Ambient air pollutants, diabetes and risk of newly diagnosed drug-resistant tuberculosis.
Ecotoxicol Environ Saf
; 219: 112352, 2021 Aug.
Article
em En
| MEDLINE
| ID: mdl-34044311
ABSTRACT
BACKGROUND:
Drug-resistant tuberculosis (DR-TB), diabetes and exposure to air pollution are thought to be important threat to human health, but no studies have explored the effects of ambient air pollutants on DR-TB when adjusting diabetes status so far.METHODS:
We performed a study among 3759 newly diagnosed TB cases with drug-susceptibility testing results, diabetes status, and individual air pollution data in Shandong from 2015 to 2019. Generalized linear mixed models (GLMM) including three models (Model 1 without covariates, Model 2 adjusted by diabetes status only, Model 3 with all covariates) were applied.RESULTS:
Of 3759 TB patients enrolled, 716 (19.05%) were DR-TB, and 333 (8.86%) had diabetes. High exposure to O3 was associated with an increased risk of RFP-resistance (Model 2 or 3 odds ratio (OR)â¯=â¯1.008, 95% confidence intervals (CI) 1.002-1.014), ethambutol-resistance (Model 3 ORâ¯=â¯1.015, 95%CI 1.004-1.027) and any rifampicin+streptomycin resistance (Model 1,2,3 ORâ¯=â¯1.01, 95%CI 1.002-1.018) at 90 days. In contrast, NO2 was associated with a reduced risk of DR-TB (Model 3 ORâ¯=â¯0.99, 95%CI 0.981-0.999) and multidrug-resistant TB (MDR-TB) (Model 3 ORâ¯=â¯0.977, 95%CI 0.96-0.994) at 360 days. Additionally, SO2 (Model 1, 2, 3 ORâ¯=â¯0.987, 95%CI 0.977-0.998) showed a protective effect on MDR-TB at 90 days. PM2.5 (90 days, Model 2 ORâ¯=â¯0.991, 95%CI 0.983-0.999), PM10 (360 days, Model 2 ORâ¯=â¯0.992, 95%CI 0.985-0.999) had protective effects on any RFP+SM resistance.CONCLUSIONS:
O3 contributed to an elevated risk of TB resistance but PM2.5, PM10, SO2, NO2 showed an inverse effect. Air pollutants may affect the development of drug resistance among TB cases by adjusting the status of diabetes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Resistente a Múltiplos Medicamentos
/
Diabetes Mellitus
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Poluição do Ar
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Exposição Ambiental
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Ecotoxicol Environ Saf
Ano de publicação:
2021
Tipo de documento:
Article