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Guo J, Han Y, Zhang X, Lin F, Chen L, Feng X. Risk factors of adult isoniazid-resistant and rifampicin-susceptible tuberculosis in Nanjing, 2019-2021. BMC Infect Dis 2024; 24:511. [PMID: 38773443 PMCID: PMC11110291 DOI: 10.1186/s12879-024-09404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION This study aimed to analyze the risk factors associated with isoniazid-resistant and rifampicin-susceptible tuberculosis (Hr-TB) in adults. METHOD The clinical data of 1,844 adult inpatients diagnosed with culture-positive pulmonary tuberculosis (PTB) in Nanjing Second Hospital from January 2019 and December 2021 were collected. All culture positive strain from the patient specimens underwent drug susceptibility testing (DST). Among them, 166 patients with Hr-TB were categorized as the Hr-TB group, while the remaining 1,678 patients were classified as having drug-susceptible tuberculosis (DS-TB). Hierarchical logistic regression was employed for multivariate analysis to identify variables associated with Hr-TB. RESULTS Multivariate logistic regression analysis revealed that individuals with diabetes mellitus (DM) (OR 1.472, 95% CI 1.037-2.088, p = 0.030) and a history of previous tuberculosis treatment (OR 2.913, 95% CI 1.971-4.306, p = 0.000) were at higher risk of developing adult Hr-TB, with this risk being more pronounced in male patients. Within the cohort, 1,640 patients were newly treated, and among them, DM (OR 1.662, 95% CI 1.123-2.461, p = 0.011) was identified as risk factors for Hr-TB. CONCLUSIONS Diabetes mellitus is a risk factor for Hr-TB in adults, and the contribution of diabetes as a risk factor was more pronounced in the newly treatment or male subgroup. And previous TB treatment history is also a risk factor for Hr-TB in adults.
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Affiliation(s)
- Jing Guo
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, PR China
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 211132, China
| | - Yan Han
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 211132, China
| | - Xia Zhang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, PR China
| | - Feishen Lin
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, PR China
| | - Liangyu Chen
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, PR China
| | - Xuebing Feng
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 211132, China.
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Aispuro Pérez A, Osuna-Martínez U, Espinoza-Gallardo JA, Dorantes-Álvarez LA, Inzunza-Leyva GK, Dorantes-Bernal KE, Quiñonez-Bastidas GN. Prevalence of Drug-Resistant Tuberculosis in HIV-Positive and Diabetic Patients in Sinaloa, Mexico: A Retrospective Cross-Sectional Study. Trop Med Infect Dis 2024; 9:89. [PMID: 38668550 PMCID: PMC11054973 DOI: 10.3390/tropicalmed9040089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/11/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
Tuberculosis (TB) is a disease caused by the bacillus Mycobacterium tuberculosis (MTB). Human immunodeficiency virus (HIV) infection and type 2 diabetes mellitus (T2DM) are among the main risk factors for the development of TB and increase the risk of drug-resistant TB developing (DR-TB). The aim of this study was to estimate the prevalence of DR-TB in patients with HIV or T2DM in Sinaloa, Mexico. This was an observational and cross-sectional study. The analysis was conducted using the clinical data of patients registered on the National Epidemiological Surveillance System for TB (SINAVE/PUI-TB) platform with a presumed diagnosis of TB during 2019 to 2021 in Sinaloa, Mexico. The prevalence of DR-TB was estimated in HIV and T2DM patients, as well as the odds ratios for their sociodemographic variables, using the Chi-square test. There were 2, 4, and 4 TB-HIV cases and 2, 6, and 9 TB-T2DM cases during 2019, 2020, and 2021, respectively, whereas there were 2 and 1 DRTB-HIV and DRTB-T2DM cases, respectively. The results indicated that the WHO guidelines for DR-TB were not properly applied to this high-risk population. Hence, the appropriate application of guidelines for TB and DR-TB detection in these patients needs to be immediately implemented by the State health system.
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Affiliation(s)
- Analy Aispuro Pérez
- Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Ciudad Universitaria, Culiacan 80013, Sinaloa, Mexico; (A.A.P.); (U.O.-M.)
| | - Ulises Osuna-Martínez
- Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Ciudad Universitaria, Culiacan 80013, Sinaloa, Mexico; (A.A.P.); (U.O.-M.)
| | - Jose Angel Espinoza-Gallardo
- Coordinación Estatal de Tuberculosis, Servicios de Salud de Sinaloa, Secretaria de Salud Blvd, Alfonso Zaragoza Maytorena No. 2204, Fraccionamiento Bonanzas, Culiacan 80020, Sinaloa, Mexico (L.A.D.-Á.); (K.E.D.-B.)
| | - Luis Alfredo Dorantes-Álvarez
- Coordinación Estatal de Tuberculosis, Servicios de Salud de Sinaloa, Secretaria de Salud Blvd, Alfonso Zaragoza Maytorena No. 2204, Fraccionamiento Bonanzas, Culiacan 80020, Sinaloa, Mexico (L.A.D.-Á.); (K.E.D.-B.)
| | - Gerardo Kenny Inzunza-Leyva
- Coordinación Estatal de Tuberculosis, Servicios de Salud de Sinaloa, Secretaria de Salud Blvd, Alfonso Zaragoza Maytorena No. 2204, Fraccionamiento Bonanzas, Culiacan 80020, Sinaloa, Mexico (L.A.D.-Á.); (K.E.D.-B.)
| | - Kimberly Estefania Dorantes-Bernal
- Coordinación Estatal de Tuberculosis, Servicios de Salud de Sinaloa, Secretaria de Salud Blvd, Alfonso Zaragoza Maytorena No. 2204, Fraccionamiento Bonanzas, Culiacan 80020, Sinaloa, Mexico (L.A.D.-Á.); (K.E.D.-B.)
| | - Geovanna Nallely Quiñonez-Bastidas
- Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Eustaquio Buelna 91, Burocrata, Culiacan 80030, Sinaloa, Mexico
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Chen Y, Liu J, Zhang Q, Chen H, Chai L, Wang Y, Zhang J, Qiu Y, Shen N, Shi X, Wang Q, Wang J, Li S, Li M. Global burden of MDR-TB and XDR-TB attributable to high fasting plasma glucose from 1990 to 2019: a retrospective analysis based on the global burden of disease study 2019. Eur J Clin Microbiol Infect Dis 2024; 43:747-765. [PMID: 38367094 DOI: 10.1007/s10096-024-04779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE High fasting plasma glucose (HFPG) has been identified as a risk factor for drug-resistant tuberculosis incidence and mortality. However, the epidemic characteristics of HFPG-attributable multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) remain unclear. We aimed to analyze the global spatial patterns and temporal trends of HFPG-attributable MDR-TB and XDR-TB from 1990 to 2019. METHODS Utilizing data from the Global Burden of Disease 2019 project, annual deaths and disability-adjusted life years (DALYs) of HFPG-attributable MDR-TB and XDR-TB were conducted from 1990 to 2019. Joinpoint regression was employed to quantify trends over time. RESULTS From 1990 to 2019, the deaths and DALYs due to HFPG-attributable MDR-TB and XDR-TB globally showed an overall increasing trend, with a significant increase until 2003 to 2004, followed by a gradual decline or stability thereafter. The low sociodemographic index (SDI) region experienced the most significant increase over the past 30 years. Regionally, Sub-Saharan Africa, Central Asia and Oceania remained the highest burden. Furthermore, there was a sex and age disparity in the burden of HFPG-attributable MDR-TB and XDR-TB, with young males in the 25-34 age group experiencing higher mortality, DALYs burden and a faster increasing trend than females. Interestingly, an increasing trend followed by a stable or decreasing pattern was observed in the ASMR and ASDR of HFPG-attributable MDR-TB and XDR-TB with SDI increasing. CONCLUSION The burden of HFPG-attributable MDR-TB and XDR-TB rose worldwide from 1990 to 2019. These findings emphasize the importance of routine bi-directional screening and integrated management for drug-resistant TB and diabetes.
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Affiliation(s)
- Yuqian Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Jin Liu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Qianqian Zhang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Huan Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Limin Chai
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Jia Zhang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Yuanjie Qiu
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Nirui Shen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Xiangyu Shi
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Qingting Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Jian Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Shaojun Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xian Jiaotong University, No. 277, West Yanta Road, Xian, Shaanxi, 710061, People's Republic of China.
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Ералиева ЛТ, Исаева АМ. [Association between treatment outcome and age in tuberculosis and diabetes patients: a population analysis]. PROBLEMY ENDOKRINOLOGII 2023; 69:93-98. [PMID: 37968956 PMCID: PMC10680549 DOI: 10.14341/probl13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/23/2023] [Accepted: 05/12/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND The undoubted importance of this work lies in the fact that for the first time in the Republic of Kazakhstan, an analysis is being made of the relationship between age and treatment outcome in patients with a comorbid diagnosis of tuberculosis and diabetes mellitus. PURPOSE OF THE STUDY Identification of the correlation between the age of patients with tuberculosis with diabetes mellitus and the outcome of treatment. MATERIALS AND METHODS Cross-sectional retrospective study of 2,125 patients with TB and diabetes mellitus out of a total of 43,807 of all patients diagnosed with TB (2017-2019). The study analyzed the data of patients with comorbidity from all regions of Kazakhstan (data from 14 regions and 3 cities of republican significance) (2017-2019). RESULTS A high prevalence of tuberculosis morbidity with a concomitant diagnosis of diabetes mellitus in the age group from 45 to 64 years was revealed. This group consisted of 1193 patients out of 2115 (56.4% of the total number of patients with tuberculosis and diabetes mellitus). The average age of all studied patients with DM was 54.7±13.4 years. There is a positive correlation between age and treatment outcome in TB patients. Mortality was higher in the age group over 45 years old - OR95%CI = 0.213 [0.019-2.362], p - 0.0000015 (p < 0.05).
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Affiliation(s)
- Л. Т. Ералиева
- Национальный медицинский университет; Национальный научный центр фтизиопульмонологии РК
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Akhtar AM, Kanwal S, Majeed S, Majeed W. Weight variation increases the risk of death during the intensive phase of treatment among MDR-TB patients: A retrospective study. Pak J Med Sci 2023; 39:1080-1085. [PMID: 37492339 PMCID: PMC10364273 DOI: 10.12669/pjms.39.4.7025] [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: 08/22/2022] [Revised: 09/30/2022] [Accepted: 03/28/2023] [Indexed: 07/27/2023] Open
Abstract
Objective To estimate the predictors of death during intensive phase of Multidrug resistant tuberculosis treatment according to the weight of patients at the time of diagnosed. Methods A retrospective study was conducted at three public hospitals in the Lahore, Punjab region, namely Jinnah Hospital, Mayo Hospital and Gulab Devi Hospital on 1,496 patients receiving treatment for MDR-TB from January 2018 to December 2020. Data were collected from electronically nominating and recording system of the hospitals. Data were fitted to Cox proportional hazards regression model with 95% confidence interval (CI) to evaluate the associations between predictors of death and weight of MDR-TB patients during the intensive phase of treatment. Results This analysis revealed a MDR-TB mortality rate of 30% and the mortality rate due to MDR-TB during the intensive phase of treatment was 23%. The variables related to increased mortality among underweight patients were age more than 60 years (HR: 0.398, 95% CI: 0.314-0.504) , diabetes (HR: 1.496, 95% CI: 1.165-1.921), current smoking (HR: 0.465, 95% CI: 0.222-0.973), history of MDR-TB (HR: 0.701, 95% CI: 0.512-0.959) and culture positive at the time of diagnosed (HR: 0.499, 95% CI: 0.379-0.659) during the intensive phase of treatment. Conclusion The high mortality rate among the underweight MDR-TB patients during the intensive phase of the treatment requires the nutritional support for malnourishment and ensured a close follow-up of the elderly patients with co-morbidities as well as family history of Tuberculosis.
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Affiliation(s)
- Abdul Majeed Akhtar
- Dr. Abdul Majeed Akhtar, Ph.D. University Institute of Public Health, The University of Lahore, Lahore, Pakistan
| | - Shamsa Kanwal
- Dr. Shamsa Kanwal, Ph.D University Institute of Public Health, The University of Lahore, Lahore, Pakistan
| | - Sufia Majeed
- Dr. Sufia Majeed, MBBS. Department of Medicine, Mayo Hospital, Lahore, Pakistan
| | - Wasif Majeed
- Wasif Majeed, M.Phil. Institute of Applied Psychology, The University of Punjab, Lahore, Pakistan
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D'Elia JA, Weinrauch LA. Gated Calcium Ion Channel and Mutation Mechanisms in Multidrug-Resistant Tuberculosis. Int J Mol Sci 2023; 24:ijms24119670. [PMID: 37298620 DOI: 10.3390/ijms24119670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
A wide spectrum of Gram-positive/Gram-negative bacteria has been found resistant to a wide spectrum of antibiotics in the United States of America during the past decade. Drug-resistant tuberculosis is not yet a major threat in North/South America, Europe, and the Middle East. However, the migration of populations in times of drought, famine, and hostilities may increase the global reach of this ancient pathogen. Given an increased spread from China and India to African countries, drug-resistant Mycobacterium tuberculosis has become an emerging topic of concern for Europe and North America. Due to the dangers associated with the spread of pathogens among different populations, the World Health Organization continues to expand healthcare advisories for therapeutic approaches for both stationary and migrating populations. As much of the literature focuses on endemic to pandemic viruses, we remain concerned that other treatable communicable diseases may be ignored. One such disease is multidrug-resistant tuberculosis. We focus on molecular mechanisms that this pathogen relies upon for the development of multidrug resistance via gene mutation and the evolutionary development of new enzyme and calcium channels.
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Affiliation(s)
- John A D'Elia
- Kidney/Hypertension Section, E P Joslin Research Laboratory, Joslin Diabetes Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Larry A Weinrauch
- Kidney/Hypertension Section, E P Joslin Research Laboratory, Joslin Diabetes Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Pan Y, Yu Y, Yi Y, Dou X, Lu J, Zhou L. The differences in drug resistance between drug-resistant tuberculosis patients with and without diabetes mellitus in northeast China: a retrospective study. BMC Infect Dis 2023; 23:162. [PMID: 36922787 PMCID: PMC10016172 DOI: 10.1186/s12879-023-08130-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) and drug-resistant tuberculosis (DR-TB) are serious global public health problems. This study aimed to explore the differences in drug resistance between DR-TB patients with and without DM. Risk factors for developing multidrug-resistant tuberculosis (MDR-TB) were also investigated among DR-TB patients. METHODS The patient's basic demographic, clinical characteristics, and drug susceptibility testing (DST) data were collected from the Chinese Disease Control Information System. Descriptive statistics were used to estimate the frequency and proportion of included variables. Categorical variables were compared using the Chi-square test or Fisher's exact test. Chi-square tests for trends were used to determine changes and trends in MDR-TB and pre-extensively drug-resistantTB (pre-XDR-TB) patterns over time. Univariate and multivariate logistic regression analysis was used to explore the risk factors of MDR-TB. RESULTS Compared with DR-TB patients with DM, DR-TB patients without DM had significantly higher rates of mono-resistant streptomycin (SM) and any resistance to kanamycin (KM), but significantly lower rates of any resistance to protionamide (PTO) and mono-resistance to levofloxacin (LFX), and pre-XDR-TB (P<0.05). The proportion of resistance to other anti-TB drugs was not statistically different between the DR-TB with and without DM. Among DR-TB patients without and with DM, the proportion of patients with MDR-TB and pre-XDR-TB patterns showed a significant downward trend from 2016 to 2021 (P<0.05). Among DR-TB patients without DM, male, previously treated DR-TB cases, and immigration were risk factors for MDR-TB (P<0.05). In DR-TB patients with DM, a negative sputum smear is a risk factor for MDR-TB (P<0.05). CONCLUSION There was no statistical difference in resistance patterns between DR-TB with and without DM, except in arbitrary resistance to PTO and KM, mono-resistant SM and LFX, and pre-XDR-TB. Great progress has been made in the prevention and control of MDR-TB and pre-XDR-TB. However, DR-TB patients with and without DM differ in their risk factors for developing MDR-TB.
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Affiliation(s)
- Yuanping Pan
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China
| | - Yingying Yu
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China
| | - Yaohui Yi
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China
| | - Jiachen Lu
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, 9 West Section, Lushun South Road, Dalian, Liaoning Province, People's Republic of China.
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Jali M, Kavital A, Hiremath M. "Challenges of diabetes in elderly TB patients". Indian J Tuberc 2022; 69 Suppl 2:S264-S266. [PMID: 36400521 PMCID: PMC9613800 DOI: 10.1016/j.ijtb.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/29/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Diabetes mellitus (DM) and tuberculosis (TB) are worldwide health burdens post-COVID-19. TB is the second-leading cause of death by a single infectious microbe. There is much evidence around the world about the responsibility of TB-DM co-morbidity. Both TB and DM prevalence is high in low- and middle-income countries. Especially the elderly with diabetes are more prone to TB infection due to compromised immune systems. Diabetic patients are three times as likely to develop tuberculosis as non-diabetic patients. DM interferes with the status of TB and leads to undesirable outcomes in the treatment of TB. This may later lead to the development of multidrug-resistant tuberculosis (MDR-TB). The coexistence of TB and DM leads to a high mortality rate and therefore becomes an enormous challenge for the medical field. This viewpoint includes the most current information about TB and DM, disease complications, treatment strategies, challenges to be faced in disease management and the importance of TB-DM bidirectional screening in older adults, which helps in early detection and better treatment programme.
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Affiliation(s)
- M.V. Jali
- KLES Diabetes Centre, KLES Dr Prabhakar Kore Hospital & J N Medical College KLE Academy of Higher Education & Research (Deemed-To-Be-University), Belagavi 590010,Corresponding author, , KLES Dr Prabhakar Kore Hospital & J N Medical College KLE Academy of Higher Education & Research (deemed to be a university), Belgaum 590010
| | - Apsara Kavital
- Department of Biotechnology & Microbiology, Karnataka University, Dharwad, India
| | - M.B. Hiremath
- Department of Biotechnology & Microbiology, Karnataka University, Dharwad, India
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Song WM, Li SJ, Liu JY, Fu Q, Xu TT, Tao NN, Zhang QY, Liu SQ, An QQ, Zhu XH, Liu Y, Yu CB, Li YF, Dong J, Li HC. Impact of alcohol drinking and tobacco smoking on the drug-resistance of newly diagnosed tuberculosis: a retrospective cohort study in Shandong, China, during 2004-2020. BMJ Open 2022; 12:e059149. [PMID: 35902191 PMCID: PMC9341182 DOI: 10.1136/bmjopen-2021-059149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the independent and collective impact of alcohol drinking and tobacco smoking on the drug-resistance of newly diagnosed tuberculosis (TB). DESIGN This was a retrospective cohort study. SETTING Shandong, China. PARTICIPANTS Patients with newly diagnosed TB from 1 January 2004 to 31 December 2020 were collected. Exclusive criteria: retreated cases; extrapulmonary tuberculosis; without information on drug susceptibility testing results, smoking or drinking habits; bacteriological identification as non-tuberculous mycobacteria. PRIMARY AND SECONDARY OUTCOME MEASURES Patients were classified into four groups including smokers only (G1), drinker only (G2), smoker +drinker (G3), non-smoker +non-drinker group (G0). We described the drug-resistant profiles, clinical factors and calculated the ORs of different drug-resistance among G1, G2, G3, compared with G0 through univariate and multivariate logistics regression models. RESULTS Of the 7996 TB cases enrolled, the proportions of G1, G2, G3 and G0 were 8.25%, 3.89%, 16.46% and 71.40%, respectively. The rates of drug-resistant (DR)-TB, mono-resistant TB, multidrug resistant (MDR)-TB, polydrug resistant TB in G1, G2, G3 and G0 were 19.24%/16.4%/17.33%/19.08%, 11.52%/8.68%/10.94%/11.63%, 3.03%/2.57%/2.96%/3.66% and 4.70%/4.82%/3.34%/ 4.08%, respectively. G3 had a higher risk of MDR1: isoniazid +rifampin (adjusted OR (aOR)=1.91, 95% CI: 1.036 to 3.532), but had a lower risk of DR-TB (aOR=0.84, 95% CI: 0.71 to 0.99), rifampin-related resistance (aOR=0.68, 95% CI: 0.49 to 0.93), streptomycin-related resistance (aOR=0.82, 95% CI: 0.68 to 0.99), ethambutol-related resistance (aOR=0.57, 95% CI: 0.34 to 0.95), MDR3: isoniazid +rifampin+streptomycin (aOR=0.41, 95% CI: 0.19 to 0.85), any isoniazid +streptomycin resistance (aOR=0.85, 95% CI: 0.71 to 1.00). However, there were no significant differences between G1 and G0, G2 and G0 in all drug-resistant subtypes. Those patients with cavity had a higher risk of DR-TB among G3 (OR=1.35, 95% CI: 1.01 to 1.81). CONCLUSION Although we did not found an independent impact of alcohol drinking or tobacco smoking on TB drug-resistance, respectively, these two habits had a combined effect on TB drug-resistance.
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Affiliation(s)
- Wan-Mei Song
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shi-Jin Li
- Department of Respiratory Medicine, Chengwu People's Hospital, Heze, Shandong, China
| | - Jin-Yue Liu
- Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, Jinan, Shandong, China
| | - Qi Fu
- State Grid Shandong Electric Power Company, Jinan, Shandong, China
| | - Ting-Ting Xu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Ning Ning Tao
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Qian-Yun Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Si-Qi Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qi-Qi An
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xue-Han Zhu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Chun-Bao Yu
- Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Jinan, Shandong, China
| | - Yi-Fan Li
- Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
| | - Jihua Dong
- Department of Respiratory Medicine, Heze Mudan People's Hospital, Heze, Shandong, China
| | - Huai-Chen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Jinan, Shandong, China
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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10
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Kim HY, Byashalira KC, Heysell SK, Märtson AG, Mpagama SG, Rao P, Sturkenboom MG, Alffenaar JWC. Therapeutic Drug Monitoring of Anti-infective Drugs: Implementation Strategies for 3 Different Scenarios. Ther Drug Monit 2022; 44:3-10. [PMID: 34686647 PMCID: PMC8755585 DOI: 10.1097/ftd.0000000000000936] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/14/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Therapeutic drug monitoring (TDM) supports personalized treatment. For successful implementation, TDM must have a turnaround time suited to the clinical needs of patients and their health care settings. Here, the authors share their views of how a TDM strategy can be tailored to specific settings and patient groups. METHODS The authors selected distinct scenarios for TDM: high-risk, complex, and/or critically ill patient population; outpatients; and settings with limited laboratory resources. In addition to the TDM scenario approach, they explored potential issues with the legal framework governing dose escalation. RESULTS The most important issues identified in the different scenarios are that critically ill patients require rapid turnaround time, outpatients require an easy sampling procedure for the sample matrix and sample collection times, settings with limited laboratory resources necessitate setting-specific analytic techniques, and all scenarios warrant a legal framework to capture the use of escalated dosages, ideally with the use of trackable dosing software. CONCLUSIONS To benefit patients, TDM strategies need to be tailored to the intended population. Strategies can be adapted for rapid turnaround time for critically ill patients, convenient sampling for outpatients, and feasibility for those in settings with limited laboratory resources.
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Affiliation(s)
- Hannah Yejin Kim
- Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia
- Westmead Hospital, Sydney, NSW 2145, Australia
- Marie Bashir Institute for Infectious Diseases, University of Sydney, Sydney, NSW 2006, Australia
| | | | - Scott K. Heysell
- Division of Infectious Diseases and International Health, University of Virginia, Virginia, USA
| | - Anne-Grete Märtson
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, the Netherlands
| | | | - Prakruti Rao
- Division of Infectious Diseases and International Health, University of Virginia, Virginia, USA
| | - Marieke G.G. Sturkenboom
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, the Netherlands
| | - Jan-Willem C. Alffenaar
- Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia
- Westmead Hospital, Sydney, NSW 2145, Australia
- Marie Bashir Institute for Infectious Diseases, University of Sydney, Sydney, NSW 2006, Australia
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11
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Song WM, Guo J, Xu TT, Li SJ, Liu JY, Tao NN, Liu Y, Zhang QY, Liu SQ, An QQ, Li YF, Yu CB, Dong JH, Li HC. Association between body mass index and newly diagnosed drug-resistant pulmonary tuberculosis in Shandong, China from 2004 to 2019. BMC Pulm Med 2021; 21:399. [PMID: 34872558 PMCID: PMC8647447 DOI: 10.1186/s12890-021-01774-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/01/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB), obesity, and malnutrition are growing public health problems in the world. However, little has discussed the impact of different BMI status on the emergence of TB drug resistance. We aimed to explore the drug-resistant profiles of DR-TB and its clinical predictors among underweight, overweight or obesity population. METHODS 8957 newly diagnosed TB cases with drug susceptibility results and BMI data in Shandong China, from 2004 to 2019 were enrolled. Multivariable and univariable logistic regression models were applied to investigate the impact of BMI on different drug-resistance. Clinical predicators and drug-resistant profiles of DR-TB among obesity, underweight, normal TB group were also described. RESULTS Among 8957 TB cases, 6417 (71.64%) were normal weight, 2121 (23.68%) were underweight, 373 (4.16%) were overweight, and 46 (0.51%) were obese. The proportion of drug resistance and co-morbidity among normal weight, underweight, overweight, obese TB groups were 18.86%/18.25%/20.38%/23.91% (DR-TB), 11.19%/11.74%/9.65%/17.39% (mono-resistant tuberculosis, MR-TB), 3.41%/3.06%/5.36%/0.00% (multidrug resistant tuberculosis, MDR-TB), 4.21%/3.39%/5.36%/6.52% (polydrug resistant tuberculosis, PDR-TB), 10.57%/8.44%/19.57%/23.91% (co-morbidity), respectively. Compared with normal weight group, underweight were associated with lower risk of streptomycin-related resistance (OR 0.844, 95% CI 0.726-0.982), but contributed to a higher risk of MR-TB (isoniazid) (odds ratio (OR) 1.347, 95% CI 1.049-1.730; adjusted OR (aOR) 1.31, 95% CI 1.017-1.686), P < 0.05. In addition, overweight were positively associated with MDR-TB (OR 1.603, 95% CI 1.002-2.566; aOR 1.639, 95% CI 1.02-2.633), isoniazid + rifampicin + streptomycin resistance (OR 1.948, 95% confidence interval (CI): 1.061-3.577; aOR 2.113, 95% CI 1.141-3.912), Any isoniazid + streptomycin resistance (OR 1.472, 95% CI 1.013-2.14; aOR 1.483, 95% CI 1.017-2.164), P < 0.05. CONCLUSIONS The higher risk of MDR-TB, isoniazid + rifampicin + streptomycin resistance, Any isoniazid + streptomycin resistance, and co-morbidity among overweight population implies that routine screening for drug sensitivity and more attention on co-morbidity among overweight TB cases may be necessary. In addition, underweight TB cases have a higher risk of isoniazid resistance. Our study suggests that an in-depth study of the interaction between host metabolic activity and infection of DR-TB may contribute more to novel treatment options or preventive measures, and accelerate the implementation of the STOP TB strategy.
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Affiliation(s)
- Wan-Mei Song
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Jing Guo
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,School of Medicine and Life Sciences, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, 271016, Shandong, People's Republic of China.,Department of Emergency, The Fifth People's Hospital of Jinan, Jinan, 250031, Shandong, People's Republic of China
| | - Ting-Ting Xu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,School of Medicine and Life Sciences, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, 271016, Shandong, People's Republic of China
| | - Shi-Jin Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Jin-Yue Liu
- Department of Intensive Care Unit, Shandong Provincial Third Hospital, Jinan, 100191, Shandong, People's Republic of China
| | - Ning-Ning Tao
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, 100730, People's Republic of China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People's Republic of China
| | - Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China
| | - Qian-Yun Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Si-Qi Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Qi-Qi An
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China.,Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China
| | - Yi-Fan Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China
| | - Chun-Bao Yu
- Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, Jinan, 250013, Shandong, People's Republic of China
| | - Ji-Hua Dong
- Department of Respiratory Medicine, Heze Mudan People's Hospital, Heze, 274000, Shandong, People's Republic of China.
| | - Huai-Chen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, People's Republic of China. .,College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, People's Republic of China.
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12
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Hocking L, Ali GC, d’Angelo C, Deshpande A, Stevenson C, Virdee M, Guthrie S. A rapid evidence assessment exploring whether antimicrobial resistance complicates non-infectious health conditions and healthcare services, 2010-20. JAC Antimicrob Resist 2021; 3:dlab171. [PMID: 34806009 PMCID: PMC8599069 DOI: 10.1093/jacamr/dlab171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Antimicrobial resistance (AMR) is one of the greatest public health threats at this time. While there is a good understanding of the impacts of AMR on infectious diseases, an area of less focus is the effects AMR may be having on non-communicable health conditions (such as cancer) and healthcare services (such as surgery). Therefore, this study aimed to explore what impact AMR is currently having on non-communicable health conditions, or areas of health services, where AMR could be a complicating factor impacting on the ability to treat the condition and/or health outcomes. To do this, a rapid evidence assessment of the literature was conducted, involving a systematic approach to searching and reviewing the evidence. In total, 101 studies were reviewed covering surgery, organ transplants, cancer, ICUs, diabetes, paediatric patients, immunodeficiency conditions, liver and kidney disease, and physical trauma. The results showed limited research in this area and studies often use a selective population, making the results difficult to generalize. However, the evidence showed that for all health conditions and healthcare service areas reviewed, at least one study demonstrated a higher risk of death for patients with resistant infections, compared with no or drug-susceptible infections. Poor health outcomes were also associated with resistant infections in some instances, such as severe sepsis and failure of treatments, as well as a greater need for invasive medical support. While there are gaps in the evidence base requiring further research, efforts are also needed within policy and practice to better understand and overcome these challenges.
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Affiliation(s)
- Lucy Hocking
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, UK
- Corresponding author. E-mail:
| | | | | | | | | | - Mann Virdee
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, UK
| | - Susan Guthrie
- RAND Europe, Westbrook Centre, Milton Road, Cambridge, UK
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13
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Izhar MD, Butar MB, Hidayati F, Ruwayda R. Predictors and health-related quality of life with short form-36 for multidrug-resistant tuberculosis patients in Jambi, Indonesia: A case-control study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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Song WM, Liu Y, Zhang QY, Liu SQ, Xu TT, Li SJ, An QQ, Liu JY, Tao NN, Liu Y, Yu CB, Yu CX, Li YF, Li HC. Ambient air pollutants, diabetes and risk of newly diagnosed drug-resistant tuberculosis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 219:112352. [PMID: 34044311 DOI: 10.1016/j.ecoenv.2021.112352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/08/2021] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB), diabetes and exposure to air pollution are thought to be important threat to human health, but no studies have explored the effects of ambient air pollutants on DR-TB when adjusting diabetes status so far. METHODS We performed a study among 3759 newly diagnosed TB cases with drug-susceptibility testing results, diabetes status, and individual air pollution data in Shandong from 2015 to 2019. Generalized linear mixed models (GLMM) including three models (Model 1: without covariates, Model 2: adjusted by diabetes status only, Model 3: with all covariates) were applied. RESULTS Of 3759 TB patients enrolled, 716 (19.05%) were DR-TB, and 333 (8.86%) had diabetes. High exposure to O3 was associated with an increased risk of RFP-resistance (Model 2 or 3: odds ratio (OR) = 1.008, 95% confidence intervals (CI): 1.002-1.014), ethambutol-resistance (Model 3: OR = 1.015, 95%CI: 1.004-1.027) and any rifampicin+streptomycin resistance (Model 1,2,3: OR = 1.01, 95%CI: 1.002-1.018) at 90 days. In contrast, NO2 was associated with a reduced risk of DR-TB (Model 3: OR = 0.99, 95%CI: 0.981-0.999) and multidrug-resistant TB (MDR-TB) (Model 3: OR = 0.977, 95%CI: 0.96-0.994) at 360 days. Additionally, SO2 (Model 1, 2, 3: OR = 0.987, 95%CI: 0.977-0.998) showed a protective effect on MDR-TB at 90 days. PM2.5 (90 days, Model 2: OR = 0.991, 95%CI: 0.983-0.999), PM10 (360 days, Model 2: OR = 0.992, 95%CI: 0.985-0.999) had protective effects on any RFP+SM resistance. CONCLUSIONS O3 contributed to an elevated risk of TB resistance but PM2.5, PM10, SO2, NO2 showed an inverse effect. Air pollutants may affect the development of drug resistance among TB cases by adjusting the status of diabetes.
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Affiliation(s)
- Wan-Mei Song
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Yi Liu
- Department of Biostatistics, School of Public Health, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Qian-Yun Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Si-Qi Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Ting-Ting Xu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, People's Republic of China
| | - Shi-Jin Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Qi-Qi An
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, People's Republic of China
| | - Jin-Yue Liu
- Department of Critical Care Medicine, Shandong Provincial Third Hospital, 100191 Jinan, Shandong, People's Republic of China
| | - Ning-Ning Tao
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, 100730 Beijing, People's Republic of China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, People's Republic of China
| | - Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, People's Republic of China
| | - Chun-Bao Yu
- Katharine Hsu International Research Center of Human Infectious Diseases, Shandong Provincial Chest Hospital, 250013 Jinan, Shandong, People's Republic of China
| | - Cui-Xiang Yu
- Department of Respiratory Medicine, Shandong Qianfoshan Hospital Affiliated to Shandong University, 250014 Jinan, Shandong, People's Republic of China
| | - Yi-Fan Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, People's Republic of China.
| | - Huai-Chen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 250021 Jinan, Shandong, People's Republic of China; Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, People's Republic of China; College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, 250355 Jinan, Shandong, People's Republic of China.
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15
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Arroyo LH, Yamamura M, Ramos ACV, Campoy LT, Crispim JDA, Berra TZ, Alves LS, Alves YM, Dos Santos FL, Souza LLL, Bruce ATI, de Andrade HLP, Bollela VR, Krainski ET, Nunes C, Arcêncio RA. Determinants of multidrug-resistant tuberculosis in São Paulo-Brazil: a multilevel Bayesian analysis of factors associated with individual, community and access to health services. Trop Med Int Health 2020; 25:839-849. [PMID: 32358845 PMCID: PMC7383622 DOI: 10.1111/tmi.13409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective Multidrug‐resistant tuberculosis (MDR‐TB) remains a serious public health problem worldwide. Accordingly, this study sought to identify individual, community and access to health services risk factors for MDR‐TB. Methods Retrospective cohort of all TB cases diagnosed between 2006 and 2016 in the state of São Paulo. A Bayesian spatial hierarchical analysis with a multilevel design was carried out. Results It was identified that the history of previous TB treatment (Odds Ratios [OR]:13.86, 95% credibility interval [95% CI]:12.06–15.93), positive sputum culture test (OR: 5.26, 95% CI: 4.44–6.23), diabetes mellitus (OR: 2.34, 95% CI: 1.87–2.91), residing at a standard address (OR: 2.62, 95% CI: 1.91–3.60), positive sputum smear microscopy (OR: 1.74, 95% CI: 1.44–2.12), cavitary pulmonary TB (OR: 1.35, 95% CI: 1.14–1.60) and diagnosis performed due to spontaneous request (OR: 1.26; 95% CI: 1.10–1.46) were associated with MDR‐TB. Furthermore, municipalities that performed HIV tests in less than 42.65% of patients with TB (OR: 1.50, 95% CI: 1.25–1.79), that diagnosed TB cases only after death (OR: 1.50, 95% CI: 1.17–1.93) and that had more than 20.16% of their population with income between ¼ and ½ of one minimum wage (OR: 1.56, 95% CI: 1.30–1.87) were also related to the MDR‐TB. Conclusions Knowledge of these predictive factors may help to develop more comprehensive disease prevention strategies for MDR‐TB, avoiding the risks expressed regarding drug resistance expansion.
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Affiliation(s)
- Luiz Henrique Arroyo
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Mellina Yamamura
- Department of Nursing, Federal University of São Carlos, São Carlos, Brazil
| | | | | | | | - Thais Zamboni Berra
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Luana Seles Alves
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Yan Mathias Alves
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | | | | | | | | | - Carla Nunes
- National School of Public Health, Nova University of Lisbon, Lisbon, Portugal
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