may differ depending on the variables used, given the high instances of TB-positive high school adolescents in South Africa, the authors recommend increasing natural ventilation, which will lower CO₂ concentrations and reduce the risk of spreading TB in schools. This recommendation may be one low-cost intervention for helping control the TB epidemic in areas of high prevalence.

Eugene Richardson added, "It seems that -- in an era of effective treatment -- current TB prevention programs have become complacent in promoting the prevention benefits of ventilation."