Smoking on Treatment Outcomes Among Tuberculosis Patients

Khan, Amer Hayat; Aftab, Raja Ahsan; Israr, Mohammad; Khan, Ayesha; Khan, Tahir Mehmood

doi:10.1097/maj.0000000000000473

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…Passive or active exposure to tobacco smoke is known to be significantly associated with TB infection and TB disease, independent of the effects of alcohol use, socioeconomic status and other factors [25]. Exposure to SHS is known to reduce the lung defense function increasing susceptibility to TB infection as well as decrease the treatment efficacy [26,27]. Exposure to SHS was also associated with delayed sputum smear conversion, persistent infectivity and relapse as well as increased risk of progression from LTBI to TB disease [28,29].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis outbreak among high school students in Novi Pazar, Serbia 2016: a retrospective-cohort study

Stošić

Plavša

Mavroeidi

et al. 2019

J Infect Dev Ctries

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Introduction: Between February and November 2016, 17 tuberculosis (TB) cases were identified among high school students in Novi Pazar, Serbia. The objectives of our study were to describe the outbreak, to identify potential risk factors and to evaluate the applied control measures. Methodology: The outbreak was described by time, person and place. A retrospective cohort study was conducted. Attack rates, unadjusted relative risks (RR) and 95% confidence intervals (CI) were calculated. Multiple log-binomial regression analysis was performed to calculate adjusted RR. Results: Sixteen of the total 17 cases occurred among grade 3 students, AR 5.5%. Previous TB family history, (RR = 5.29; 95% CI = 1.63-17.12), spending time with a known TB case at school (RR = 5.38; 95% CI = 1.48-19.55) and exposure to secondhand smoke (RR = 3.37; 95% CI = 1.11-10.29) were all significantly and independently associated with the occurrence of TB. Conclusions: Delayed diagnosis and reporting resulted in delayed initiation of the contact investigation and non-identification of latent TB cases probably favored the occurrence of this outbreak in a low incidence country. Public health authorities should consider revising the existing guidelines, promoting inter-sectorial collaboration and increasing awareness of public health professionals.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis outbreak among high school students in Novi Pazar, Serbia 2016: a retrospective-cohort study

Stošić

Plavša

Mavroeidi

et al. 2019

J Infect Dev Ctries

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“…Although the prevalence of tuberculosis in males depends on the geographic region, there is a general trend for the male-to-female ratio affecting more males with poorer outcome in developing countries, including a higher risk of mortality [ 93 , 95 – 100 ]. This male gender prevalence is also observed when combining other risk factors such as human immunodeficiency virus (HIV) infection, diabetes mellitus, and smoking [ 101 – 104 ]. It has been reported that Bacillus Calmette-Guerin (BCG) unvaccinated males display a stronger IFN-γ response against the tuberculin purified protein derivative (PPD) than females, which suggests that males display a stronger immune response that could be associated with an uncontrolled inflammatory response and a poor prognosis during M. tuberculosis infection [ 105 ].…”

Section: Bacterial Infections In the Respiratory Tractmentioning

confidence: 99%

Sexual dimorphism in bacterial infections

et al. 2018

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BackgroundSex differences are important epidemiological factors that impact in the frequency and severity of infectious diseases. A clear sexual dimorphism in bacterial infections has been reported in both humans and animal models. Nevertheless, the molecular mechanisms involved in this gender bias are just starting to be elucidated. In the present article, we aim to review the available data in the literature that report bacterial infections presenting a clear sexual dimorphism, without considering behavioral and social factors.Main bodyThe sexual dimorphism in bacterial infections has been mainly attributed to the differential levels of sex hormones between males and females, as well as to genetic factors. In general, males are more susceptible to gastrointestinal and respiratory bacterial diseases and sepsis, while females are more susceptible to genitourinary tract bacterial infections. However, these incidences depend on the population evaluated, animal model and the bacterial species. Female protection against bacterial infections and the associated complications is assumed to be due to the pro-inflammatory effect of estradiol, while male susceptibility to those infections is associated with the testosterone-mediated immune suppression, probably via their specific receptors. Recent studies indicate that the protective effect of estradiol depends on the estrogen receptor subtype and the specific tissue compartment involved in the bacterial insult, suggesting that tissue-specific expression of particular sex steroid receptors contributes to the susceptibility to bacterial infections. Furthermore, this gender bias also depends on the effects of sex hormones on specific bacterial species. Finally, since a large number of genes related to immune functions are located on the X chromosome, X-linked mosaicism confers a highly polymorphic gene expression program that allows women to respond with a more expanded immune repertoire as compared with men.ConclusionNotwithstanding there is increasing evidence that confirms the sexual dimorphism in certain bacterial infections and the molecular mechanisms associated, further studies are required to clarify conflicting data and to determine the role of specific hormone receptors involved in the gender bias of bacterial infections, as well as their potential as therapeutic targets.

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“…Other authors have however suggested that the success of any counselling program is dependent not only on the qualification and competence of health care workers but also their attitudes towards patients, their desire to improve patients' treatment outcome, and the type of intervention [30] Cigarette smoking has been shown to be associated with TB infection, disease and death [37]- [39]. It can also affect treatment outcomes and studies have shown that smoking was associated with unsuccessful treatment outcomes, default and relapse [40]- [42]. In this study, smokers had over 2 fold risk of treatment interruption than non-smokers.…”

Section: Factors Associated With Treatment Interruptionmentioning

confidence: 99%

Factors Affecting Treatment Interruption among TB Patients in Lagos Nigeria: Is There Any Need for Treatment Supporters?

Adejumo¹,

Daniel²,

Otesanya³

et al. 2016

IJCM

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Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.

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Smoking on Treatment Outcomes Among Tuberculosis Patients

Cited by 15 publications

References 17 publications

Tuberculosis outbreak among high school students in Novi Pazar, Serbia 2016: a retrospective-cohort study

Tuberculosis outbreak among high school students in Novi Pazar, Serbia 2016: a retrospective-cohort study

Sexual dimorphism in bacterial infections

Factors Affecting Treatment Interruption among TB Patients in Lagos Nigeria: Is There Any Need for Treatment Supporters?

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