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1.
BMC Public Health ; 20(1): 854, 2020 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-32498682

RESUMO

BACKGROUND: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. The current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients. METHODS: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form. RESULTS: Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smokers, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with extrapulmonary TB. Male gender (OR = 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR = 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR = 0.74, 95% CI 0.58-0.95), urban residents (OR = 1.46, 95% CI 1.33-1.61), employed individuals (OR = 1.21, 95% CI 1.09-1.34), alcoholics (OR = 4.91, 95% CI 4.04-5.96), drug abusers (OR = 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR = 1.27, 95% CI 1.16-1.40) all showed significant association with smoking habits. This study found that 3236 (75.0%) patients were successfully treated in the smokers' group, while 4004 (79.7%) patients were non-smokers. The proportion of deaths (6.6%, n = 283), defaulters (6.6%, n = 284) and treatment interruptions (4.7%, n = 204) was higher in the smokers' group. CONCLUSIONS: Smoking has a strong influence on TB and is a major barrier towards treatment success (OR = 0.76, 95% CI 0.69-0.84, p < 0.001). Therefore, the findings indicate that smoking cessations are an effective way to decrease treatment failure and drug resistance.

2.
Am J Physiol Lung Cell Mol Physiol ; 318(5): L1004-L1007, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32233791
3.
Alcohol ; 86: 113-119, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32325101

RESUMO

Collaborative activities to address tobacco addiction among tuberculosis (TB) patients are in place in India. The research was carried out to estimate the prevalence and to determine the predictors of hazardous alcohol use among pulmonary TB patients, assessing the need for joint TB-alcohol collaborative activities. It was a cross-sectional study carried out among 200 drug-sensitive pulmonary TB patients of Bhavnagar city of Gujarat using the "Alcohol Use Disorder Identification Test" (AUDIT), with patients scoring ≥8 on AUDIT said to be having hazardous alcohol use. The prevalence of hazardous alcohol use among drug-sensitive pulmonary tuberculosis patients was found to be 20% (95% CI = 15%-26%). On applying multiple logistic regression, regular use of smokeless tobacco (adjusted Odds Ratio aOR = 5, 95% CI = 1.8-14.9, p = 0.002), history of alcohol use by father (aOR = 4, 95% CI = 1.7-10.2, p = 0.002), residing at a place where spurious liquor was being brewed (aOR = 4.8, 95% CI = 1.4-16.4, p = 0.012), and belonging to scheduled caste/scheduled tribe (SC/ST) (aOR = 2.7, 95% CI = 1.1-6.8, p = 0.034) were the significant predictors for hazardous alcohol use. It is concluded from the study that one-fifth of drug-sensitive pulmonary tuberculosis patients in Bhavnagar have hazardous alcohol use. The study calls for joint TB-alcohol collaborative activities in India.

4.
Int J Tuberc Lung Dis ; 24(2): 170-175, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32127100

RESUMO

BACKGROUND: Cigarette smoking contributes to tuberculosis (TB) epidemiology. However, limited evidence exists on how smoking impacts TB treatment outcomes such as treatment loss to follow-up and culture conversion.METHODS: This meta-analysis assessed current evidence of the impact of active cigarette smoking on TB treatment outcomes. PubMed, Scopus, Embase, and the Cochrane Library were searched for English-language articles published from database inception through 2017. Articles addressing active pulmonary TB and cigarette smoking were identified and data abstracted. Smokers were defined as those who smoked every day or some days at the time of interview/diagnosis. Non-smokers did not smoke at the time of interview/diagnosis. Unfavorable outcomes included any outcome other than cure or completion of TB treatment. Three different data sets were examined: 8 articles addressing unfavorable treatment outcomes, 9 analyzing only treatment loss to follow-up, and 5 addressing delayed smear or culture conversion. Studies that had <20 subjects or that addressed only populations with comorbidities were excluded.RESULTS: We identified 1030 studies; 21 studies fulfilled the inclusion/exclusion criteria. Smokers had greater odds of unfavorable outcomes (pooled odds ratio [pOR] 1.23, 95%CI 1.14-1.33), delayed smear or culture conversion (pOR 1.55, 95%CI 1.04-2.07), and treatment loss to follow-up (pOR 1.35, 95%CI 1.21-1.50).CONCLUSION: Cigarette smoking is associated with negative treatment results and delayed conversion to negative smear or culture, suggesting smoking is an important factor for consideration in TB elimination efforts.

5.
Epidemiol Serv Saude ; 28(3): e2018294, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32022216

RESUMO

OBJECTIVE: to describe drug-resistant tuberculosis (DR-TB) notifications in Brazil. METHODS: this is a descriptive study of clinical and epidemiological characteristics of DR-TB notifications in 2014 on SITETB and TBWeb, these being information systems on which cases involving special treatment regimens are registered. RESULTS: there were 1,574 cases, 94.8% of which had the pulmonary form, 27.6% involved primary resistance, and 50.9% were multidrug-resistant; 70.6% of cases were male, 87.0% were between 20 and 59 years old, 60.9% were of Afro-Brazilian, and 68.0% had less than 8 years of schooling; as for comorbidities, 13.1% of patients had AIDS, 11.3% had diabetes, 25.8% made harmful use of alcohol, 21.0% were illegal drugs users, and 22.2% were tobacco users. CONCLUSION: the majority of DR-TB notifications were related to men, young people, Afro-Brazilian and people with low levels of education; there was a high percentage of primary resistance, as well as multidrug-resistance and comorbidities, with emphasis on substance use.

6.
Rev Med Liege ; 75(2): 100-104, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32030934

RESUMO

Tuberculosis (TB) and smoking are causing a heavy mortality worldwide. Tobacco smoke increases the risk of Mycobacterium tuberculosis infection and tuberculosis disease, including severe pulmonary tuberculosis, resistant bacilli forms and death from this disease. Smoking patients with TB have poorer compliance with treatment of tuberculosis than non-smokers. In countries with high TB incidence and smoking prevalence tending to increase, smoking cessation is a means of controlling the TB epidemic. Stopping smoking improves the course of tuberculosis and promotes its final cure, it is accompanied by a better therapeutic observance. WHO recommended coordination between national tuberculosis and tobacco control programs to optimize control of the TB epidemic. The mobilization of health professionals in helping smokers with tuberculosis stopping smoking is required.


Assuntos
Abandono do Hábito de Fumar , Tuberculose Pulmonar , Humanos , Fumantes , Fumar
7.
Genomics ; 112(2): 1223-1232, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31306748

RESUMO

We investigated whether genetic susceptibility to tuberculosis (TB) influences lung adenocarcinoma development among never-smokers using TB genome-wide association study (GWAS) results within the Female Lung Cancer Consortium in Asia. Pathway analysis with the adaptive rank truncated product method was used to assess the association between a TB-related gene-set and lung adenocarcinoma using GWAS data from 5512 lung adenocarcinoma cases and 6277 controls. The gene-set consisted of 31 genes containing known/suggestive associations with genetic variants from previous TB-GWAS. Subsequently, we followed-up with Mendelian Randomization to evaluate the association between TB and lung adenocarcinoma using three genome-wide significant variants from previous TB-GWAS in East Asians. The TB-related gene-set was associated with lung adenocarcinoma (p = 0.016). Additionally, the Mendelian Randomization showed an association between TB and lung adenocarcinoma (OR = 1.31, 95% CI: 1.03, 1.66, p = 0.027). Our findings support TB as a causal risk factor for lung cancer development among never-smoking Asian women.

8.
Indian J Tuberc ; 66(4): 555-560, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31813448

RESUMO

BACKGROUND: Ending the TB epidemic by 2030 is among the key targets for countries to achieve Sustainable Development Goals. In current times we are grappling with dual burden of tuberculosis as well as tobacco use. METHODS: There is sufficient evidence to establish that tobacco smoking significantly spikes up the risk of acquiring, developing and death among tuberculosis patients. Active or passive exposure to tobacco smoke is significantly associated with tuberculosis infection and tuberculosis disease, independent of a large number of other potential confounders. RESULTS: Despite having substantial evidence about the impact of tobacco control measures, particularly tobacco cessation, on TB outcomes, the integration of TB and tobacco control still remains far-off. CONCLUSION: It is high time when TB control programs must begin to address tobacco control as a potential preventive intervention to combat colliding epidemics of tobacco and tuberculosis. This white paper discusses about the role of tobacco control in reaching the ambitious goal of ending TB epidemic by 2030.


Assuntos
Abandono do Hábito de Fumar , Tuberculose Pulmonar/epidemiologia , Epidemias/prevenção & controle , Saúde Global , Humanos , Tuberculose Pulmonar/prevenção & controle
9.
Toxicol Rep ; 6: 1230-1239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31799123

RESUMO

Tuberculosis is one of the major causes of illnesses and deaths throughout world particularly in Asia. Smoking is linked with tuberculosis recurrence and its mortality and may influence bacteriological conversion, clinical symptoms and treatment outcome. The aim of current study was to estimate association among essential trace elements {zinc (Zn), iron (Fe) and copper (Cu)} in human biological samples particularly blood, serum, scalp hair, saliva, sputum, and nasal fluid of smoking and nonsmoking pulmonary tuberculosis patients (n = 165, age ranged 16-35 years) residents of Hyderabad, Pakistan. The biological samples of age matched healthy controls were chosen as referents of both genders (n = 171) for the comparison purpose. The human biological samples were wet digested in microwave oven by 65 % HNO3 and 30 % H2O2 with (2:1) ratio. The concentrations of elements in acid digested samples were determined by atomic absorption spectrometry. The average zinc and iron concentration was lower, while level of copper was higher in the biological samples of pulmonary Tuberculosis patients as compared to referent subjects (p < .001). It was also concluded as a result of Zn and Fe deficiency combined with high contact of copper due to smoking of tobacco can be synergistic with the risk factors related with pulmonary tuberculosis.

10.
Tob Induc Dis ; 17: 69, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31582957

RESUMO

INTRODUCTION: Smoking cessation should be part of tuberculosis (TB) treatment, but a cessation service is not available as part of a routine TB service in most low- and middle-income countries. WHO and The International Union Against Tuberculosis and Lung Disease (The Union) issued a guideline and China implemented a pilot project 5 years ago. This study aimed to determine changes in smoking status among TB patients at 5 years after completion of anti-TB treatment to observe long-term outcome of a smoking cessation project whose baseline characteristics were associated with a relapse of smoking behavior. METHODS: A prospective longitudinal study was conducted 5 years after completion of anti-TB treatment to assess changes in patient smoking status against individual baseline data that were entered into a database at the time of TB registration. The patients were tracked by trained village doctors and validated by township health staff. Their smoking status was assessed and entered into the database and analysed. RESULTS: Of the 800 TB patients registered at baseline, 650 (81.2%) were tracked. Ninety-one (11.4%) patients died and 59 (7.4%) were lost to follow-up. The rates of remaining non-smoking after 5 years were 82.0%, 63.0%, 49.6%, 43.5% and 30.0%, respectively for non-smokers, ex-smokers, current smokers who received cessation intervention, recent quitters, and current smokers not on a cessation intervention. The odds of smoking relapse were significantly higher for those aged ≥65 years (p=0.003) and registered in Xingguo County (p=0.025). CONCLUSIONS: Findings from this study confirmed that non-smokers, ex-smokers and current smokers who received cessation intervention at baseline maintained higher non-smoking rates compared with those who did not receive the intervention. To prevent relapse, intensive cessation support should be given to TB patients aged ≥65 years. TB programme managers need to ensure integration and provision of smoking cessation advice and smoke-free policy in routine TB services.

11.
Lung ; 197(6): 793-801, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31583454

RESUMO

CONTEXT: Observational studies investigating household air pollution (HAP) exposure to biomass fuel smoke as a risk factor for pulmonary tuberculosis have reported inconsistent results. OBJECTIVE: To evaluate the association between HAP exposure and the prevalence of self-reported previous pulmonary tuberculosis. DESIGN: We analyzed pooled data including 12,592 individuals from five population-based studies conducted in Latin America, East Africa, and Southeast Asia from 2010 to 2015. We used multivariable logistic regression to model the association between HAP exposure and self-reported previous pulmonary tuberculosis adjusted for age, sex, tobacco smoking, body mass index, secondary education, site and country of residence. RESULTS: Mean age was 54.6 years (range of mean age across settings 43.8-59.6 years) and 48.6% were women (range of % women 38.3-54.5%). The proportion of participants reporting HAP exposure was 38.8% (range in % HAP exposure 0.48-99.4%). Prevalence of previous pulmonary tuberculosis was 2.7% (range of prevalence 0.6-6.9%). While participants with previous pulmonary tuberculosis had a lower pre-bronchodilator FEV1 (mean - 0.7 SDs, 95% CI - 0.92 to - 0.57), FVC (- 0.52 SDs, 95% CI - 0.69 to - 0.33) and FEV1/FVC (- 0.59 SDs, 95% CI - 0.76 to - 0.43) as compared to those who did not, we did not find an association between HAP exposure and previous pulmonary tuberculosis (adjusted odds ratio = 0.86; 95% CI 0.56-1.32). CONCLUSIONS: There was no association between HAP exposure and self-reported previous pulmonary tuberculosis in five population-based studies conducted worldwide.

12.
Indian J Tuberc ; 66(3): 353-357, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31439179

RESUMO

BACKGROUND: Several determinants are responsible for different incidences of smear positive pulmonary tuberculosis (TB). The main determinants are cigarette smoking and diabetes mellitus. The aim of this study is to determine the effect of these risk factors effect modifiers in TB/gender association. METHODOLOGY: In this retrospective cohort, relative risk of gender in developing smear positive TB as well as its interaction with smoking and diabetes mellitus were investigated. RESULTS: Of 1243 smear positive TB cases, 63.2% were male. Prevalences of diabetes mellitus among men and women TB cases were 9.2% and 22.9% respectively (p<0.001). Frequency of cigarette smoking among men was significantly higher than that in women (61.7% vs. 7.6% respectively, p<0.001). Male gender, increased the risk of developing smear positive TB as of 98% and 5% in smokers and non-smokers respectively (p=0.001), indicating an interaction between gender and smoking in the effect on TB. In addition, male gender increased the risk of TB as of 13% and 34% in patients with and without diabetes mellitus respectively (p=0.300) indicating no interaction between gender and diabetes mellitus on TB incidence. CONCLUSION: Our study showed that cigarette smoking is a determinant factor for gender differences in TB incidence but diabetes mellitus does not affect the association between TB and gender.


Assuntos
Diabetes Mellitus Tipo 2 , Identidade de Gênero , Fumar , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Escarro/microbiologia , Tuberculose Pulmonar/etiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
13.
PLoS One ; 14(7): e0220507, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31365583

RESUMO

BACKGROUND: More than 20% of tuberculosis (TB) disease worldwide may be attributable to smoking and alcohol abuse. India is the second largest consumer of tobacco products, a major consumer of alcohol particularly among males, and has the highest burden of TB globally. The impact of increasing tobacco dose, relevance of alcohol misuse and past versus current or never smoking status on TB treatment outcomes remain inadequately defined. METHODS: We conducted a multi-centric prospective cohort study of newly diagnosed adult pulmonary TB patients initiated on TB treatment and followed for a minimum of 6 months to assess the impact of smoking status with or without alcohol abuse on treatment outcomes. Smokers were defined as never smokers, past smokers or current smokers. Alcohol Use Disorder Identification Test (AUDIT) scores were used to assess alcohol misuse. The association between smoking status and treatment outcomes was assessed in univariate and multivariate random effects poisson regression models. RESULTS: Of 455 enrolled, 129 (28%) had a history of smoking with 94 (20%) current smokers and 35 (8%) past smokers. Unfavourable treatment outcomes were significantly higher among past and current smokers as compared to never smokers. Specifically, the risk of treatment failure was significantly higher among past smokers (aIRR = 2.66, 95% CI: 1.41-4.90, p = 0.002), recurrent TB among current smokers (aIRR = 2.94, 95% CI: 1.30-6.67, p = 0.010) and death among both past (2.63, 95% CI: 1.11-6.24, p = 0.028) and current (aIRR = 2.59, 95% CI: 1.29-5.18, p = 0.007) smokers. Furthermore, the combined effect of alcohol misuse and smoking on unfavorable treatment outcomes was significantly higher among past smokers (aIRR: 4.67, 95% CI: 2.17-10.02, p<0.001) and current smokers (aIRR: 3.58, 95% CI: 1.89-6.76, p<0.001). CONCLUSION: Past and current smoking along with alcohol misuse have combined effects on increasing the risk of unfavourable TB treatment outcomes. Innovative interventions that can readily address both co-morbidities are urgently needed.


Assuntos
Alcoolismo/complicações , Antituberculosos/uso terapêutico , Mycobacterium tuberculosis/efeitos dos fármacos , Fumar/efeitos adversos , Tuberculose/mortalidade , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Taxa de Sobrevida , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Tuberculose/etiologia
14.
Trials ; 20(1): 457, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349850

RESUMO

BACKGROUND: South Africa is among the seven highest tuberculosis (TB) burden countries. Harmful lifestyle behaviours, such as smoking and alcohol, and poor adherence to medication can affect clinical outcomes. Modification of these behaviours is likely to improve TB treatment outcomes and has proven possible using motivational interviewing (MI) techniques or use of short message service (SMS) text messaging. There have been no studies assessing the effect of combined MI and SMS interventions on multiple lifestyle factors and TB treatment outcomes. METHODS: This is a prospective, multicentre, two-arm individual randomised controlled trial looking at the effectiveness and cost-effectiveness of a complex behavioural intervention (the ProLife programme) on improving TB and lifestyle-related outcomes in three provinces of South Africa. The ProLife programme consists of an MI counselling strategy, delivered by lay health workers, augmented with subsequent SMS. We aim to recruit 696 adult participants (aged 18 years and over) with drug-sensitive pulmonary TB who are current smokers and/or report harmful or hazardous alcohol use. Patients will be consecutively enrolled at 27 clinics in three different health districts in South Africa. Participants randomised individually to the intervention arm will receive three MI counselling sessions one month apart. Each MI session will be followed by twice-weekly SMS messages targeting treatment adherence, alcohol use and tobacco smoking, as appropriate. We will assess the effect on TB treatment success, using standard World Health Organization (WHO) treatment outcome definitions (primary outcome), as well as on a range of secondary outcomes including smoking cessation, reduction in alcohol use, and TB medication and anti-retroviral therapy adherence. Secondary outcomes will be measured at the three-month and six-month follow-ups. DISCUSSION: This trial aligns with the WHO agenda of integrating TB care with the care for chronic diseases of lifestyle, such as provision of smoking cessation treatments, and with the use of digital technologies. If the ProLife programme is found to be effective and cost-effective, the programme could have significant implications for TB treatment globally and could be successfully implemented in a wide range of TB treatment settings. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN62728852. Registered on 13 April 2018.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Antituberculosos/uso terapêutico , Comportamentos Relacionados com a Saúde , Entrevista Motivacional , Comportamento de Redução do Risco , Envio de Mensagens de Texto , Tuberculose/tratamento farmacológico , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Adesão à Medicação , Estudos Multicêntricos como Assunto , Ensaios Clínicos Pragmáticos como Assunto , Estudos Prospectivos , Abandono do Hábito de Fumar , África do Sul , Fatores de Tempo , Resultado do Tratamento , Tuberculose/diagnóstico , Tuberculose/microbiologia , Tuberculose/psicologia
15.
Washington, D.C.; OPS; 2019-07-02.
em Espanhol | PAHO-IRIS | ID: phr-51351

RESUMO

[Introducción]. Este material de autoayuda se preparó a partir del módulo 4 de capacitación de la Organización Mundial de la Salud (OMS) sobre el fortalecimiento de los sistemas de salud para tratar la dependencia del tabaco a nivel de la atención primaria y de la publicación “Una monografía de la OMS y La Unión sobre control del tabaco y la tuberculosis: Unir esfuerzos para controlar dos epidemias mundiales relacionadas”. Está dirigido a las personas que tienen tuberculosis (TB) y que fuman. Su objetivo es brindar consejos e información a fin de mejorar la disposición del fumador para abandonar el tabaco y ayudar a aquellos que ya están preparados para dejar de fumar a planificar su intento. El contenido de este material de autoayuda se divide en tres partes: 1. Cómo prepararse para dejar de fumar (para personas con TB que no están listas para abandonar el tabaco, con énfasis en los riesgos que el consumo de tabaco suma a la TB). 2. Cómo planificar y hacer el intento de dejar de fumar (para personas con TB que están listas para abandoner el tabaco). 3. Recursos locales de apoyo al abandono del tabaco.


Assuntos
Abandono do Uso de Tabaco , Tuberculose Pulmonar , Redução do Consumo de Tabaco
16.
Washington, D.C.; OPS; 2019-07-02.
em Espanhol | PAHO-IRIS | ID: phr-51350

RESUMO

[Introducción]. Este material de autoayuda se preparó a partir del módulo 4 de capacitación de la OMS sobre el fortalecimiento de los sistemas de salud para tratar la dependencia del tabaco a nivel de la atención primaria y de la publicación “Una monografía de la OMS y la Unión sobre la tuberculosis y el control del tabaco: Unir esfuerzos para controlar dos epidemias mundiales relacionadas”. La publicación está dirigida al personal de salud que brinda atención a personas con tuberculosis, y su objetivo es servir de guía de referencia rápida para ayudarles a suministrar intervenciones breves contra el consumo de tabaco como parte de su práctica habitual a nivel de la atención primaria. El contenido de este documento incluye: 1. La tuberculosis y el consumo de tabaco: Una combinación letal 2. Papel protagónico del personal de salud que brinda atención a personas con tuberculosis en cuanto al control del Tabaco 3. Aspectos básicos del consumo y la dependencia del Tabaco 4. Modelo de las 5A para ayudar a las personas que están listas para dejar de fumar; 5. Modelo de las 5R para aumentar la motivación para dejar de fumar; 6. Uso de las 5A para evitar la exposición al humo de tabaco.


Assuntos
Guia de Prática Clínica , Uso de Tabaco , Tuberculose Pulmonar , Abandono do Uso de Tabaco
17.
BMC Infect Dis ; 19(1): 532, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208362

RESUMO

BACKGROUND: There is controversy regarding the relative influence of 'exogenous' versus 'endogenous' factors on the risk of progression from latent tuberculosis infection to active tuberculosis (TB) disease in children. METHODS: We conducted a cross-sectional analysis to identify risk factors for active tuberculosis in QuantiFERON®-TB Gold (QFT-G)-positive children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Children underwent clinical and radiological screening for active tuberculosis, and data relating to potential risk factors for disease progression were collected by questionnaire and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios were calculated using generalized estimating equations with adjustment for potential confounders. RESULTS: 129/938 (13.8%) QFT-positive children were diagnosed with active tuberculosis. Risk of active tuberculosis was independently associated with household exposure to pulmonary TB (adjusted risk ratio [aRR] 2.40, 95% CI 1.74 to 3.30, P < 0.001), month of sampling (adjusted risk ratio [aRR] for March-May vs. June-November 3.31, 95% CI 1.63 to 6.74, P < 0.001; aRR for December-February vs. June-November 2.53, 95% CI 1.23 to 5.19, P = 0.01) and active smoking by the child (aRR 5.23, 95% CI 2.70 to 10.12, P < 0.001). No statistically significant independent association was seen for age, sex, socio-economic factors, presence of a Bacillus Calmette-Guérin (BCG) scar, tobacco exposure or vitamin D status. CONCLUSIONS: Household exposure to active TB, winter or spring season and active smoking were independently associated with risk of active tuberculosis in QFT-positive children. Our findings highlight the potentially high yield of screening child household contacts of infectious index cases for active tuberculosis in low- and middle-income countries.


Assuntos
Tuberculose Latente/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Criança , Estudos Transversais , Progressão da Doença , Feminino , Testes Hematológicos/métodos , Humanos , Tuberculose Latente/diagnóstico , Masculino , Programas de Rastreamento , Mongólia/epidemiologia , Mycobacterium bovis , Razão de Chances , Fatores de Risco , Fumar , Inquéritos e Questionários , Tuberculose Pulmonar/diagnóstico , Vitamina D/análogos & derivados , Vitamina D/sangue
18.
Am J Infect Control ; 47(11): 1324-1328, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31204093

RESUMO

BACKGROUND: Currently, very little data exists that compare the features of pulmonary nontuberculous mycobacteria (NTM) and Mycobacterium tuberculosis (TB). Both have similar symptomology and analogous preliminary laboratory results, as both present with positive acid-fast bacilli stains. The objective of this study was to provide data that would help guide clinicians in their decision making regarding isolation precautions for patients, with a preliminary positive result for mycobacteria, prior to species identification. METHODS: We conducted queries for patients who had positive respiratory cultures for mycobacteria via our electronic medical record system, between January 1, 2011, and December 31, 2017. Additionally, we collected demographic and medical history, clinical presentation, and radiographic findings. The 2-sample unpaired Student t test, the Χ2 test, and logistic regression were used to compare each group. RESULTS: Through logistic regression, 8 variables were significantly associated with patients who grew either TB or NTM. History of incarceration, born outside of the United States, cavitation, and lymphadenopathy were associated with TB; tobacco smoke exposure, pre-existing lung disease, immunosuppression, and bronchiectasis were associated with NTM. Incidence of HIV and hemoptysis was not significantly different between the 2 groups. CONCLUSIONS: Through the use of our study findings, improper use of airborne isolation precautions may be reduced or avoided.

19.
Artigo em Inglês | MEDLINE | ID: mdl-31137851

RESUMO

BACKGROUND: Occupational crystalline silica dust exposure is associated with an elevated risk of pulmonary tuberculosis (PTB). However, there is less evidence for an association with environmental silica dust exposure. METHODS: A cross-sectional study of 310 participants was conducted in an exposed community living within 2 km of gold mine tailings and an unexposed population residing more than 10 km from the nearest gold mine tailing. Chest radiographs (n = 178) were read for PTB, past or current, by three readers. RESULTS: Past or current PTB was radiologically identified in 14.4% (95%CI 9.2-21.8) in the exposed and 7.5% (95%CI 2.8-18.7) in the unexposed groups. Multivariate logistic regression models suggested that PTB prevalence was independently associated with exposure to second-hand smoke (OR = 8.13, 95%CI 1.16-57.22), a lower body mass index (OR = 0.88, 95%CI 0.80-0.98), previous diagnosis and treatment of PTB (OR = 8.98, 95%CI 1.98-40.34), and exposure to dust in the workplace from sand, construction, and/or mining industries (OR = 10.2, 95%CI 2.10-50.11). CONCLUSION: We found no association between PTB and environmental exposure to gold mine tailing dust. However, workplace silica dust exposure is a significant risk factor for PTB in South Africa, and PTB patients of working age should be screened for silica exposure.


Assuntos
Poeira/análise , Exposição Ambiental/análise , Dióxido de Silício/análise , Tuberculose Pulmonar/epidemiologia , Adulto , Idoso , Estudos Transversais , Feminino , Ouro , Humanos , Masculino , Pessoa de Meia-Idade , Mineração , Doenças Profissionais/epidemiologia , Prevalência , Fatores de Risco , África do Sul/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Tuberculose Pulmonar/diagnóstico , Adulto Jovem
20.
J Bras Pneumol ; 45(2): e20180359, 2019 Apr 25.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31038651

RESUMO

OBJECTIVE: To determine the association between smoking and pulmonary tuberculosis treatment failure. METHODS: This was a case-control study conducted at the Brazilian Institute for Tuberculosis Research in the city of Salvador, Brazil, between 2007 and 2015. We evaluated 284 patients treated for pulmonary tuberculosis, comparing 50 cases of treatment failure with 234 control cases in which the final outcome was cure. RESULTS: Treatment failure was attributed to smoking and age rather than to gender, income, level of education, alcohol consumption, or marital status. Therefore, even after adjustment for age, the risk of treatment failure was 2.1 times (95% CI: 1.1-4.1) higher among the patients with a history of smoking. In addition, being over 50 years of age was found to increase the likelihood of treatment failure by 2.8 times (95% CI: 1.4-6.0). CONCLUSIONS: Smoking and aging are both associated with pulmonary tuberculosis treatment failure. Therefore, as part of a tuberculosis control program, health personnel should be prepared to offer strategies to promote smoking cessation and should be more careful with older patients.


Assuntos
Fumar/efeitos adversos , Tuberculose Pulmonar/terapia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/efeitos adversos , Brasil , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Falha de Tratamento
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