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Pourali F, Khademloo M, Abedi S, Roozbeh F, Barzegari S, Moosazadeh M. Relationship between smoking and tuberculosis recurrence: A systematic review and meta-analysis. Indian J Tuberc 2023; 70:475-482. [PMID: 37968054 DOI: 10.1016/j.ijtb.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Of the problems in tuberculosis (TB) control program is the recurrence of this disease. In some studies, smoking has been reported as the most important risk factor. Therefore, the present study aimed at examining the association between smoking and tuberculosis recurrence using meta-analysis. METHODS To report the findings of this meta-analysis, we used PRISMA. The protocol of this study has been recorded in PROSPERO. The research question has been formulated based on PICO, and the search was performed using both MeSH and non-MeSH keywords. After screening and selecting the articles and evaluating their quality using the NOS checklist, the overall estimate of the odds ratio of tuberculosis recurrence in smokers was assessed with a 95% confidence interval. RESULTS Fourteen studies met the inclusion criteria. The total number of samples in the group of patients with tuberculosis recurrence was 1988 with 855 (43%) smokers, and in the group of patients affected by tuberculosis without recurrence, it was 27,226 with 7503 (27.56%) smokers. In 13 studies, the odds ratio of tuberculosis recurrence was higher in smokers; this difference was statistically significant in 12 of them. Combining the results of these 14 studies, the odds ratio of tuberculosis recurrence in smokers was 2.10 times higher, using the random effects model (95% CI:1.69, 2.61). CONCLUSION Based on the results of study present, smoking increases the risk of tuberculosis recurrence. Therefore, to eradicate tuberculosis by 2030, more serious interventions should be taken to quit smoking, which in turn reduces the incidence of tuberculosis.
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Affiliation(s)
- Fatemeh Pourali
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Khademloo
- Department of Community Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavosh Abedi
- Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Roozbeh
- Health Deputy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Barzegari
- Department of Paramedicine, Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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Tengku Khalid TNF, Wan Mohammad WMZ, Ab Samat R, Nik Husain NR. Predictors of tuberculosis disease in smokers: a case-control study in northeastern Malaysia. PeerJ 2022; 10:e13984. [PMID: 36093335 PMCID: PMC9462367 DOI: 10.7717/peerj.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/10/2022] [Indexed: 01/21/2023] Open
Abstract
Objective Tuberculosis (TB) is a leading infectious disease. However, many TB cases remain undetected and only present symptoms at a late stage of the infection. Therefore, targeted TB screening in high-risk populations, including smokers, is crucial. This study aimed to determine the predictors of TB disease among the smoker population in northeast Malaysia from 2019 to 2020. Methods A case-control study was conducted involving smokers aged 18 years and older from health clinics in Bachok Kelantan, Malaysia. Data were collected via face-to-face interviews or telephone calls from 159 participants, randomly selected from outpatient TB records. Simple and multiple logistic regression, using R software, were used to identify the determinants of TB. Results Most participants were male (59.1%) and had a secondary education (56.0%). Active smokers constituted 35.2% of the group, and the mean (SD) duration of exposure to smoking was 23.9 (16.47) and 18.4 (12.84) years for the case and control groups, respectively. Being an ex-smoker (adjusted odds ratio (AOR) 6.17; 95% CI [1.55-28.32]; p = 0.013), weight loss (AOR 13.45; 95% CI [4.58-44.46]; p < 0.005), night sweats (AOR 63.84; 95% CI [8.99-1392.75]; p < 0.005) and duration of symptoms (AOR 1.02; 95% CI [1.01-1.04]; p = 0.022) were shown to be significant predictors for TB disease. Conclusion Four predictors of TB disease in the population of smokers were recognised in this study and should be prioritised for early TB screening and diagnosis. This may help increase TB detection, initiate prompt treatment and reduce complications among the group at risk for TB.
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Affiliation(s)
- Tengku Noor Farhana Tengku Khalid
- Universiti Sains Malaysia, Department of Community Medicine, School of Medical Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Wan Mohd Zahiruddin Wan Mohammad
- Universiti Sains Malaysia, Department of Community Medicine, School of Medical Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Razan Ab Samat
- Bachok District Health Office, Bachok, Kelantan, Malaysia
| | - Nik Rosmawati Nik Husain
- Universiti Sains Malaysia, Department of Community Medicine, School of Medical Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
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Shafiek H, Shabana A, El-Seedy A, Khalil Y. P2X7 1513A/C loss-of-function polymorphism and active tuberculosis disease in a cohort of Egyptian population: a pilot study. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00304-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) is a multifactorial disease, and increasing evidence shows that genetic variants in regulating genes of immune response confer susceptibility to active TB at the individual level. We aimed to identify the contribution of P2X7 receptor 1513A/C genetic polymorphisms to different clinical forms of active tuberculosis in a cohort of Egyptian population.
Methods
A case–control study that enrolled 25 newly diagnosed pulmonary TB (PTB) patients by positive sputum for AFB or positive culture, 25 extrapulmonary TB (EPTB) diagnosed by pathological/bacteriological/immunological studies and 25 healthy controls. A blood sample was taken before starting of therapy for P2X7 1513A/C polymorphism genotyping using PCR-restriction fragment length polymorphism.
Results
Fifty-two percent of the participants were in the third decade with equal gender distribution. P2X7 receptor 1513AA (homozygote wild), AC (heterozygote) and CC (homozygote mutant) genotypes were identified. AC and CC genotypes distribution were significantly more frequent in the active TB cases (either PTB or EPTB) rather than controls (p < 0.05). Further, P2X7 1513A/C genotypes’ distribution did not associate with old TB or gender (p > 0.05), but significantly associated with history of smoking (x2 trend analysis p = 0.036).
Conclusions
There is positive association between P2X7 receptor 1513A/C polymorphism and active tuberculosis in the Egyptians.
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de Haro-Acosta J, Jacobo-Delgado YM, Rodríguez-Carlos A, Torres-Juárez F, Araujo Z, Serrano CJ, Gonzalez-Curiel I, Hernández-Pando R, Salinas E, Rivas-Santiago B. Nicotine associates to intracellular Mycobacterium tuberculosis inducing genes related with resistance to antimicrobial peptides. Exp Lung Res 2021; 47:487-493. [PMID: 34809501 DOI: 10.1080/01902148.2021.2006829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tobacco consumption is related to an increased risk to develop tuberculosis. Antimicrobial peptides are essential molecules in the response to Mycobacterium tuberculosis (Mtb) because of their direct antimicrobial activity. The aim of this study was to demonstrate that nicotine enters into Mtb infected epithelial cells and associates with the mycobacteria inducing genes related to antimicrobial peptides resistance. Epithelial cells were infected with virulent Mtb, afterwards cells were stimulated with nicotine. The internalization of nicotine was followed using electron and confocal microscopy. The lysX expression was evaluated isolating mycobacterial RNA and submitted to RT-PCR analysis. Our results indicated that nicotine promotes Mtb growth in a dose-dependent manner in infected cells. We also reported that nicotine induces lysX expression. In conclusion, nicotine associates to intracellular mycobacteria promoting intracellular survival.
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Affiliation(s)
- Jeny de Haro-Acosta
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.,Laboratory of Immunology, Department of Microbiology, Center of Basic Sciences, Autonomous University of Aguascalientes, Aguascalientes, Mexico
| | | | - Adrian Rodríguez-Carlos
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - Flor Torres-Juárez
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - Zaida Araujo
- Laboratory of Immunology of Infectious Diseases, Instituto de Biomedicina "Dr. Jacinto Convit", Central University of Venezuela, Caracas, Venezuela
| | - Carmen J Serrano
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - Irma Gonzalez-Curiel
- Laboratory of Immunotoxicology and Experimental Therapeutics, Post-graduate program in Sciences and Chemical Technology, Chemistry Sciences School, University Autonomous of Zacatecas, Zacatecas, Mexico
| | - Rogelio Hernández-Pando
- Laboratory of Experimental Pathology, Nacional Institute of Medical Sciences and Nutrition "Salvador-Zubiran", Mexico City, Mexico
| | - Eva Salinas
- Laboratory of Immunology, Department of Microbiology, Center of Basic Sciences, Autonomous University of Aguascalientes, Aguascalientes, Mexico
| | - Bruno Rivas-Santiago
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
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Alsharani F, Zafar M, Omar EO, Muzaheed. Lifestyle Risk Factors Associated with Tuberculosis Patients in Asir Region of Saudi Arabia. Int J Prev Med 2021; 12:89. [PMID: 34584655 PMCID: PMC8428305 DOI: 10.4103/ijpvm.ijpvm_211_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 06/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background: Tuberculosis remains to be a major public health problem. Lifestyle factors that have indirectly influence to the burden of tuberculosis. The aim of this study is to determine the lifestyle risk factors associated with tuberculosis patients in Asir region of KSA. Methods: We conducted a case-control study at the military hospital of Asir region of KSA. A total of 135 sample which is divided into 67 cases and 67 controls. Cases were included from hospital database between 2017 and 2018. Control were selected from patient attending the same hospital with respiratory disease other than tuberculosis. Data collection done through interview using a structured questionnaire. Lifestyle factors and socio-demographic factors associated with tuberculosis were analyzed using logistic regression. Results: Mean age of study participants (cases and control) are 38.04 ± 9.66 and 40.16 ± 7.72 respectively. Most important factors associated with tuberculosis patients are overweight and obese [OR = 4.40, 95% CI 1.27-15.25 and 2.38 (1.61-9.22)], Smoker [OR = 1.34, 95% CI 0.52-3.43], abnormal sleep at night (<8 hours) [OR = 5.03, 95% CI 1.57-16.10], blue color job worker [OR = 2.69, 95% CI 1.02-7.28], physical exercise <3 days/week [OR = 1.41, 95% CI 1.21-3.47]. Conclusions: In Saudi Arabia, a person's lifestyle and socioeconomic condition are associated with tuberculosis. Interventions focused on improving the quality of life through a reduction of risky lifestyle which prevent the spread of Tuberculosis in Saudi society and improve the efficiency of Saudi national tuberculosis control programme.
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Affiliation(s)
- Faisal Alsharani
- Department of Public Health, Military Hospital Asir Region, Dammam, KSA
| | - Mubashir Zafar
- Department of Family and Community Medicine, College of Medicine, University of Hail, Dammam, KSA
| | - Eltigani Osman Omar
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Muzaheed
- Department of Clinical Laboratory Science, College of Applied Science, Imam Abdulrahman Bin Faisal University, Dammam, KSA
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Moussa N, Kacem JH, Gargouri R, Kallel N, Kammoun S. Clinico-radiological particularities of common pulmonary tuberculosis among smokers in Tunisia. LA TUNISIE MEDICALE 2021; 99:638-643. [PMID: 35244916 PMCID: PMC8795993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
INRODUCTION Smoking and tuberculosis are two major public health issues worldwide, particularly in emerging countries. Currently, the relationship between these two scourges is well established. AIM Describe the clinical, radiological and progressive features of common pulmonary tuberculosis in smokers. METHODS Comparative study, carried out at the Pneumology department of the Hédi Chaker in Sfax, Tunisia, including 120 patients hospitalized for common pulmonary tuberculosis from January 2014 to December 2016 and who completed their follow-ups for a minimum period of 2 years . The patients were divided into 2 groups: Group1 (G1) consisting of 60 smoking patients and Group 2 (G2) consisting of 60 non-smoking patients. To assess the severity of radiological lesions, we used the International Labour Organization classification for simple pneumoconiosis and the Brouet classification. RESULTS The mean age of the patients was comparable in the two groups with a predominance of male for G1 (91%) and female for G2 (70%). The smokers consulted later (113 days versus 60 days (p=0.023). Dyspnea, hemoptysis and chest pain were significantly more frequent in the smokers. The radiological lesions were more serious in smoking group. Bilateral lesions were more observed in smokers (58% vs 25% p = 0.004). A positive association was noted between the extent of radiological lesions, stage 3 and 4 according to the Brouet classification, and smoking status (p <0.001). Similarly for the International Labour Organization classification for simple pneumoconiosis , the radiological lesions were more severe (scores 6 - 15) in the smokers (p <0.001).Smoking was associated with poor adherence (p <0.008), prolonged anti-tuberculosis treatment (p <0.001), delayed RBK negativation in sputum (p <0.001), and more frequent reactivation of tuberculosis (p=0.001). After the diagnosis of CPT, 83% of patients continued to smoke at the same rate and only 7% of patients had quit smoking. CONCLUSION Smoking worsens CPT by making the clinical picture noisier, radiological lesions more aggressive, negativation of BK in sputum later, and reactivation of CPT more frequent.
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Affiliation(s)
- Nadia Moussa
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Jihene Haj Kacem
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Rahma Gargouri
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Nessrine Kallel
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Samy Kammoun
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
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Alipour Fayez E, Moosavi SAJ, Kouranifar S, Delbandi AA, Teimourian S, Khoshmirsafa M, Bolouri MR, Sadeghi Shermeh A, Shekarabi M. The effect of smoking on latent tuberculosis infection susceptibility in high risk individuals in Iran. J Immunoassay Immunochem 2020; 41:885-895. [PMID: 32799615 DOI: 10.1080/15321819.2020.1806075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Tuberculosis has been declared as a global emergency. Latent tuberculosis infection (LTBI) is a state in which host immunity cannot completely eradicate Mycobacterium tuberculosis. Cigarette smoke increases the risk of respiratory infections, such a TB, as it has adverse effects on respiratory immune function. In this cross-sectional study, which was performed from 2016 to 2017, 31 patients with newly diagnosed lung cancer, 63 Chronic obstructive pulmonary disease (COPD), 46 with problems in respiratory system, and 40 healthy subjects were studied. Demographic data of all subjects were recorded via a questionnaire. IGRAs (Interferon-γ release assays) were used to determine LTBI. We showed that smoking has significant odds ratio for COPD patients (OR: 4.58, 95% CI: 1.93-10.87). Also, the concordance of smoking with COPD (OR: 22, 95% CI: 2.7-179.2), lung cancer (OR: 10, 95% CI: 1.03-97), and other respiratory diseases (OR: 4.54, 95% CI: 1.93-10.87) is a significant risk factor for the presence of LTBI whereas the existence of LTBI in the study groups did not show any significant odds ratio. This study is the first to analyze the relationship between smoking in patients with respiratory diseases and LTBI susceptibility in Iran by IGRAs, which proposes cigarette smoking as a powerful risk factor for LTBI.
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Affiliation(s)
- Elham Alipour Fayez
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran
| | | | - Siavash Kouranifar
- Rasoul-e-Akram Hospital, Iran University of Medical Sciences , Tehran, Iran
| | - Ali Akbar Delbandi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran.,Immunology Research Center, Iran University of Medical Sciences , Tehran, Iran
| | - Shahram Teimourian
- Department of Medical Genetics, School of Medicine, Iran University of Medical Sciences , Tehran, Iran
| | - Majid Khoshmirsafa
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran
| | - Mohammad Reza Bolouri
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran
| | - Atefeh Sadeghi Shermeh
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran
| | - Mehdi Shekarabi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences , Tehran, Iran.,Immunology Research Center, Iran University of Medical Sciences , Tehran, Iran
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8
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Divergent Effect of Cigarette Smoke on Innate Immunity in Inflammatory Bowel Disease: A Nicotine-Infection Interaction. Int J Mol Sci 2020; 21:ijms21165801. [PMID: 32823518 PMCID: PMC7461043 DOI: 10.3390/ijms21165801] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 02/07/2023] Open
Abstract
Cigarette smoke (CS) has adverse effects in patients with Crohn’s disease (CD), an inflammatory bowel disease (IBD) that has been associated with microbial infection, immuno-dysregulation, and mucosal dysfunction. However, CS seems to provide relief and protection to patients with another IBD known as ulcerative colitis (UC). These two subsets are featured as M1- and M2-mediated responses, respectively. Nicotine is the most active, addictive, and studied ingredient in CS. The mechanism of how nicotine and/or other CS ingredients induce pro-inflammatory or anti-inflammatory phenotypes in IBD patients remains under investigation. Our most recent in vitro nicotine study provided significant insights toward understanding the contradictory effects of nicotine on IBD patients, and it elucidated the mechanistic role of α7nAChR in modulation of macrophages in tobacco smokers. Shifting the beneficial effect of nicotine to a harmful outcome in CD patients was linked to a nicotine-microbe interaction that supports a microbial etiology in CD pathogenesis. Among the most debated pathogens in CD etiology is Mycobacterium avium subspecies paratuberculosis (MAP). Other studies associated nicotine with upregulation of miR-124 expression in macrophages, which led to anti-inflammatory response. This review discusses published work on the role of nicotine in modulation of the innate immune response and subsequent signaling in macrophages in IBD subsets.
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9
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Reichler MR, Hirsch C, Yuan Y, Khan A, Dorman SE, Schluger N, Sterling TR. Predictive value of TNF-α, IFN-γ, and IL-10 for tuberculosis among recently exposed contacts in the United States and Canada. BMC Infect Dis 2020; 20:553. [PMID: 32736606 PMCID: PMC7394686 DOI: 10.1186/s12879-020-05185-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 06/22/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We examined cytokine immune response profiles among contacts to tuberculosis patients to identify immunologic and epidemiologic correlates of tuberculosis. METHODS We prospectively enrolled 1272 contacts of culture-confirmed pulmonary tuberculosis patients at 9 United States and Canadian sites. Epidemiologic characteristics were recorded. Blood was collected and stimulated with Mycobacterium tuberculosis culture filtrate protein, and tumor necrosis factor (TNF-α), interferon gamma (IFN-γ), and interleukin 10 (IL-10) concentrations were determined using immunoassays. RESULTS Of 1272 contacts, 41 (3.2%) were diagnosed with tuberculosis before or < 30 days after blood collection (co-prevalent tuberculosis) and 19 (1.5%) during subsequent four-year follow-up (incident tuberculosis). Compared with contacts without tuberculosis, those with co-prevalent tuberculosis had higher median baseline TNF-α and IFN-γ concentrations (in pg/mL, TNF-α 129 versus 71, P < .01; IFN-γ 231 versus 27, P < .001), and those who subsequently developed incident tuberculosis had higher median baseline TNF-α concentrations (in pg/mL, 257 vs. 71, P < .05). In multivariate analysis, contact age < 15 years, US/Canadian birth, and IFN or TNF concentrations > the median were associated with co-prevalent tuberculosis (P < .01 for each); female sex (P = .03) and smoking (P < .01) were associated with incident tuberculosis. In algorithms combining young age, positive skin test results, and elevated CFPS TNF-α, IFN-γ, and IL-10 responses, the positive predictive values for co-prevalent and incident tuberculosis were 40 and 25%, respectively. CONCLUSIONS Cytokine concentrations and epidemiologic factors at the time of contact investigation may predict co-prevalent and incident tuberculosis.
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Affiliation(s)
- Mary R Reichler
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Mailstop E-10, 1600 Clifton Road NE, 30329-4027, Atlanta, GA, USA.
| | - Christina Hirsch
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Yan Yuan
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Mailstop E-10, 1600 Clifton Road NE, 30329-4027, Atlanta, GA, USA
| | - Awal Khan
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Mailstop E-10, 1600 Clifton Road NE, 30329-4027, Atlanta, GA, USA
| | - Susan E Dorman
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Neil Schluger
- Department of Medicine, Columbia University, New York, NY, USA
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Lampalo M, Jukić I, Bingulac-Popović J, Stanić HS, Barišić B, Popović-Grle S. THE ROLE OF CIGARETTE SMOKING AND ALCOHOL CONSUMPTION IN PULMONARY TUBERCULOSIS DEVELOPMENT AND RECURRENCE. Acta Clin Croat 2019; 58:590-594. [PMID: 32595242 PMCID: PMC7314290 DOI: 10.20471/acc.2019.58.04.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
During a two-year period (2001-2003), 464 patients were treated for tuberculosis at Jordanovac Department for Lung Diseases in Croatia. Besides pulmonary tuberculosis in 97.7% of patients, patients were also treated for tuberculous pleurisy (0.9%), tuberculous laryngitis (0.6%), tuberculous meningitis (0.2%), tuberculous pericarditis (0.2%) and urogenital tuberculosis (0.4%). Out of the total number of patients, 57.3% declared themselves to be active smokers (men were predominant and made up to 80.8%) and 20.9% to be active alcohol consumers. Both risk factors, i.e. smoking and alcohol consumption, were present in 15.1% of all patients. The most common comorbidities were diabetes mellitus (30.4%), cardiac diseases (11.2%) and chronic obstructive pulmonary disease (8.0%). Lung carcinoma was the most common malignant disease (n=51), with Mycobacterium tuberculosis isolated in 33% of them. Seventy-two of 464 (15.5%) patients had recurrences of tuberculosis. Of these, 30.5% had one of the risk factors (20.8% were smokers and 9.7% consumed alcohol), while 32.5% of patients had both risk factors. In conclusion, cigarette smoking was proved to be the most significant risk factor for development of pulmonary tuberculosis and its recurrence.
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Affiliation(s)
| | - Irena Jukić
- 1Jordanovac University Department for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia; 2Croatian Institute of Transfusion Medicine, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Molecular Diagnosis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Jasna Bingulac-Popović
- 1Jordanovac University Department for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia; 2Croatian Institute of Transfusion Medicine, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Molecular Diagnosis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Hana Safić Stanić
- 1Jordanovac University Department for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia; 2Croatian Institute of Transfusion Medicine, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Molecular Diagnosis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Blaženka Barišić
- 1Jordanovac University Department for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia; 2Croatian Institute of Transfusion Medicine, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Molecular Diagnosis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Sanja Popović-Grle
- 1Jordanovac University Department for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia; 2Croatian Institute of Transfusion Medicine, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Molecular Diagnosis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
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Abstract
Although considerable progress has been made in reducing US tuberculosis incidence, the goal of eliminating the disease from the United States remains elusive. A continued focus on preventing new tuberculosis infections while also identifying and treating persons with existing tuberculosis infection is needed. Continued vigilance to ensure ongoing control of tuberculosis transmission remains key.
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Affiliation(s)
- Adam J Langer
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop US12-4, Atlanta, GA 30329, USA.
| | - Thomas R Navin
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop US12-4, Atlanta, GA 30329, USA
| | - Carla A Winston
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop US12-4, Atlanta, GA 30329, USA
| | - Philip LoBue
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop US12-4, Atlanta, GA 30329, USA
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12
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Anaam MS, Alrasheedy AA, Alsahali S, Alfadly SO, Aldhubhani AH. Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study. Infect Dis (Lond) 2019; 52:161-169. [DOI: 10.1080/23744235.2019.1690162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mohammed Saif Anaam
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | - Alian A. Alrasheedy
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | - Saud Alsahali
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | - Saeed O. Alfadly
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
- Pharmacy Department, College of Medicine and Health Sciences, Hadramout University, Hadramout, Yemen
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13
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Valdez-Miramontes CE, Trejo Martínez LA, Torres-Juárez F, Rodríguez Carlos A, Marin-Luévano SP, de Haro-Acosta JP, Enciso-Moreno JA, Rivas-Santiago B. Nicotine modulates molecules of the innate immune response in epithelial cells and macrophages during infection with M. tuberculosis. Clin Exp Immunol 2019; 199:230-243. [PMID: 31631328 DOI: 10.1111/cei.13388] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 01/12/2023] Open
Abstract
Smoking increases susceptibility to becoming infected with and developing tuberculosis. Among the components of cigarette smoke, nicotine has been identified as the main immunomodulatory molecule; however, its effect on the innate immune system is unknown. In the present study, the effect of nicotine on molecules of the innate immune system was evaluated. Lung epithelial cells and macrophages were infected with Mycobacterium tuberculosis (Mtb) and/or treated with nicotine. The results show that nicotine alone decreases the expression of the Toll-like receptors (TLR)-2, TLR-4 and NOD-2 in all three cell types, as well as the production of the SP-D surfactant protein in type II pneumocytes. Moreover, it was observed that nicotine decreases the production of interleukin (IL)-6 and C-C chemokine ligand (CCL)5 during Mtb infection in epithelial cells (EpCs), whereas in macrophages derived from human monocytes (MDMs) there is a decrease in IL-8, IL-6, tumor necrosis factor (TNF)-α, IL-10, CCL2, C-X-C chemokine ligand (CXCL)9 and CXCL10 only during infection with Mtb. Although modulation of the expression of cytokines and chemokines appears to be partially mediated by the nicotinic acetylcholine receptor α7, blocking this receptor found no effect on the expression of receptors and SP-D. In summary, it was found that nicotine modulates the expression of innate immunity molecules necessary for the defense against tuberculosis.
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Affiliation(s)
- C E Valdez-Miramontes
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.,Research Center in Health Sciences and Biomedicine, San Luis Potosí, México
| | - L A Trejo Martínez
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - F Torres-Juárez
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.,Research Center in Health Sciences and Biomedicine, San Luis Potosí, México
| | - A Rodríguez Carlos
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.,Research Center in Health Sciences and Biomedicine, San Luis Potosí, México
| | - S P Marin-Luévano
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.,Research Center in Health Sciences and Biomedicine, San Luis Potosí, México
| | - J P de Haro-Acosta
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - J A Enciso-Moreno
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - B Rivas-Santiago
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
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14
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Elobaid YE, Jabari AL, Al Hamiz A, Al Kaddour AR, Bakir S, Barazi H, Kazim E, Sherman S, Ali R. "Stages of change, smoking behavior and acceptability of a textmessaging intervention for tobacco cessation among cigarette, dokha and shishasmokers: A qualitative research study.". BMJ Open 2019; 9:e029144. [PMID: 31501110 PMCID: PMC6738749 DOI: 10.1136/bmjopen-2019-029144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/31/2019] [Accepted: 08/09/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To explore: (A) the underlying motivators and barriers to smoking cessation among young Arabic speaking smokers and (B) to examine the suitability and preferences for tobacco cessation interventions (specifically text messages) and study the possibility of enrollment methods for a randomised controlled study using text messages as an intervention for tobacco cessation. DESIGN Qualitative research using focus group discussions and content analysis. SETTINGS Two universities, one of them is the first and foremost comprehensive national university in the United Arab Emirates (UAE). The third setting is the largest hospital in the UAE and the flagship institution for the public health system in the emirate of Abu Dhabi. PARTICIPANTS Six focus group discussions with a total of 57 participants. Forty-seven men and 10 women. Fifty-three of them were current smokers. RESULTS The analysis of six focus groups was carried out. Main themes arose from the data included: preferences for tobacco cessation interventions and acceptability and feasibility of text messaging as tobacco cessation intervention. Different motives and barriers for quitting smoking including shisha and dokha were explored. CONCLUSION Interventions using text messaging for smoking cessation have not been used in the Middle East and they could potentially be effective; however, tailoring and closely examining the content and acceptability of text messages to be used is important before the conduction of trials involving their use. Social media is perceived to be more effective and influential, with a higher level of penetration into communities of young smokers.
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Affiliation(s)
- Yusra Elhidaia Elobaid
- Health and Medical Sciences, Al Khawarizmi International College - Al Ain Campus, Abu Dhabi, United Arab Emirates
| | | | - Aisha Al Hamiz
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Sherif Bakir
- Department of Cardiology, Sheikh Khalifa Medical Center, Abu Dhabi, UAE
| | - Heba Barazi
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | | | - Scott Sherman
- Department of Population Health, New York University Langone Medical Center (NYUMC), New York City, New York, USA
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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15
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Torres M, Carranza C, Sarkar S, Gonzalez Y, Osornio Vargas A, Black K, Meng Q, Quintana-Belmares R, Hernandez M, Angeles Garcia JJF, Páramo-Figueroa VH, Iñiguez-Garcia MA, Flores JL, Zhang JJ, Gardner CR, Ohman-Strickland P, Schwander S. Urban airborne particle exposure impairs human lung and blood Mycobacterium tuberculosis immunity. Thorax 2019; 74:675-683. [PMID: 31036772 PMCID: PMC7162557 DOI: 10.1136/thoraxjnl-2018-212529] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 02/12/2019] [Accepted: 02/25/2019] [Indexed: 12/20/2022]
Abstract
RATIONALE Associations between urban (outdoor) airborne particulate matter (PM) exposure and TB and potential biological mechanisms are poorly explored. OBJECTIVES To examine whether in vivo exposure to urban outdoor PM in Mexico City and in vitro exposure to urban outdoor PM2.5 (< 2.5 µm median aerodynamic diameter) alters human host immune cell responses to Mycobacterium tuberculosis. METHODS Cellular toxicity (flow cytometry, proliferation assay (MTS assay)), M. tuberculosis and PM2.5 phagocytosis (microscopy), cytokine-producing cells (Enzyme-linked immune absorbent spot (ELISPOT)), and signalling pathway markers (western blot) were examined in bronchoalveolar cells (BAC) and peripheral blood mononuclear cells (PBMC) from healthy, non-smoking, residents of Mexico City (n=35; 13 female, 22 male). In vivo-acquired PM burden in alveolar macrophages (AM) was measured by digital image analysis. MEASUREMENTS AND MAIN RESULTS In vitro exposure of AM to PM2.5 did not affect M. tuberculosis phagocytosis. High in vivo-acquired AM PM burden reduced constitutive, M. tuberculosis and PM-induced interleukin-1β production in freshly isolated BAC but not in autologous PBMC while it reduced constitutive production of tumour necrosis factor-alpha in both BAC and PBMC. Further, PM burden was positively correlated with constitutive, PM, M. tuberculosis and purified protein derivative (PPD)-induced interferon gamma (IFN-γ) in BAC, and negatively correlated with PPD-induced IFN-γ in PBMC. CONCLUSIONS Inhalation exposure to urban air pollution PM impairs important components of the protective human lung and systemic immune response against M. tuberculosis. PM load in AM is correlated with altered M. tuberculosis-induced cytokine production in the lung and systemic compartments. Chronic PM exposure with high constitutive expression of proinflammatory cytokines results in relative cellular unresponsiveness.
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Affiliation(s)
- Martha Torres
- Department of Microbiology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Claudia Carranza
- Department of Microbiology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Srijata Sarkar
- Environmental and Occupational Health, Rutgers School of Public Health New Brunswick Campus, Piscataway, New Jersey, USA
| | - Yolanda Gonzalez
- Department of Microbiology, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | | | - Kathleen Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Qingyu Meng
- Environmental and Occupational Health, Rutgers School of Public Health New Brunswick Campus, Piscataway, New Jersey, USA
| | | | - Martha Hernandez
- Contaminacion y salud ambiental, Instituto Nacional de Ecologia y Cambio Climatico, Coyoacan, Mexico
| | | | | | | | - Jose L Flores
- Departamento de ciencias de la salud, Universidad Autonoma Metropolitana Iztapalapa, Iztapalapa, Mexico
| | - Junfeng Jim Zhang
- Duke Global Health Institute and Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Carol R Gardner
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New Jersey, USA
| | - Pamela Ohman-Strickland
- Biostatistics, Rutgers School of Public Health New Brunswick Campus, Piscataway, New Jersey, USA
| | - Stephan Schwander
- Urban-Global Public Health and Environmental and Occupational Health, Rutgers School of Public Health New Brunswick Campus, Piscataway, New Jersey, USA
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Simkovich SM, Goodman D, Roa C, Crocker ME, Gianella GE, Kirenga BJ, Wise RA, Checkley W. The health and social implications of household air pollution and respiratory diseases. NPJ Prim Care Respir Med 2019; 29:12. [PMID: 31028270 PMCID: PMC6486605 DOI: 10.1038/s41533-019-0126-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/05/2019] [Indexed: 12/29/2022] Open
Abstract
Approximately three billion individuals are exposed to household air pollution (HAP) from the burning of biomass fuels worldwide. Household air pollution is responsible for 2.9 million annual deaths and causes significant health, economic and social consequences, particularly in low- and middle-income countries. Although there is biological plausibility to draw an association between HAP exposure and respiratory diseases, existing evidence is either lacking or conflicting. We abstracted systematic reviews and meta-analyses for summaries available for common respiratory diseases in any age group and performed a literature search to complement these reviews with newly published studies. Based on the literature summarized in this review, HAP exposure has been associated with acute respiratory infections, tuberculosis, asthma, chronic obstructive pulmonary disease, pneumoconiosis, head and neck cancers, and lung cancer. No study, however, has established a causal link between HAP exposure and respiratory disease. Furthermore, few studies have controlled for tobacco smoke exposure and outdoor air pollution. More studies with consistent diagnostic criteria and exposure monitoring are needed to accurately document the association between household air pollution exposure and respiratory disease. Better environmental exposure monitoring is critical to better separate the contributions of household air pollution from that of other exposures, including ambient air pollution and tobacco smoking. Clinicians should be aware that patients with current or past HAP exposure are at increased risk for respiratory diseases or malignancies and may want to consider earlier screening in this population.
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Affiliation(s)
- Suzanne M Simkovich
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dina Goodman
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Christian Roa
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Mary E Crocker
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Sleep Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Gonzalo E Gianella
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Servicio de Neumología, Unidad de Cuidados Intensivos, Clinica Ricardo Palma, Lima, Peru
| | - Bruce J Kirenga
- Makerere Lung Institute, Makerere University, Kampala, Uganda
- Pulmonology Unit, Department of Medicine, Makerere University, Mulago Hospital, Kampala, Uganda
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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17
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Awang H, Nik Husain NR, Abdullah H. Pediatric Tuberculosis in a Northeast State of Peninsular Malaysia: Diagnostic Classifications and Determinants. Oman Med J 2019; 34:110-117. [PMID: 30918604 PMCID: PMC6425061 DOI: 10.5001/omj.2019.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives We sought to determine the total proportion of pediatric tuberculosis cases, characterize tuberculosis by its anatomical location and pretreatment sputum smear status, and to determine the association of the sociodemographic and clinical factors with tuberculosis disease among pediatric patients in Kelantan from 2012 until 2015. Methods We conducted a comparative cross-sectional study between tuberculosis cases and tuberculosis contacts among pediatric patients using the Tuberculosis Information System as a source population. All notified cases that fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics, simple and multiple logistic regressions were used for data analysis. Results Of 5412 tuberculosis cases, 456 (8.4%) were pediatric patients with a mean age of 15.9 years. The majority had the pulmonary form of tuberculosis (78.1%) followed by the extrapulmonary (14.9%) and pulmonary form with concomitant extrapulmonary (7.0%) forms. Of all pulmonary tuberculosis cases, 64.9% were sputum smear-positive, and 35.1% were sputum smear-negative. Among 322 pediatric patients with tuberculosis, the majority were Malay (90.7%), 8.4% were illiterate, and 79.5% resided in non-urban areas. Of all cases, 2.8% were HIV-positive, and 14.6% were cigarette smokers. Older age, Malay ethnicity, female gender, non-urban residence, good education level, and cigarette smoking were the significant associated factors for tuberculosis disease among pediatric patients with an adjusted odds ratio (aOR) of 1.41 (95% confidence interval (CI): 1.29–1.54; p < 0.001), 0.17 (95% CI: 0.07–0.44; p < 0.001), 1.88 (95% CI: 1.33–2.65; p < 0.001), 1.92 (95% CI: 1.33–2.79; p = 0.001), 0.20 (95% CI: 0.12–0.33; p < 0.001), and 3.35 (95% CI: 1.86–6.01; p < 0.001), respectively. Conclusions The study will assist practices of tuberculosis detection and control management in the local setting and may help other national tuberculosis programs to review their detection criteria with similar statistics.
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Affiliation(s)
- Hafizuddin Awang
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nik Rosmawati Nik Husain
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Hasniza Abdullah
- Tuberculosis and Leprosy Control Unit, Kelantan State Health Department, Kelantan, Malaysia
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18
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Muttamba W, Kirenga B, Ssengooba W, Sekibira R, Katamba A, Joloba ML. Prevalence of Tuberculosis Risk Factors among Bacteriologically Negative and Bacteriologically Confirmed Tuberculosis Patients from Five Regional Referral Hospitals in Uganda. Am J Trop Med Hyg 2019; 100:386-391. [PMID: 30594259 PMCID: PMC6367623 DOI: 10.4269/ajtmh.18-0281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/04/2018] [Indexed: 11/07/2022] Open
Abstract
Understanding risk factors for tuberculosis (TB) and their prevalence helps guide early diagnosis. We determined their prevalence among bacteriologically negative and bacteriologically confirmed TB patients in five regional referral hospitals in Uganda. This cross-sectional study considered 1,862 adult presumptive TB participants. We performed fluorescent microscopy, Xpert MTB/RIF (Xpert), Lowenstein-Jensen culture, human immunodeficiency virus, and random blood sugar testing on recruited patients. Prevalence and prevalence ratios of risk factors were compared among bacteriologically negative and confirmed cases. Odds ratios and 95% confidence interval (CI) were determined for significant risk factors in bacteriologically confirmed patients. Of the 1,862 participants, 978 (55%) were male and the median age of the participants was 36 years (interquartile range: 27-48). Up to 273 (15%) had a positive result on all three TB tests. Most prevalent risk factors (prevalence ratio [PR] > 1.0) among bacteriologically negative and positive TB patients were cigarette smoking (9.3% versus 2.1%; PR = 2.1), biosmoke (24% versus 39.7%; PR = 1.7), contact (4.2% versus 6.5%; PR = 1.6), male gender (51.4% versus 72.5%; PR = 1.4), alcohol use (17.2% versus 24.4%; PR = 1.4), diabetes (0.7% versus 0.9%; PR = 1.3), and family history of TB (12.1% versus 13.7%; PR = 1.1). The risk factors and their adjusted prevalence rate ratios (95% CI) of being bacteriologically positive were male (1.8 [1.4-2.4]), biosmoke exposure (1.5 [1.2-2.0]), and history of cigarette smoking (1.6 [1.1-2.4]). Among bacteriologically confirmed patients in Uganda, cigarette smoking, biosmoke exposure, contact, male gender, alcohol use, diabetes, and family history of TB are important risk factors for TB. Interventions for TB control in people with these risk factors would help in TB control efforts.
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Affiliation(s)
- Winters Muttamba
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Bruce Kirenga
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Willy Ssengooba
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rogers Sekibira
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Achilles Katamba
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L. Joloba
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
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19
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Choi JY, Jhun BW, Hyun SH, Chung MJ, Koh WJ. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Assessing Treatment Response of Pulmonary Multidrug-Resistant Tuberculosis. J Clin Med 2018; 7:jcm7120559. [PMID: 30562940 PMCID: PMC6307081 DOI: 10.3390/jcm7120559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/10/2018] [Accepted: 12/14/2018] [Indexed: 11/23/2022] Open
Abstract
Background: The purpose of this prospective study was to evaluate the role of 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for assessing treatment response in patients with pulmonary multidrug-resistant tuberculosis (MDR-TB). Methods: The study subjects were four patients diagnosed with pulmonary MDR-TB who underwent MDR-TB treatment and serial 18F-FDG PET/CT at baseline and 6 and 12 months after treatment. The highest lung maximum standardized uptake value (SUVmax), average SUVmean (average of all hypermetabolic parenchymal lesions), total metabolic lung volume (TMLV, sum of metabolic volumes from the hypermetabolic parenchymal lesions), and total lung glycolysis (TLG, sum of lesion glycolysis from the hypermetabolic parenchymal lesions) were determined as representative quantitative PET parameters for each patient. Results: All patients except one had negative sputum culture conversion after one month of treatment and achieved successful treatment outcomes. Baseline TMLV and TLG PET parameters were much higher in the single patient with treatment failure than in the remaining three patients with treatment success. No other PET parameters at baseline or follow-up were associated with the treatment results. Conclusions: Pretreatment volume-based 18F-FDG PET/CT lung parameters were associated with the final therapeutic response in patients with pulmonary MDR-TB. Our preliminary results warrant a larger study.
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Affiliation(s)
- Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnamgu, Seoul 06351, Korea.
| | - Seung Hyup Hyun
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
| | - Myung Jin Chung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
| | - Won-Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnamgu, Seoul 06351, Korea.
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20
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Nakao M, Muramatsu H, Arakawa S, Sakai Y, Suzuki Y, Fujita K, Sato H. Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio. Respir Investig 2018; 57:60-66. [PMID: 30528689 DOI: 10.1016/j.resinv.2018.08.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/06/2018] [Accepted: 08/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several reports have described the importance of immunological and nutritional factors in the morbidity and/or mortality of patients with tuberculosis. The aim of this study was to evaluate the association between pulmonary cavitation and immunonutritional status, assessed by parameters such as neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI), in patients with pulmonary tuberculosis. METHODS We retrospectively analyzed the data of 137 patients with culture-positive active pulmonary tuberculosis without bacterial pneumonia diagnosed at Kainan Hospital between April 2008 and March 2016. The associations between the levels of serum albumin, lymphocytes, NLR, PNI, platelet to lymphocyte ratio (PLR), and body mass index (BMI) and pulmonary cavitation were evaluated in the patients. RESULTS A total of 83 men and 63 women (median age, 75 years; range, 16-94 years) were included in the study. Sixty-six patients had smoking history; 55 patients had respiratory symptoms, while 44 patients did not have any symptoms. Patient׳s delay, defined as medical examination performed over 60 days after the onset of symptoms was observed in 25 patients. Univariate analysis showed that high NLR (≥ 5), high PLR (≥200), low serum albumin (<3 g/dL), high neutrophil count (≥6000/mm3), and low lymphocyte count (<1000/mm3) were associated with pulmonary cavitation. Multivariate analysis showed that high NLR and low serum albumin were associated with pulmonary cavitation. CONCLUSION Malnutrition and increased severity of inflammation may be associated with pulmonary cavitation in patients with tuberculosis. Further studies are warranted to confirm the findings of the present study.
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Affiliation(s)
- Makoto Nakao
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan.
| | - Hideki Muramatsu
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Sosuke Arakawa
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Yusuke Sakai
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Yuto Suzuki
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Kohei Fujita
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Hidefumi Sato
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
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Dhiman R, Singh R. Recent advances for identification of new scaffolds and drug targets for Mycobacterium tuberculosis. IUBMB Life 2018; 70:905-916. [PMID: 29761628 DOI: 10.1002/iub.1863] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/07/2018] [Indexed: 02/06/2023]
Abstract
Tuberculosis (TB) is a leading cause of mortality and morbidity with an estimated 1.7 billion people latently infected with the pathogen worldwide. Clinically, TB infection presents itself as an asymptomatic infection, which gradually manifests to life threatening disease. The emergence of various drug resistant strains of Mycobacterium tuberculosis and lengthy duration of chemotherapy are major challenges in the field of TB drug development. Hence, there is an urgent need to develop scaffolds that possess a novel mechanism of action, can shorten the duration of therapy, and are active against both drug resistant and susceptible strains. In this review, we will discuss recent progress made in the field of TB drug development with emphasis on screening methods and drug targets from M. tuberculosis. The current review provides insights into mechanism of action of new scaffolds that are being evaluated in various stages of clinical trials. © 2018 IUBMB Life, 70(9):905-916, 2018.
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Affiliation(s)
- Rohan Dhiman
- Laboratory of Mycobacterial Immunology, Department of Life Science, National Institute of Technology, Rourkela, Odisha, India
| | - Ramandeep Singh
- Tuberculosis Research Laboratory, Vaccine and Infectious Disease Research Centre, Translational Health Science and Technology Institute, Haryana, India
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22
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Mjid M, Hedhli A, Zakhma M, Zribi M, Ouahchi Y, Toujani S, Cherif J. [Clinical and microbiological profile of patients experiencing relapses of tuberculosis in Tunisia]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:76-80. [PMID: 29402488 DOI: 10.1016/j.pneumo.2018.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Relapse of tuberculosis (TB) is known to be as one of the major risk factors for resistant TB. The aim of this study is to focus on clinical, radiological and bacteriological features of patients with pulmonary TB relapse. METHODS We performed a retrospective survey in the respiratory department of the teaching hospital La Rabta in Tunis between January 2000 and December 2014. Data of patients with a pulmonary TB relapse were analyzed. RESULTS During the study period, among 1250 patients hospitalized for pulmonary TB, 44 had a TB relapse. The TB relapse rate was estimated to be at 3.5%. The average age was 43.95±16.7 years. Sex ratio was 5,2. Eighty one percent of patients were current smokers. Alcoholism was found in 40.9% of cases. The mean time to relapse was 6.37±3.7 years. The radiological lesions were moderately extended at least in 54.6% of cases. A resistant TB was found in 33% of cases (mono-resistance: 33.3%, multi-drug resistance (TB-MR): 11,1%, poly-resistance: 55.5%). The most incriminated drugs were isoniazid, rifampicin and pyrazinamide. One patient received TB-MR treatment regimen for 18 months. In the other cases, the duration of treatment was prolonged. Recovery was obtained in 72.7% of cases, two patients died and 22.7% of patients were lost to follow up. CONCLUSION In Tunisia, TB relapse usually affects young male patients who are often alcoholic and smokers. Resistant TB is frequent among these patients. These findings lead us to emphasize the need of rapid diagnosis tools and adapted treatment regimen in these patients.
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Affiliation(s)
- M Mjid
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
| | - A Hedhli
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis.
| | - M Zakhma
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
| | - M Zribi
- Service de bactériologie, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
| | - Y Ouahchi
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
| | - S Toujani
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
| | - J Cherif
- Service de pneumo-allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El Manar, CHU La Rabta, 1007 Tunis
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23
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Berkowitz L, Schultz BM, Salazar GA, Pardo-Roa C, Sebastián VP, Álvarez-Lobos MM, Bueno SM. Impact of Cigarette Smoking on the Gastrointestinal Tract Inflammation: Opposing Effects in Crohn's Disease and Ulcerative Colitis. Front Immunol 2018; 9:74. [PMID: 29441064 PMCID: PMC5797634 DOI: 10.3389/fimmu.2018.00074] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 01/11/2018] [Indexed: 01/06/2023] Open
Abstract
Cigarette smoking is a major risk factor for gastrointestinal disorders, such as peptic ulcer, Crohn’s disease (CD), and several cancers. The mechanisms proposed to explain the role of smoking in these disorders include mucosal damage, changes in gut irrigation, and impaired mucosal immune response. Paradoxically, cigarette smoking is a protective factor for the development and progression of ulcerative colitis (UC). UC and CD represent the two most important conditions of inflammatory bowel diseases, and share several clinical features. The opposite effects of smoking on these two conditions have been a topic of great interest in the last 30 years, and has not yet been clarified. In this review, we summarize the most important and well-understood effects of smoking in the gastrointestinal tract; and particularly, in intestinal inflammation, discussing available studies that have addressed the causes that would explain the opposite effects of smoking in CD and UC.
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Affiliation(s)
- Loni Berkowitz
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bárbara M Schultz
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Geraldyne A Salazar
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catalina Pardo-Roa
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Valentina P Sebastián
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel M Álvarez-Lobos
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Susan M Bueno
- Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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Risk factors for infectiousness of patients with tuberculosis: a systematic review and meta-analysis. Epidemiol Infect 2018; 146:345-353. [PMID: 29338805 DOI: 10.1017/s0950268817003041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We performed a systematic review and meta-analyses of studies assessing tuberculosis (TB) patient-related risk factors for transmission of Mycobacterium tuberculosis infection. Meta-analyses were conducted for sputum smear-positivity, lung cavitation and HIV seropositivity of index patients with both crude and adjusted odds ratios (AORs) pooled using random effect models. Thirty-seven studies were included in the review. We found that demographic characteristics such as age and sex were not significant risk factors, while behaviours such as smoking and alcohol intake were associated with infectiousness although inconsistently. Treatment delay of >28 days was a significant predictor of greater infectiousness. Contacts of sputum smear-positive index patients were found to be more likely to be infected than contacts of sputum smear-negative patients, with a pooled AOR of 2.15 (95% confidence interval (CI) 1.47-3.17, I 2 = 38%). Similarly, contacts of patients with the cavitary disease were around twice as likely to be infected as contacts of patients without cavitation (pooled AOR 1.9, 95% CI 1.26-2.84, I 2 = 63%). In contrast, HIV seropositive patients were associated with few contact infections than HIV seronegative patients (AOR 0.45, 95% CI 0.26-0.80, I 2 = 52%). In conclusion, behavioural and clinical characteristics of TB patients can be used to identify highly infectious patients for targeted interventions.
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25
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Adetifa IMO, Kendall L, Donkor S, Lugos MD, Hammond AS, Owiafe PK, Ota MOC, Brookes RH, Hill PC. Mycobacterium tuberculosis Infection in Close Childhood Contacts of Adults with Pulmonary Tuberculosis is Increased by Secondhand Exposure to Tobacco. Am J Trop Med Hyg 2017; 97:429-432. [PMID: 28722570 PMCID: PMC5544071 DOI: 10.4269/ajtmh.16-0611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 04/06/2017] [Indexed: 11/07/2022] Open
Abstract
Tobacco use is a major risk factor for tuberculosis (TB). Secondhand smoke (SHS) is also a risk factor for TB and to a lesser extent, Mycobacterium tuberculosis infection without disease. We investigated the added risk of M. tuberculosis infection due to SHS exposure in childhood contacts of TB cases in The Gambia. Participants were childhood household contacts aged ≤ 14 years of newly diagnosed pulmonary TB (PTB) cases. The intensity of exposure to the case was categorized according to whether contacts slept in the same room, same house, or a different house as the case. Contacts were tested with an enzyme-linked immunospot interferon gamma release assay. In multivariate regression models, M. tuberculosis infection was associated with increasing exposure to a case (odds ratios [OR]: 3.9, 95% confidence interval [CI]: 2.11-71.4, P < 0.001]) and with male gender (OR: 1.5 [95% CI: 1.12-2.11], P = 0.008). Tobacco use caused a 3-fold increase in the odds of M. tuberculosis infection in children who slept closest to a case who smoked within the same home compared with a nonsmoking case (OR: 8.0 [95% CI: 2.74-23.29] versus 2.4 [95% CI: 1.17-4.92], P < 0.001). SHS exposure as an effect modifier appears to greatly increase the risk of M. tuberculosis infection in children exposed to PTB cases. Smoking cessation campaigns may be important for reducing transmission of M. tuberculosis to children within households.
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Affiliation(s)
- Ifedayo M. O. Adetifa
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- College of Medicine, University of Lagos, Lagos, Nigeria
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
| | - Lindsay Kendall
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
| | - Simon Donkor
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
| | - Moses D. Lugos
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
- Department of Medical Laboratory Science, University of Jos, Plateau, Nigeria
| | - Abdulrahman S. Hammond
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
| | - Patrick K. Owiafe
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia
| | - Martin O. C. Ota
- World Health Organization-Regional Office for Africa, Brazzaville, Congo
| | - Roger H. Brookes
- Bioprocess Research and Development, Sanofi Pasteur, Toronto, Ontario, Canada
| | - Philip C. Hill
- Department of Preventive and Social Medicine, Centre for International Health and the Otago International Health Research Network, University of Otago School of Medicine, Dunedin, New Zealand
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Torrelles JB, Schlesinger LS. Integrating Lung Physiology, Immunology, and Tuberculosis. Trends Microbiol 2017; 25:688-697. [PMID: 28366292 PMCID: PMC5522344 DOI: 10.1016/j.tim.2017.03.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/03/2017] [Accepted: 03/10/2017] [Indexed: 11/17/2022]
Abstract
Lungs are directly exposed to the air, have enormous surface area, and enable gas exchange in air-breathing animals. They are constantly 'attacked' by microbes from both outside and inside and thus possess a unique, highly regulated local immune defense system which efficiently allows for microbial clearance while minimizing damaging inflammatory responses. As a prototypic host-adapted airborne pathogen, Mycobacterium tuberculosis traverses the lung and has several 'interaction points' (IPs) which it must overcome to cause infection. These interactions are critical, not only from a pathogenesis perspective but also in considering the effectiveness of therapies and vaccines in the lungs. Here we discuss emerging views on immunologic interactions occurring in the lungs for M. tuberculosis and their impact on infection and persistence.
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Affiliation(s)
- Jordi B Torrelles
- Department of Microbial Infection and Immunity, College of Medicine, and the Center for Microbial Interface Biology, The Ohio State University, Columbus, OH 43210, USA.
| | - Larry S Schlesinger
- Department of Microbial Infection and Immunity, College of Medicine, and the Center for Microbial Interface Biology, The Ohio State University, Columbus, OH 43210, USA.
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27
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Santra A, Dutta P, Manjhi R, Pothal S. Clinico-Radiologic and Spirometric Profile of an Indian Population with Post-Tuberculous Obstructive Airway Disease. J Clin Diagn Res 2017; 11:OC35-OC38. [PMID: 28511433 PMCID: PMC5427359 DOI: 10.7860/jcdr/2017/24555.9529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/17/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tuberculosis is a public health problem in developing countries and in spite of receiving adequate anti-tuberculous therapy, patients often continues to have several post-tuberculous sequelae, especially airflow limitation. AIM To evaluate pulmonary function by spirometry among post-tuberculosis cases with airway obstruction and their relationship with smoking. MATERIALS AND METHODS All patients who presented to the pulmonary medicine Outpatient Department (OPD) with symptoms of obstructive airway disease and had completed adequate anti-tuberculous therapy for pulmonary tuberculosis were taken up for study. They were initially evaluated with sputum smear for Acid Fast Bacilli (AFB) and chest X-ray. Patients without evidence of active tuberculosis underwent spirometry and those having post-bronchodilator Forced Expiratory Volume in first second (FEV1)/ Forced Vital Capacity (FVC) FEV1/FVC<0.7 were taken up for final analysis. Spirometric parameters were compared between smokers and non-smokers. RESULTS Out of 138 finally selected cases, 84.06% were male and 71.01% were within age range of 40-69 years. Significant positive association was found between extent of radiologic lesion and severity of airflow obstruction. Purely obstructive pattern was found in 27.54% cases and 72.46% showed mixed pattern. Patients with mixed ventilatory abnormality had worse pulmonary function and poorer bronchodilator reversibility than patients with pure obstruction. Comparison of post-bronchodilator FEV1, FVC, Peak Expiratory Flow (PEF) and Forced Expiratory Flow (FEF) 25-75 between smokers and non-smokers did not show statistically significant difference. CONCLUSION Majority of patients with post-tuberculous obstructive airway disease have associated restrictive component. But smoking did not cause significant alteration in pulmonary function among such patients.
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Affiliation(s)
- Avradip Santra
- Assistant Professor, Department of Pulmonary Medicine, Medical College, Kolkata, West Bengal, India
| | - Pravati Dutta
- Professor and Head, Department of Pulmonary Medicine, V.S.S. Medical College, Burla, Sambalpur, Odisha, India
| | - Rekha Manjhi
- Associate Professor, Department of Pulmonary Medicine, V.S.S. Medical College, Burla, Sambalpur, Odisha, India
| | - Sudarsan Pothal
- Assistant Professor, Department of Pulmonary Medicine, V.S.S. Medical College, Burla, Sambalpur, Odisha, India
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28
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Rao V, Bhat J, Yadav R, Muniyandi M, Bhondeley M, Wares D. Smoking and alcohol consumption: Risk factors for pulmonary tuberculosis among the tribal community in central India. ACTA ACUST UNITED AC 2017; 64:40-43. [DOI: 10.1016/j.ijtb.2016.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/10/2016] [Accepted: 11/01/2016] [Indexed: 12/01/2022]
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29
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Aldridge RW, Zenner D, White PJ, Williamson EJ, Muzyamba MC, Dhavan P, Mosca D, Thomas HL, Lalor MK, Abubakar I, Hayward AC. Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519 955 migrants screened before entry to England, Wales, and Northern Ireland. Lancet 2016; 388:2510-2518. [PMID: 27742165 PMCID: PMC5121129 DOI: 10.1016/s0140-6736(16)31008-x] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Tuberculosis elimination in countries with a low incidence of the disease necessitates multiple interventions, including innovations in migrant screening. We examined a cohort of migrants screened for tuberculosis before entry to England, Wales, and Northern Ireland and tracked the development of disease in this group after arrival. METHODS As part of a pilot pre-entry screening programme for tuberculosis in 15 countries with a high incidence of the disease, the International Organization for Migration screened all applicants for UK visas aged 11 years or older who intended to stay for more than 6 months. Applicants underwent a chest radiograph, and any with results suggestive of tuberculosis underwent sputum testing and culture testing (when available). We tracked the development of tuberculosis in those who tested negative for the disease and subsequently migrated to England, Wales, and Northern Ireland with the Enhanced Tuberculosis Surveillance system. Primary outcomes were cases of all forms of tuberculosis (including clinically diagnosed cases), and bacteriologically confirmed pulmonary tuberculosis. FINDINGS Our study cohort was 519 955 migrants who were screened for tuberculosis before entry to the UK between Jan 1, 2006, and Dec 31, 2012. Cases notified on the Enhanced Tuberculosis Surveillance system between Jan 1, 2006, and Dec 31, 2013, were included. 1873 incident cases of all forms of tuberculosis were identified, and, on the basis of data for England, Wales, and Northern Ireland, the estimated incidence of all forms of tuberculosis in migrants screened before entry was 147 per 100 000 person-years (95% CI 140-154). The estimated incidence of bacteriologically confirmed pulmonary tuberculosis in migrants screened before entry was 49 per 100 000 person-years (95% CI 45-53). Migrants whose chest radiographs were compatible with active tuberculosis but with negative pre-entry microbiological results were at increased risk of tuberculosis compared with those with no radiographic abnormalities (incidence rate ratio 3·2, 95% CI 2·8-3·7; p<0·0001). Incidence of tuberculosis after migration increased significantly with increasing WHO-estimated prevalence of tuberculosis in migrants' countries of origin. 35 of 318 983 pre-entry screened migrants included in a secondary analysis with typing data were assumed index cases. Estimates of the rate of assumed reactivation tuberculosis ranged from 46 (95% CI 42-52) to 91 (82-102) per 100 000 population. INTERPRETATION Migrants from countries with a high incidence of tuberculosis screened before being granted entry to low-incidence countries pose a negligible risk of onward transmission but are at increased risk of tuberculosis, which could potentially be prevented through identification and treatment of latent infection in close collaboration with a pre-entry screening programme. FUNDING Wellcome Trust, UK National Institute for Health Research, UK Medical Research Council, Public Health England, and Department of Health Policy Research Programme.
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Affiliation(s)
- Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; Farr Institute of Health Informatics Research, University College London, London, UK; Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
| | - Dominik Zenner
- Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Peter J White
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK; MRC Centre for Outbreak Analysis and Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Imperial College London, London, UK
| | | | - Morris C Muzyamba
- Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Poonam Dhavan
- Migration Health Division, International Organization for Migration, Geneva, Switzerland
| | - Davide Mosca
- Migration Health Division, International Organization for Migration, Geneva, Switzerland
| | - H Lucy Thomas
- Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Maeve K Lalor
- Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Andrew C Hayward
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; Farr Institute of Health Informatics Research, University College London, London, UK
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You S, Tong YW, Neoh KG, Dai Y, Wang CH. On the association between outdoor PM 2.5 concentration and the seasonality of tuberculosis for Beijing and Hong Kong. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 218:1170-1179. [PMID: 27595179 DOI: 10.1016/j.envpol.2016.08.071] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 05/16/2023]
Abstract
Tuberculosis (TB) is still a serious public health problem in various countries. One of the long-elusive but critical questions about TB is what the risk factors are and how they contribute for its seasonality. An ecologic study was conducted to examine the association between the variation of outdoor PM2.5 concentration and the TB seasonality based on the monthly TB notification and PM2.5 concentration data of Hong Kong and Beijing. Both descriptive analysis and Poisson regression analysis suggested that the outdoor PM2.5 concentration could be a potential risk factor for the seasonality of TB disease. The significant relationship between the number of TB cases and PM2.5 concentration was not changed when regression models were adjusted by sunshine duration, a potential confounder. The regression analysis showed that a 10 μg/m3 increase in PM2.5 concentrations during winter is significantly associated with a 3% (i.e. 18 and 14 cases for Beijing and Hong Kong, respectively) increase in the number of TB cases notified during the coming spring or summer for both Beijing and Hong Kong. Three potential mechanisms were proposed to explain the significant relationship: (1) increased PM2.5 exposure increases host's susceptibility to TB disease by impairing or modifying the immunology of the human respiratory system; (2) increased indoor activities during high outdoor PM2.5 episodes leads to an increase in human contact and thus the risk of TB transmission; (3) the seasonal change of PM2.5 concentration is correlated with the variation of other potential risk factors of TB seasonality. Preliminary evidence from the analysis of this work favors the first mechanism about the PM2.5 exposure-induced immunity impairment. This work adds new horizons to the explanation of the TB seasonality and improves our understanding of the potential mechanisms affecting TB incidence, which benefits the prevention and control of TB disease.
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Affiliation(s)
- Siming You
- NUS Environmental Research Institute, National University of Singapore, 1 Create Way, Create Tower, #15-02, 138602, Singapore
| | - Yen Wah Tong
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore
| | - Koon Gee Neoh
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore
| | - Yanjun Dai
- School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai 200240, China
| | - Chi-Hwa Wang
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore.
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Semunigus T, Tessema B, Eshetie S, Moges F. Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia. Ann Clin Microbiol Antimicrob 2016; 15:50. [PMID: 27581729 PMCID: PMC5007822 DOI: 10.1186/s12941-016-0165-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) remains one of the globe's deadliest communicable diseases. The homeless individuals are at high risk to acquire TB and multi-drug resistant TB (MDR-TB), because of their poor living conditions and risky behaviors. Tuberculosis and MDR-TB in the homeless individuals can pose a risk to entire communities. However, the magnitude of the problem is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of smear positive pulmonary TB (PTB) and MDR-TB among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia. METHODS A community based cross-sectional study design was conducted from September 2014 to June 2015. Using an active screening with cough of ≥2 weeks, 351 TB suspects homeless individuals were participated in this study. Data were collected by using pre-tested and structured questionnaire. Spot-morning-spot sputum sample was collected and examined for acid-fast bacilli (AFB) using fluorescence microscopy by Auramine O staining technique. All AFB positive sputum was further analyzed by GeneXpert for detection of Mycobacterium tuberculosis complex and rifampicin resistant gene. Univariate and multivariate logistic regressions were applied to identify factors associated with smear positive PTB and P value <0.05 was considered as statistically significant. RESULTS The prevalence of smear positive PTB was 2.6 % (95 % CI 1.3-5) among TB suspect homeless individuals. Extrapolation of this study finding implies that there were 505 smear positive PTB per 100,000 homeless individuals. All smear positive PTB sputum specimens were further analyzed by GeneXpert assay, the assay confirmed that all were positive for MTBC but none were resistant to RIF or MDR. Smoking cigarette regularly for greater than 5 years (AOR 10.1, 95 % CI 1.1, 97.7), body mass index lower than 18.5 (AOR 6.9, 95 % CI 1.12, 41.1) and HIV infection (AOR 6.8, 95 % CI 1.1, 40.1) were significantly associated with smear positive PTB. CONCLUSION The prevalence of smear positive PTB among TB suspect homeless individuals was 2.6 %. Among smear positive PTB, prevalence of HIV co-infection was very high 5 (55.5 %). Smoking cigarette regularly for greater than 5 years, BMI lower than 18.5 and HIV infection were factors associated with smear positive PTB. Special emphasis is needed for homeless individuals to exert intensive effort to identify undetected TB cases to limit the circulation of the disease into the community.
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Affiliation(s)
- Tsedale Semunigus
- Amhara Regional Health Bureau, North Shewa Zonal Health Bureau, Debre Birhan, Ethiopia
| | - Belay Tessema
- School of Biomedical and Laboratory Sciences, Department of Medical Microbiology, University of Gondar, P.O. Box: 196, Gonder, Ethiopia
| | - Setegn Eshetie
- School of Biomedical and Laboratory Sciences, Department of Medical Microbiology, University of Gondar, P.O. Box: 196, Gonder, Ethiopia
| | - Feleke Moges
- School of Biomedical and Laboratory Sciences, Department of Medical Microbiology, University of Gondar, P.O. Box: 196, Gonder, Ethiopia
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Modulation of Human Macrophage Responses to Mycobacterium tuberculosis by Silver Nanoparticles of Different Size and Surface Modification. PLoS One 2015; 10:e0143077. [PMID: 26580078 PMCID: PMC4651328 DOI: 10.1371/journal.pone.0143077] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/31/2015] [Indexed: 11/19/2022] Open
Abstract
Exposure to silver nanoparticles (AgNP) used in consumer products carries potential health risks including increased susceptibility to infectious pathogens. Systematic assessments of antimicrobial macrophage immune responses in the context of AgNP exposure are important because uptake of AgNP by macrophages may lead to alterations of innate immune cell functions. In this study we examined the effects of exposure to AgNP with different particle sizes (20 and 110 nm diameters) and surface chemistry (citrate or polyvinlypyrrolidone capping) on cellular toxicity and innate immune responses against Mycobacterium tuberculosis (M.tb) by human monocyte-derived macrophages (MDM). Exposures of MDM to AgNP significantly reduced cellular viability, increased IL8 and decreased IL10 mRNA expression. Exposure of M.tb-infected MDM to AgNP suppressed M.tb-induced expression of IL1B, IL10, and TNFA mRNA. Furthermore, M.tb-induced IL-1β, a cytokine critical for host resistance to M.tb, was inhibited by AgNP but not by carbon black particles indicating that the observed immunosuppressive effects of AgNP are particle specific. Suppressive effects of AgNP on the M.tb-induced host immune responses were in part due to AgNP-mediated interferences with the TLR signaling pathways that culminate in the activation of the transcription factor NF-κB. AgNP exposure suppressed M.tb-induced expression of a subset of NF-κB mediated genes (CSF2, CSF3, IFNG, IL1A, IL1B, IL6, IL10, TNFA, NFKB1A). In addition, AgNP exposure increased the expression of HSPA1A mRNA and the corresponding stress-induced Hsp72 protein. Up-regulation of Hsp72 by AgNP can suppress M.tb-induced NF-κB activation and host immune responses. The observed ability of AgNP to modulate infectious pathogen-induced immune responses has important public health implications.
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Liaquat A, Iram S, Hussain S, Yusuf NW, Azeem H. Concomitant presence of culture-proven active pulmonary tuberculosis in patients with chronic obstructive pulmonary disease - A hospital based study. Pak J Med Sci 2015; 31:1344-8. [PMID: 26870094 PMCID: PMC4744279 DOI: 10.12669/pjms.316.8166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 05/08/2015] [Accepted: 09/03/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To find out the prevalence of concomitant active pulmonary Tuberculosis (TB) in patients of Chronic Obstructive Pulmonary Disease (COPD) using the gold standard liquid and solid culture media for the detection of acid fast bacillus. METHODS Eighty clinically and radiologically diagnosed cases of COPD of any severity, ≥40 years of age with no previous history of anti-tuberculous therapy were selected from department of Pulmonology, Jinnah Hospital, Lahore. Detailed demographic profile, clinical symptomatology and history of smoking were recorded. Sputum samples of these patients were subjected to ZiehlNeelsen (ZN) stain and culture on Lowenstein-Jensen (L.J) medium and Mycobacterium Growth Indicator Tube (MGIT) for the detection and isolation of Mycobacteriumtuberculosis (MTB). RESULTS Out of 80 COPD patients, 6 (7.5%) were culture positive for acid fast bacillus consistent with active tuberculous infection. The concomitance was more prevalent in elderly, male, smokers. MGIT was a more sensitive and a rapid technique to detect the presence of mycobacterium as compared to LJ culture media and ZN stain. CONCLUSION The prevalence of active TB in COPD patients was 7.5%. Detection was improved when liquid culture media was employed for the detection of acid fast bacillus. Regular monitoring and screening of patients with COPD for PTB should be routinely carried out in susceptible cohort to avoid cross spreading of infection and appropriate management.
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Affiliation(s)
- Aneela Liaquat
- Aneela Liaquat, M.Phil Microbiology. Govt. College University Lahore, Pakistan
| | - Shagufta Iram
- Shagufta Iram, M.Phil Microbiology, Assistant Professor, Dept. of Pathology, Allama Iqbal Medical College, Lahore, Pakistan
| | - Shahida Hussain
- Shahida Hussain, M.Phil Biotechnology, Dept. of Pathology, Allama Iqbal Medical College, Lahore, Pakistan
| | - Noshin Wasim Yusuf
- Noshin Wasim Yusuf, MBBS, MRC.Path, FRC.Path (UK), Professor of Pathology, Rashid Lateef Medical College, Lahore, Pakistan
| | - Hassan Azeem
- Hassan Azeem, MBBS, Dept. of Pulmonology. Jinnah Hospital Lahore, Pakistan
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Aziza R, Sanae H, Hatim K, Bourkadi JE. Pulmonary tuberculosis specificities in smokers. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2015.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ogbonnaya A, Manafa P, Chucks E, Okeke K, Alo M, Godwin O. The prevalence of diabetes mellitus in human immunodeficiency virus seropositive subjects co-infected with mycobacterium tuberculosis. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/jahr2015.0310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Borba RCN, Vidal VM, Moreira LO. The re-emergency and persistence of vaccine preventable diseases. AN ACAD BRAS CIENC 2015; 87:1311-22. [PMID: 26312431 DOI: 10.1590/0001-3765201520140663] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The introduction of vaccination worldwide dramatically reduced the incidence of pathogenic bacterial and viral diseases. Despite the highly successful vaccination strategies, the number of cases among vaccine preventable diseases has increased in the last decade and several of those diseases are still endemic in different countries. Here we discuss some epidemiological aspects and possible arguments that may explain why ancient diseases such as, measles, polio, pertussis, diphtheria and tuberculosis are still with us.
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Affiliation(s)
- Rodrigo C N Borba
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Vinícius M Vidal
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Lilian O Moreira
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
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Jiménez-Ruiz CA, Andreas S, Lewis KE, Tonnesen P, van Schayck CP, Hajek P, Tonstad S, Dautzenberg B, Fletcher M, Masefield S, Powell P, Hering T, Nardini S, Tonia T, Gratziou C. Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. Eur Respir J 2015; 46:61-79. [PMID: 25882805 DOI: 10.1183/09031936.00092614] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 12/24/2014] [Indexed: 12/18/2022]
Abstract
Chronic obstructive pulmonary disease (COPD), lung cancer, asthma and pulmonary tuberculosis are common pulmonary diseases that are caused or worsened by tobacco smoking. Growing observational evidence suggests that symptoms and prognosis of these conditions improve upon smoking cessation. Despite increasing numbers of (small) randomised controlled trials suggesting intensive smoking cessation treatments work in people with pulmonary diseases many patients are not given specific advice on the benefits or referred for intensive cessation treatments and, therefore, continue smoking.This is a qualitative review regarding smoking cessation in patients with COPD and other pulmonary disorders, written by a group of European Respiratory Society experts. We describe the epidemiological links between smoking and pulmonary disorders, the evidence for benefits of stopping smoking, how best to assess tobacco dependence and what interventions currently work best to help pulmonary patients quit. Finally, we describe characteristics and management of any "hardcore" smoker who finds it difficult to quit with standard approaches.
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Affiliation(s)
| | - Stefan Andreas
- Lungenfachklinik Immenhausen and Pneumology, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Keir E Lewis
- Dept of Respiratory Medicine, Prince Philip Hospital and Swansea College of Medicine, Swansea, UK
| | - Philip Tonnesen
- Dept of Sleep Medicine, Glostrup Hospital, Glostrup, Denmark
| | - C P van Schayck
- Care and Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Serena Tonstad
- Section for Preventive Cardiology, Oslo University Hospital, Oslo, Norway
| | | | | | | | | | | | - Stefano Nardini
- Pulmonary and TB Unit, Ospedale Civile, Vittorio Veneto, Italy
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Christina Gratziou
- University Centre for Research and Smoking Cessation, Evgenidio Hospital, Medical School, Athens University, Athens, Greece
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Volkmann T, Moonan PK, Miramontes R, Oeltmann JE. Tuberculosis and excess alcohol use in the United States, 1997-2012. Int J Tuberc Lung Dis 2015; 19:111-9. [PMID: 25519800 PMCID: PMC4798229 DOI: 10.5588/ijtld.14.0516] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Excess alcohol use among tuberculosis (TB) patients complicates TB control strategies. OBJECTIVES To characterize the role of excess alcohol use in TB control, we describe the epidemiology of excess alcohol use and TB in the United States among those aged ⩾15 years. DESIGN Using data reported to the National Tuberculosis Surveillance System, 1997-2012, we examined associations between excess alcohol use and TB treatment outcomes and markers for increased transmission (involvement in a local genotype cluster of cases) using multivariate logistic regression. We used Cox proportional hazards regression analysis to examine the relationship between excess alcohol use and the rate of conversion from positive to negative in sputum culture results. RESULTS Excess alcohol use was documented for 31 207 (15.1%) of 207 307 patients. Prevalence of excess alcohol use was greater among male patients (20.6%) and US-born patients (24.6%). Excess alcohol use was associated with a positive sputum smear result (aOR 1.23, 95%CI 1.18-1.28) and death during treatment (vs. completion of treatment) (aOR 1.16, 95%CI 1.10-1.22). The rate of culture conversion was higher among patients without excess alcohol use (adjusted hazard ratio 1.20, 95%CI 1.18-1.23). CONCLUSIONS Excess alcohol use was common among patients with TB, and was associated with TB transmission, lower rates of sputum culture conversion, and greater mortality.
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Affiliation(s)
- T Volkmann
- Epidemic Intelligence Service, assigned to Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - P K Moonan
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - R Miramontes
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J E Oeltmann
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Stevens H, Ximenes RA, Dantas OM, Rodrigues LC. Risk factors for tuberculosis in older children and adolescents: a matched case-control study in Recife, Brazil. Emerg Themes Epidemiol 2014; 11:20. [PMID: 25642275 PMCID: PMC4312596 DOI: 10.1186/s12982-014-0020-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 12/04/2014] [Indexed: 11/17/2022] Open
Abstract
Background Tuberculosis is a major disease worldwide and most research focus on risk factors for adults, although there is a marked adolescent peak in incidence. The objective of this study was to identify risk factors for tuberculosis in children aged 7 to 19. Methods A case control study matched by age with 169 cases and 477 controls. The study population consisted of adolescents and older children from Recife, Brazil. Cases were individuals diagnosed with tuberculosis in the control programme and controls were selected in the neighborhood of cases. Conditional logistic regression was used to identify risk factors. Results Cigarette smoking increased by 50% the risk of tuberculosis but that this was not statistically significant (OR = 1.6). Other risk factors were sleeping in the same house as a case of tuberculosis (OR = 31.6), living in a house with no piped water (OR = 7.7) (probably as a proxy for bad living conditions), illiteracy (OR = 3.7) and male sex (OR = 1.8). The increase in risk with living in houses with no piped water was much more marked in males. The proportion of cases of tuberculosis attributed to contact with someone with TB was 38% and to illiteracy, lack of piped water and smoking, 20%. Conclusion Household contact with tuberculosis, social factors and male sex play the biggest role in determining risk of TB disease among children and adolescents in the study. We recommend further research on the relationship of cigarette smoking on tuberculosis in adolescents, and on whether the sex differentials are more marked in bad living conditions. Separate studies should be conducted in older children and in adolescents.
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Affiliation(s)
- Hilary Stevens
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Ricardo Aa Ximenes
- Department Medicina Tropical, Universidade Federal do Pernambuco, Bl. A do Hospital das Clinicas. Av. Prof. Moraes Rego s/n, Cidade Universitária, Recife, PE 50670-420 Brazil ; Department Medicina Interna, Universidade de Pernambuco, Recife, Brazil
| | - Odimariles Ms Dantas
- Department Medicina Tropical, Universidade Federal do Pernambuco, Bl. A do Hospital das Clinicas. Av. Prof. Moraes Rego s/n, Cidade Universitária, Recife, PE 50670-420 Brazil ; Department de Saúde Materno Infantil, Universidade Federal do Pernambuco, Recife, Brazil
| | - Laura C Rodrigues
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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Janah H, Souhi H, Kouissmi H, Marc K, Zahraoui R, Benamor J, Soualhi M, Bourkadi JE. [Pulmonary tuberculosis and tobacco: about 100 cases]. Pan Afr Med J 2014; 19:202. [PMID: 25821545 PMCID: PMC4369393 DOI: 10.11604/pamj.2014.19.202.5329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022] Open
Abstract
Le tabagisme et la tuberculose sont deux enjeux majeurs de santé publique au niveau mondial, en particulier dans les pays émergents. Pour déterminer les particularités cliniques, radiologiques, bactériologiques et thérapeutiques de la tuberculose pulmonaire chez les sujets tabagiques nous avons mené une étude prospective au service de phtisiologie de l'hôpital Moulay Youssef sur une période de 10 mois, portant sur 100 nouveaux cas de tuberculose pulmonaire, répartis en 2 groupes, 50 patients tabagiques: Groupe A et 50 patients non tabagiques: Groupe B. Tous nos patients étaient de sexe masculin, l’âge moyen était de 41 ans ± 12 chez le groupe A et de 36 ans ± 16 chez le groupe B. Le délai de consultation était plus long chez les tabagiques, la médiane était de 60j (30; 98) contre 40j (30; 60), la symptomatologie clinique était variable chez les deux groupes, dominée par les expectorations chez les tabagiques 96% contre 60%. Les lésions radiologiques étaient similaires chez les deux groupes ainsi que la charge bacillaire. Tous les patients ont été mis sous traitement antituberculeux. Après un mois du traitement, la Bacilloscopie était négative chez 50% du groupe A contre 66% chez le groupe B. la régression des lésions radiologiques était similaire chez les deux groupes. Le retard diagnostique et le retard de négativation des frottis sont les principales particularités de la tuberculose pulmonaire du sujet tabagique. Le sevrage tabagique doit faire partie intégrante de la prise en charge des patients atteints de tuberculose.
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Affiliation(s)
- Hicham Janah
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Hicham Souhi
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Hatim Kouissmi
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Karima Marc
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Rachida Zahraoui
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Jouda Benamor
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
| | - Mona Soualhi
- Service de Phtisiologie de l'Hôpital Moulay Youssef, CHU Rabat, Maroc
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The Surgeon Generals' reports and respiratory diseases. From 1964 to 2014. Ann Am Thorac Soc 2014; 11:141-8. [PMID: 24575983 DOI: 10.1513/annalsats.201311-417ps] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Chen M, Deng J, Su C, Li J, Wang M, Abuaku BK, Hu S, Tan H, Wen SW. Impact of passive smoking, cooking with solid fuel exposure, and MBL/MASP-2 gene polymorphism upon susceptibility to tuberculosis. Int J Infect Dis 2014; 29:1-6. [PMID: 25312983 DOI: 10.1016/j.ijid.2014.08.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 07/15/2014] [Accepted: 08/16/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To explore the impact of passive smoking, cooking with solid fuel, mannose-binding lectin (MBL) gene, MBL-associated serine proteases 2 (MASP-2) gene, and gene-environment interactions on the susceptibility to tuberculosis (TB) in non-smokers. METHODS A total of 205 TB patients and 216 healthy controls were recruited to participate in this case-control study. PCR with sequence-specific primers (PCR-SSP) technology was leveraged to genotype rs7096206 of MBL genes and rs2273346 and rs6695096 of MASP-2 genes. Demographic data and information on exposures of participants were collected. Unconditioned logistic regression analysis was conducted to identify associations between the various factors and TB, and marginal structural linear odds models were used to estimate the interactions. RESULTS Passive smoking and cooking with solid fuel were associated with the risk of TB, with odds ratios (OR) of 1.58 and 2.93, respectively (p<0.05). Genotype CG at rs7096206 of MBL genes (OR 2.02) and genotype TC at rs6695096 of MASP-2 genes (OR 1.67) were more prevalent in the TB patients than in healthy controls (p<0.05). The relative excess risk of interaction (RERI) between rs7096206 of MBL genes and passive smoking or cooking with solid fuel exposure was 1.86 (95% confidence interval (CI) 0.59-3.16) and 2.66 (95% CI 1.85-3.47), respectively. The RERI between rs6695096 of MASP-2 genes and cooking with solid fuel exposure was 3.70 (95% CI 2.63-4.78), which was also a positive interaction. However, the RERI between rs6695096 of MASP-2 genes and passive smoking was not statistically significant. CONCLUSIONS Passive smoking, cooking with solid fuel, and polymorphisms of MBL (rs7096206) and MASP-2 (rs6695096) genes were associated with susceptibility to TB in non-smokers, and there were gene-environment interactions among them. Further studies are needed to explore details of the mechanisms of association.
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Affiliation(s)
- Mengshi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China; Hunan Children's Hospital, Changsha, Hunan, PR China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China
| | - Congxu Su
- Yueyanglou Center for Disease Control and Prevention, Yueyang, Hunan, PR China
| | - Jun Li
- Hunan Provincial Tumor Hospital, Changsha, Hunan, PR China
| | - Mian Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China
| | - Benjamin Kwaku Abuaku
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China
| | - ShiMin Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China.
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, PR China; Department of Obstetrics and Gynecology, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada
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Tulu B, Dida N, Kassa Y, Taye B. Smear positive pulmonary tuberculosis and its risk factors among tuberculosis suspect in South East Ethiopia; a hospital based cross-sectional study. BMC Res Notes 2014; 7:285. [PMID: 24884870 PMCID: PMC4023165 DOI: 10.1186/1756-0500-7-285] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 04/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculosis remains a deadly infectious disease, affecting millions of people worldwide. Ethiopia ranks seventh among the twenty two high tuberculosis burden countries. The aim of this study was to determine the prevalence of smear positive pulmonary tuberculosis and its associated risk factors in Goba and Robe hospitals of Bale zone. METHODS A cross-sectional study was conducted on tuberculosis suspected patients from February-May 2012. Sputum samples were examined for acid fast bacilli using Ziehl-Neelsen staining and interview was conducted for each patient. Descriptive statistics, binary logistic and multivariable logistic regression analyses were employed to identify factors associated with pulmonary tuberculosis infection. RESULT The prevalence of smear positive tuberculosis was 9.2%. Age >36 (AOR = 3.54, 95% CI = 1. 3-9.82), marital status (AOR = 8.40, 95% CI = 3.02-23.20), family size (AOR = 4. 10, 95% CI = 1.60-10.80), contact with active tuberculosis patient (AOR = 5. 90; 95% CI = 2. 30-15.30), smoking cigarette regularly (AOR = 3. 90; 95% CI = 1. 20-12.40), and human immunodeficiency virus sero-status (AOR = 11. 70; 95% CI = 4. 30-31.70) were significantly associated with smear positive pulmonary tuberculosis. CONCLUSION The prevalence of smear positive pulmonary tuberculosis was high in the study area. Age, marital status, family size, history of contact with active tuberculosis patient, smoking cigarettes, and HIV sero-status were among the risk factors significantly associated with acquiring tuberculosis. Hence, strict pulmonary tuberculosis screening of HIV patients and intensification of health education to avoid risk factors identified are recommended.
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Affiliation(s)
- Begna Tulu
- Microbiology, Immunology and Parasitology Department, College of Medicine and Health Sciences, Bahir Dar University, P, O, Box 79, Bahir Dar, Ethiopia.
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van Zyl-Smit RN, Binder A, Meldau R, Semple PL, Evans A, Smith P, Bateman ED, Dheda K. Cigarette smoke impairs cytokine responses and BCG containment in alveolar macrophages. Thorax 2014; 69:363-70. [PMID: 24287167 PMCID: PMC5523928 DOI: 10.1136/thoraxjnl-2013-204229] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is a strong epidemiological link between smoking and tuberculosis (TB), but the association is confounded by socioeconomic and other factors. A direct relationship between cigarette smoke and poor treatment-related outcomes in patients with TB is therefore questionable. We investigated whether constituents of tobacco smoke impair mycobacterial host immune responses in vitro. METHODOLOGY Preparation of a cigarette smoke extract (CSE) from Marlboro Red cigarettes was standardised and reproducibility verified by mass spectroscopy. Macrophages were derived from peripheral blood monocytes (MDM) and alveolar macrophages from bronchoalveolar lavage fluid from healthy non-smoking volunteers. Mycobacterial uptake (flow cytometric detection of fluorescence using green fluorescent protein-labelled BCG), cytokine responses (ELISA) and mycobacterial containment (colony forming units) was evaluated in both macrophage populations with and without co-culture with CSE, nicotine and a nicotine receptor blocker. RESULTS Cigarette smoke failed to impair the uptake of mycobacteria by monocyte-derived or alveolar macrophages. CSE (vs no CSE) reduced the mean (SD) BCG-driven macrophage (MDM) interferon γ (IFN-γ), tumour necrosis factor α (TNF-α) and interleukin 10 (IL-10) responses by 56.4 (18.6)%, 67.0 (33.4)% and 77.7 (27.7)%, respectively (p<0.001). Nicotine alone impaired IL-10 and TNF-α production by 48.8 (37)% and 49 (50)%, respectively (p<0.05) through an α-7 nicotine receptor-independent mechanism. In 5-day cultures, CSE impaired mycobacterial (BCG) containment in both monocyte-derived and alveolar macrophages. CONCLUSIONS Cigarette smoke attenuates effector cytokine responses and impairs mycobacterial containment within infected human macrophages derived from the peripheral blood and alveolar compartments, thus supporting the hypothesis that cigarette smoke subverts mycobacteria-related immunity.
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Affiliation(s)
- Richard N van Zyl-Smit
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - Anke Binder
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - Richard Meldau
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - Patricia L Semple
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - Alicia Evans
- Division of Pharmacology, Department of Medicine, University of Cape Town, South Africa
| | - Peter Smith
- Division of Pharmacology, Department of Medicine, University of Cape Town, South Africa
| | - Eric D Bateman
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - Keertan Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology & UCT Lung Institute, Department of Medicine, University of Cape Town, South Africa
- Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa
- Department of Infection, University College London Medical School, UK
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Sreedhar G, Narayanappa Sumalatha M, Shukla D. An overview of the risk factors associated with multiple oral premalignant lesions with a case report of extensive field cancerization in a female patient. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 159:178-83. [PMID: 24401899 DOI: 10.5507/bp.2013.092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/10/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Field cancerization is a well-known and well-documented process of malignant transformation first coined by Slaughter et al. in 1953. Tobacco chewing was associated with the greatest increase in the risk of multiple oral premalignant lesions and may be the major source of field cancerization of the oral cavity in the Indian population. The field cancerization will probably help clinicians in complementing evaluation of pathologic biopsy specimens. MATERIAL AND METHODS We present a case report of field cancerization in a 63-year-old Indian female. She presented with an intra-oral generalized hyperkeratotic verruciform type white lesions involving right and left buccal mucosa, lower labial mucosa, upper and lower vestibule, dorsal, ventral and right lateral border of the tongue, hard and soft palate. Microscopic examination revealed features of verrucous carcinoma in one area, squamous cell carcinoma in another and carcinoma in situ in other areas. Based on the overall features in various areas of the oral cavity, the lesion was diagnosed as field cancerization. CONCLUSION Reviewing the literature revealed the presence of a field with genetically altered cells appear to be induced by tobacco (smoking/smokeless form). The large number of premalignant cells in the fields may increase cancer risk considerably. Thus screening and monitoring of the field may have serious implications for oral cancer prevention.
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Affiliation(s)
- Gadiputi Sreedhar
- Department of Oral Pathology and Microbiology, Babu Banarasi Das College of Dental Sciences, Lucknow, India
| | | | - Deepika Shukla
- Department of Oral Pathology and Microbiology, Babu Banarasi Das College of Dental Sciences, Lucknow, India
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Maciel EL, Brioschi AP, Peres RL, Guidoni LM, Ribeiro FK, Hadad DJ, Vinhas SA, Zandonade E, Palaci M, Dietze R, Johnson JL. Smoking and 2-month culture conversion during anti-tuberculosis treatment. Int J Tuberc Lung Dis 2013; 17:225-8. [PMID: 23317958 DOI: 10.5588/ijtld.12.0426] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate risk factors for delayed sputum culture conversion to negative during anti-tuberculosis treatment, with an emphasis on smoking. DESIGN Nested case-control study of adults with non-cavitary, culture-confirmed pulmonary tuberculosis (TB) participating in an anti-tuberculosis treatment trial in Brazil. A case of delayed culture conversion was a patient who remained culture-positive after 2 months of treatment. Odds ratios with 95% confidence intervals were calculated. RESULTS Fifty-three cases and 240 control patients were analyzed. Smokers had three-fold greater odds of remaining culture-positive after 2 months of treatment (P = 0.007) than non-smokers, while smokers and ex-smokers who smoked >20 cigarettes a day had two-fold greater odds of remaining culture-positive after 2 months of treatment (P = 0.045). CONCLUSION Cigarette smoking adversely affects culture conversion during anti-tuberculosis treatment. Support for smoking cessation should be considered to improve outcomes in TB control programs.
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Affiliation(s)
- E L Maciel
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
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Pasipanodya JG, Moonan PK, Vecino E, Miller TL, Fernandez M, Slocum P, Drewyer G, Weis SE. Allopatric tuberculosis host-pathogen relationships are associated with greater pulmonary impairment. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2013; 16:433-40. [PMID: 23501297 PMCID: PMC4582658 DOI: 10.1016/j.meegid.2013.02.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 02/20/2013] [Accepted: 02/22/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Host pathogen relationships can be classified as allopatric, when the pathogens originated from separate, non-overlapping geographic areas from the host; or sympatric, when host and pathogen shared a common ancestral geographic location. It remains unclear if host-pathogen relationships, as defined by phylogenetic lineage, influence clinical outcome. We sought to examine the association between allopatric and sympatric phylogenetic Mycobacterium tuberculosis lineages and pulmonary impairment after tuberculosis (PIAT). METHODS Pulmonary function tests were performed on patients 16 years of age and older who had received ≥20 weeks of treatment for culture-confirmed M. tuberculosis complex. Forced Expiratory Volume in 1 min (FEV1) ≥80%, Forced Vital Capacity (FVC) ≥80% and FEV1/FVC >70% of predicted were considered normal. Other results defined pulmonary impairment. Spoligotype and 12-locus mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) were used to assign phylogenetic lineage. PIAT severity was compared between host-pathogen relationships which were defined by geography and ethnic population. We used multivariate logistic regression modeling to calculate adjusted odds ratios (aOR) between phylogenetic lineage and PIAT. RESULTS Self-reported continental ancestry was correlated with Mycobacterium. tuberculosis lineage (p<0.001). In multivariate analyses adjusting for phylogenetic lineage, age and smoking, the overall aOR for subjects with allopatric host-pathogen relationships and PIAT was 1.8 (95% confidence interval [CI]: 1.1, 2.9) compared to sympatric relationships. Smoking >30 pack-years was also associated with PIAT (aOR: 3.2; 95% CI: 1.5, 7.2) relative to smoking <1 pack-years. CONCLUSIONS PIAT frequency and severity varies by host-pathogen relationship and heavy cigarette consumption, but not phylogenetic lineage alone. Patients who had disease resulting from allopatric-host-pathogen relationship were more likely to have PIAT than patients with disease from sympatric-host-pathogen relationship infection. Further study of this association may identify ways that treatment and preventive efforts can be tailored to specific lineages and racial/ethnic populations.
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Batista JDL, de Albuquerque MDFPM, Maruza M, Ximenes RADA, Santos ML, Montarroyos UR, de Barros Miranda-Filho D, Lacerda HR, Rodrigues LC. Incidence and risk factors for tuberculosis in people living with HIV: cohort from HIV referral health centers in Recife, Brazil. PLoS One 2013; 8:e63916. [PMID: 23675515 PMCID: PMC3651200 DOI: 10.1371/journal.pone.0063916] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 04/08/2013] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To identify the incidence of and risk factors for tuberculosis in people living with HIV (PLHIV). DESIGN Observational, prospective cohort study. METHODS A total of 2069 HIV-infected patients was observed between July 2007 and December 2010. The Kaplan-Meier method was used to estimate the probability of survival free of tuberculosis, and Cox regression analysis to identify risk factors associated with the development of tuberculosis. RESULTS Survival free of tuberculosis (TB) was 91%. The incidence rate of tuberculosis was 2.8 per 100 persons/years. Incidence of tuberculosis was higher when subjects had CD4 cell count <200 cells/mm(3); were not on antiretroviral therapy; in those who had, a body mass index <18.5 kg/m(2), anemia (or were not tested for it), were illiterate or referred previous tuberculosis treatment at entry into the cohort. Those not treated for latent TB infection had a much higher risk (HR = 7.9) of tuberculosis than those with a negative tuberculin skin test (TST). Having a TST≥5 mm but not being treated for latent TB infection increased the risk of incident tuberculosis even in those with a history of previous tuberculosis. CONCLUSIONS Preventive actions to reduce the risk of TB in people living with HIV should include an appropriate HAART and treatment for latent TB infection in those with TST≥5 mm. The actions towards enabling rigorous implementation of treatment of latent TB infection and targeting of PLHIV drug users both at the individual and in public health level can reduce substantially the incidence of TB in PLHIV.
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Amare H, Gelaw A, Anagaw B, Gelaw B. Smear positive pulmonary tuberculosis among diabetic patients at the Dessie referral hospital, Northeast Ethiopia. Infect Dis Poverty 2013; 2:6. [PMID: 24499664 PMCID: PMC3707095 DOI: 10.1186/2049-9957-2-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 03/18/2013] [Indexed: 11/26/2022] Open
Abstract
Background Tuberculosis (TB) is an infectious disease which is still a major cause of morbidity and mortality throughout the world. People with diabetes mellitus (DM) have a three times higher risk of developing active TB than people without diabetes. However, there is not enough credible information on the burden of pulmonary tuberculosis (PTB) among DM patients in Ethiopia, in general, and in the city of Dessie, in particular. Therefore, this study aims to determine the prevalence and associated risk factors of smear positive PTB among diabetic patients at a referral hospital in Dessie. Methods A cross-sectional study was conducted from February 2012 to April 2012. Patient demographic characteristics were collected using a pre-tested standard questionnaire format. Spot-morning-spot sputum specimens were collected from the study participants and examined for acid-fast bacilli using direct microscopy by the Ziehl-Neelsen staining technique. Data was entered and analyzed using the SPSS version 16 statistical software and p-value <0.05 was considered as statistically significant. Results Out of 225 TB suspected diabetic patients, 52% were males and 48% were females. Their ages ranged from 12 to 82 years, with a mean age of 47.2 years. Urban residence (AOR: 5.5; 95% CI: 1.07–28.20), history of TB (AOR: 13.4; 95% CI: 2.74–65.73), contact with TB patients in the family (AOR: 9.4; 95% CI: 1.822–48.50), and long duration of DM (AOR: 8.89; 95% CI: 1.88–58.12) were independently associated with the development of active TB in people living with DM. Conclusions The prevalence of smear positive PTB was 6.2% in TB suspected diabetic patients, which is higher compared with the general population (0.39%). Patients with a previous history of contact with TB patients, as well as those who had prolonged diabetes, were more prone to have PTB. Therefore, screening of diabetic patients for PTB infection during follow-up is necessary.
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Affiliation(s)
- Hiwot Amare
- Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
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Correlation of ambient pollution levels and heavily-trafficked roadway proximity on the prevalence of smear-positive tuberculosis. Public Health 2013; 127:268-74. [DOI: 10.1016/j.puhe.2012.12.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 11/12/2012] [Accepted: 12/21/2012] [Indexed: 01/17/2023]
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