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Teshima A, Shatnawi AA, Satyanarayana S, Khader YS, Maia IF, Wilson NC. High prevalence of current tobacco smoking among patients with tuberculosis and people living with HIV in Jordan: A cross-sectional survey. Tob Induc Dis 2023; 21:136. [PMID: 37869614 PMCID: PMC10587893 DOI: 10.18332/tid/171551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION Continued smoking by patients with tuberculosis (TB) and people living with HIV (PLHIV) leads to adverse treatment outcomes. Estimates of tobacco use among the population are scarce in the Eastern Mediterranean region, where the burden of TB and HIV is also low but highly variable. This study determined the prevalence of current smoking and assessed factors associated with current smoking among patients with TB and PLHIV in Jordan. METHODS We analyzed data from the Jordan Knowledge, Attitude, and Practices survey in 2021. Information on current tobacco use, including products and frequency of smoking, was collected from 452 patients with TB and 152 PLHIV. We performed multivariable logistic regression to assess the sociodemographic characteristics independently associated with current smoking. RESULTS Prevalence of current smoking was 43.8% among TB patients and 67.8 % among PLHIV, and conventional cigarettes were the most used tobacco products. The prevalence of current smoking among patients with TB was higher among males (AOR=8.20; 95% CI: 5.05-13.32), Jordanians (AOR=5.37; 95% CI: 2.66-10.86) and Syrians (AOR=4.13; 95% CI: 1.60-10.67), and those experiencing financial difficulties (AOR=2.83; 95% CI: 1.69-4.74). The prevalence of current smoking among PLHIV was higher in those with financial difficulties (AOR=3.13; 95% CI: 1.19-8.27). CONCLUSIONS Nearly half of the patients with TB and PLHIV were current tobacco smokers, higher than the general population. There is an urgent need to investigate the reasons for such a high smoking prevalence and introduce and strengthen smoking cessation services under the TB and HIV control programs.
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Affiliation(s)
- Ayaka Teshima
- Tobacco Control Unit, Department of Cancer Epidemiology and Prevention, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ayah A. Shatnawi
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
| | - Srinath Satyanarayana
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
| | - Yousef S. Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ibrahim F. Maia
- Department of Chest Diseases and Migrant Health, Ministry of Health, Amman, Jordan
| | - Nevin C. Wilson
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
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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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3
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Adegbite BR, Edoa JR, Achimi Agbo P, Dejon-Agobé JC, N Essone P, Lotola-Mougeni F, Mbong Ngwese M, Mfoumbi A, Mevyann C, Epola M, Zinsou JF, Honkpehedji YJ, Agnandji ST, Kremsner PG, Alabi AS, Adegnika AA, Grobusch MP. Epidemiological, Mycobacteriological, and Clinical Characteristics of Smoking Pulmonary Tuberculosis Patients, in Lambaréné, Gabon: A Cross-Sectional Study. Am J Trop Med Hyg 2020; 103:2501-2505. [PMID: 32975178 DOI: 10.4269/ajtmh.20-0424] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gabon carries a high burden of both tuberculosis (TB) and smoking. This study examines the disease characteristics of smoking pulmonary TB patients in Lambaréné. We interviewed adult pulmonary TB patients in Lambaréné, between March 2016 and April 2019. Clinical and biological patient characteristics were collected. Bivariate and logistic regression analyses were performed to assess factors associated with smoking. The mean age of patients included was 31 years (±13). The proportion of smokers in our study was 30% (89/295). Smoking was significantly associated with patient-related diagnostic delay (adjusted odds ratio [AOR] = 8.18; 95% CI = 3.67-19.56), a higher number of pulmonary TB signs and symptoms (AOR = 2.74; 95% CI = 1.18-6.73), and a higher sputum mycobacterial load (AOR = 3.18; 95% CI = 1.33-8.11). The prevalence of smoking among TB patients is high, and leading to aggravated disease as compared with controls. Our study findings suggest that smoking patients should be regularly screened for TB, to reduce diagnostic delay and TB transmission within community. Smoking cessation activities should be included in the national TB control program in Gabon.
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Affiliation(s)
- Bayode Romeo Adegbite
- Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.,Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Pacome Achimi Agbo
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean Claude Dejon-Agobé
- Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.,Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Paulin N Essone
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Fabrice Lotola-Mougeni
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Mirabeau Mbong Ngwese
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Arnault Mfoumbi
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Chester Mevyann
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Micheska Epola
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jeannot Frejus Zinsou
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Yabo Josiane Honkpehedji
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Selidji Todagbe Agnandji
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Peter Gottfried Kremsner
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Abraham Sunday Alabi
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Martin Peter Grobusch
- Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
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Aguilar JP, Arriaga MB, Rodas MN, Martins Netto E. Smoking and pulmonary tuberculosis treatment failure: a case-control study. ACTA ACUST UNITED AC 2019; 45:e20180359. [PMID: 31038651 PMCID: PMC6733738 DOI: 10.1590/1806-3713/e20180359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/05/2019] [Indexed: 12/02/2022]
Abstract
Objective: To determine the association between smoking and pulmonary tuberculosis treatment failure. Methods: This was a case-control study conducted at the Brazilian Institute for Tuberculosis Research in the city of Salvador, Brazil, between 2007 and 2015. We evaluated 284 patients treated for pulmonary tuberculosis, comparing 50 cases of treatment failure with 234 control cases in which the final outcome was cure. Results: Treatment failure was attributed to smoking and age rather than to gender, income, level of education, alcohol consumption, or marital status. Therefore, even after adjustment for age, the risk of treatment failure was 2.1 times (95% CI: 1.1-4.1) higher among the patients with a history of smoking. In addition, being over 50 years of age was found to increase the likelihood of treatment failure by 2.8 times (95% CI: 1.4-6.0). Conclusions: Smoking and aging are both associated with pulmonary tuberculosis treatment failure. Therefore, as part of a tuberculosis control program, health personnel should be prepared to offer strategies to promote smoking cessation and should be more careful with older patients.
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Affiliation(s)
- Juan Pablo Aguilar
- . Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | - María B Arriaga
- . Programa de Pós-Graduação em Patologia Humana e Patologia Experimental. Fundação Oswaldo Cruz - Fiocruz-BA - Salvador (BA) Brasil.,. Fundação José Silveira, Salvador (BA) Brasil
| | - Monica Ninet Rodas
- . Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Coordinación de Trabajos de Graduación, Facultad de Medicina, Universidad de San Carlos - USAC - Ciudad de Guatemala, Guatemala
| | - Eduardo Martins Netto
- . Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Fundação José Silveira, Salvador (BA) Brasil.,. Laboratório de Pesquisa em Infectologia - LAPI - Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
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Arnedo-Pena A, Romeu-Garcia MA, Meseguer-Ferrer N, Vivas-Fornas I, Vizcaino-Batllés A, Safont-Adsuara L, Bellido-Blasco JB, Moreno-Muñoz R. Pulmonary Versus Extrapulmonary Tuberculosis Associated Factors: A Case-Case Study. Microbiol Insights 2019; 12:1178636119840362. [PMID: 30992667 PMCID: PMC6449815 DOI: 10.1177/1178636119840362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022] Open
Abstract
Background Tuberculosis (TB) incidence remains low in health departments of Castellon and La Plana-Vila-real, but TB elimination is challenging. The objective of this study was to estimate associated factors of pulmonary tuberculosis (PTB) compared with extrapulmonary tuberculosis (ETB) and investigate epidemiological characteristics of these pathologies to orient control and prevention actions. Materials and Methods A prospective case-case study was implemented by comparing PTB and ETB incidences during 2013-2016 from notification reports, epidemiological surveillance, and microbiological results of hospitals' laboratories Hospital General Castellon and La Plana-Vila-Real in the province of Castellon of Valencia region in Spain. In this design, cases were patients with PTB and controls were patients with ETB. Directed acyclic graph approach was used for selection of potential risk and confounding factors. Adjusted odds ratios (AORs) were estimated by logistic regression models. Results The study included 136 patients with PTB and 57 patients with ETB, with microbiological confirmation of 93.4% and 52.6%, and the annual median of incidence rates were 7.5 and 3.1 per 100 000 inhabitants, respectively. In general, patients with PTB were younger with higher male proportion than patients with ETB. Risk factors of PTB were smoking tobacco (AOR = 3.98; 95% confidence interval [CI] = 1.66-9.56), social problems (social marginalization, homeless, residence in shelters for the poor, or stay in prison) (AOR = 3.39; 95% CI = 1.05-10.94), and contact with patients with TB (AOR = 2.51; 95% CI = 1.06-5.95). No-smoking tobacco and no-drug abuse interaction decrease PTB risk (AOR = 0.27; 95% CI = 0.12-0.64). From these results, specific measures of health promotion and prevention can be addressed. Conclusions The estimated associated factors of PTB may be prevented, and it was demonstrated that the case-case design is useful in the study of TB.
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Affiliation(s)
- Alberto Arnedo-Pena
- Epidemiology Division, Public Health Center, Castellon, Spain.,Department Medicine Preventive and Public Health, Faculty of Health Sciences, Public University of Navarra, Pamplona, Spain.,CIBER-Epidemiology and Public Health, Barcelona, Spain
| | | | | | | | | | | | - Juan Bautista Bellido-Blasco
- Epidemiology Division, Public Health Center, Castellon, Spain.,CIBER-Epidemiology and Public Health, Barcelona, Spain.,Department of Epidemiology and Public Health. School of Medicine, Jaume I University, Castellon, Spain
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6
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Ma Y, Che NY, Liu YH, Shu W, Du J, Xie SH, Li L. The joint impact of smoking plus alcohol drinking on treatment of pulmonary tuberculosis. Eur J Clin Microbiol Infect Dis 2019; 38:651-657. [PMID: 30771122 DOI: 10.1007/s10096-019-03489-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/15/2019] [Indexed: 11/25/2022]
Abstract
Tuberculosis, smoking, and alcohol drinking are major public health and social issues worldwide. We investigated the joint effect of smoking plus alcohol drinking on TB treatment. Retrospective study was conducted among TB patients in 49 units from eight provinces in China. All patients enrolled were classified into four groups according to their smoking and/or alcohol status. Current smokers plus drinkers belonged to group 1; ex-smokers plus ex-drinkers were in group 2; current smokers and ex-drinkers, current smokers and never drinkers, ex-smokers and current drinkers, ex-smokers and never drinkers, never smokers and current drinkers, and never smokers and ex-drinkers belonged to group 3; while the never smokers plus never drinkers were in group 4. We used a chi-square test to compare adverse drug reaction, lesions absorption and cavities of lung, sputum culture at the end of the second month, and treatment outcomes among the four groups. Among the 1256 participants enrolled in the study, 6.1% (76/1256) were current smokers plus drinkers; 25.9% (325/1256) were ex-smokers plus drinkers; 29.1% (366/1256) were current/never/ex-smokers and/or drinkers, and 38.9% (489/1256) were never smokers plus drinkers, respectively. Compared to the never smokers and drinkers, smoker plus drinker TB patients were more likely to experience adverse drug reaction (x2 = 8.480, P = 0.037), less proportion of lesions absorption in lungs (x2 = 10.330, P = 0.016), lower proportion of culture conversion (x2 = 18.83, P = 0.04), and more unfavorable outcomes. Smoking plus alcohol drinking adversely affect response against TB treatment, which increase adverse drug reactions, sputum culture-positive rate at the end of the second month, and failure rate of pulmonary tuberculosis patients.
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Affiliation(s)
- Y Ma
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - N-Y Che
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - Y-H Liu
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - W Shu
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - J Du
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - S-H Xie
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China
| | - Liang Li
- Beijing Chest Hospital, Capital Medical University, Machang Road, No. 97, Beijing, 101149, China. .,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China. .,Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing, 101149, China.
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[Tobacco smoking and stopping smoking interventions in patients with TB]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:391-399. [PMID: 30316651 DOI: 10.1016/j.pneumo.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/01/2018] [Accepted: 09/10/2018] [Indexed: 02/08/2023]
Abstract
Tuberculosis and tobacco smoking are two major public health problems causing significant mortality worldwide. Tobacco smoke increases the risk of Mycobacterium tuberculosis infection, severe pulmonary or extrapulmonary TB, and death of TB. In emerging countries, quitting smoking is one way to control the TB epidemic. Compared with non-smokers, smokers with tuberculosis are less observant of anti-tuberculosis treatment. Smoking abstinence improves the course of their illness, the treatment compliance and facilitates the final cure justifying smoking cessation interventions. The involvement of all healthcare professionals in helping smokers stopping smoking is required.
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Kombila UD, Kane YD, Mbaye FBR, Diouf NF, Ka W, Touré NO. [Radiological features of microscopy-positive pulmonary tuberculosis in patients in the Pneumology Department at the National University Hospital, Fann, Dakar (Sénégal)]. Pan Afr Med J 2018; 30:21. [PMID: 30167049 PMCID: PMC6110565 DOI: 10.11604/pamj.2018.30.21.14208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 02/01/2018] [Indexed: 11/24/2022] Open
Abstract
This study aimed to determine the radiological features of microscopy-positive pulmonary tuberculosis (TB). We conducted a retrospective study, analyzing radiographical imaging of patients with microscopy-positive pulmonary tuberculosis between 15 November 2015 and 15 March 2016. The medical records of 66 patients meeting the inclusion criteria were selected, 81.8% of which belonged to men. The average age of patients was 37.5 ± 14.9 years. Patients had variable parenchymal lesions dominated by infiltrated lesions in 84.8% (CI 95%; 73.9-92.4%) of cases, followed by alveolar syndrome in 68.2% (CI95%; 55.5-79.1%) of cases. Lesions were extensive in 71.2% (CI 95%; 58.7-81.7%) of cases and bilateral in 45.4% (CI 95%; 31.1-58.1%) of cases. These radiological abnormalities occurred in 52.2% (CI 95%; 36.9 - 67.1%) of cases in undernourished patients. In 22.7% (CI 95%; 13.3-34.7%) of cases, these lesions were secondary to an episode of pulmonary tuberculosis; 34.8% (IC95; 23.5 - 47.5%) of patients were regular tobacco smokers consuming, on average, 17 tobacco packs per year (±11.3). TB recurrences were more frequent in patients with a history of smoking versus non-smokers (26.1% versus 20.9%, p < 0.42 respectively). HIV-1 serology test was positive in 7.6% of cases. This study highlights the importance of suspecting pulmonary tuberculosis in young undernourished patients, having a history of smoking, with infiltrated lesions associated or not with cavitary lesions on radiographic examination and living in TB epidemic area.
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Affiliation(s)
- Ulrich Davy Kombila
- Service de Médecine Interne, Centre Hospitalier Universitaire de Libreville (CHUL), Libreville, Gabon
- Clinique de Pneumologie, Centre Hospitalier National Universitaire de FANN (CHNUF), Dakar, Sénégal
| | - Yacine Dia Kane
- Clinique de Pneumologie, Centre Hospitalier National Universitaire de FANN (CHNUF), Dakar, Sénégal
| | | | - Ndeye Fatou Diouf
- Clinique de Pneumologie, Centre Hospitalier National Universitaire de FANN (CHNUF), Dakar, Sénégal
| | - Waly Ka
- Clinique de Pneumologie, Centre Hospitalier National Universitaire de FANN (CHNUF), Dakar, Sénégal
| | - Nafissatou Oumar Touré
- Clinique de Pneumologie, Centre Hospitalier National Universitaire de FANN (CHNUF), Dakar, Sénégal
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9
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[Clinical and radiological characteristics of pulmonary tuberculosis in tobacco smokers]. Rev Mal Respir 2018; 35:538-545. [PMID: 29395566 DOI: 10.1016/j.rmr.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/24/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Tobacco smoke alters lung defense mechanisms against infections and so increases the risk of mycobacterium tuberculosis infection. OBJECTIVE To determine the particular clinical features of tuberculosis in smokers and identify risk factors. METHODS AND PATIENTS We conducted a prospective, cross-sectional study over a period of nine months in Dakar, Senegal. The Chi-square test and multiple logistic regression were used to identify differences between smokers and non-smokers and to identify factors associated with clinical outcomes. RESULTS We included 165 patients with active pulmonary tuberculosis (59 smokers versus 106 never-smokers). The average age of smokers was 43.8±12.7 versus 32.1±13.1 years (P<0.0001). Smokers were overwhelmingly male (98.3% versus 1.8%, P<0.0001). The average delay to consultation was longer among smokers (90 days [30-120] versus 60 days [30-90] ; P<0.0001). In multivariate analysis, alcohol abuse, increasing age, male sex, and an unknown retroviral status were independent risk factors for pulmonary tuberculosis. Haemoptysis was observed more frequently in smokers (49.1% versus 31.1%, P=0.017). With regards to chest X-ray features, smokers presented with more advanced, bilateral and cavitating lung lesions. CONCLUSION Diagnostic delay and haemoptysis are important characteristics of the pulmonary tuberculosis in tobacco smokers.
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