Tobacco, alcohol and tuberculosis

Brown, Komal; Campbell, Alastair H.

doi:10.1016/s0007-0971(61)80109-5

Cited by 62 publications

(29 citation statements)

References 6 publications

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“…Although alcohol use is a well-known confounder [26,27], its prevalence was relatively low in the present cohort. Smoking showed independent effect on LTBI and development of TB, even after controlling for the effect of alcohol (tables 2, 4 and 5).…”

Section: Discussioncontrasting

confidence: 53%

Smoking and tuberculosis among silicotic patients

Leung¹,

Yew²,

Law³

et al. 2006

Eur Respir J

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The aim of the present study was to investigate the relationship between smoking and tuberculosis (TB) among high-risk silicotic patients in Hong Kong.A cohort of 435 silicotic patients tuberculin tested from 1995-2002 was prospectively followedup until the end of 2005. Baseline characteristics were analysed with respect to positive tuberculin reaction (o10 mm) at baseline and subsequent development of TB.Smoking, alcohol use and body mass index were independent predictors of positive tuberculin reaction at baseline in multiple logistic regression analysis. Total cigarette pack-yrs did not demonstrate any significant effect. The annual incidences of TB were 1,841, 2,294 and 4,181 per 100,000 for never-, ex-and current smokers, respectively. On Cox proportional hazard analysis, current smokers have a significantly higher risk of TB than other silicotic patients (adjusted hazard ratio (95% confidence interval (CI)): 1.96 (1.14-3.35)) after controlling for age, alcohol use, tuberculin status, treatment for latent TB infection and other relevant background/disease factors. A significant dose-response relationship was also observed with the daily number of cigarettes currently smoked. Smoking cessation may reduce 32.4% (95% CI: 6.5-54.0) of the risk.Smoking increases the risk of both tuberculosis infection and subsequent development of the disease among silicotic patients.

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Section: Discussioncontrasting

confidence: 53%

Smoking and tuberculosis among silicotic patients

Leung¹,

Yew²,

Law³

et al. 2006

Eur Respir J

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“…While few studies have shown the association between smoking and TB and between alcoholism and TB, 7,9,[13][14][15] none of these had simultaneously colt t lected data on both smoking and alcot t holism. We found that male patients who were both smokers and alcoholics had a higher SMR (10.7) than those who were either only smokers (3.7) or only alcoholics (6.0) demonstrating that smoking alone and alcoholism alone were not risk factors but smoking and alcoholism in combination became a risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,5,7,9 WHO defines TB mortality as the number of TB cases dying during treatt t ment, regardless of the cause.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8] Risk factors such as smoking, alcoholism, irregular and incomplete antittuberculosis treatment as well as HIV infection are known to increase the mortality associated with TB. 2,4,5,7,9 WHO defines TB mortality as the number of TB cases dying during treatt t ment, regardless of the cause. 10 This definition, however, does not reflect the actual TB mortality rate because it includes deaths due to cotmorbidities and accidents, excludes deaths among treatment defaulters who have a high risk for mortality and presupposes that TB mortality does not occur after the completion of treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Although it is difficult to ext t plain this increase in mortality after 12 months from the start of treatment, it is likely that these deaths were due to drugt sensitive or drugtresistant relapse cases. In our cohort, mortality continued to occur even after the completion of treatment emphasizing that the definit t tion of TB mortality should not be ret t stricted to the treatment period alone as this may result in underestimation of mortality.While few studies have shown the association between smoking and TB and between alcoholism and TB, 7,9,[13][14][15] none of these had simultaneously colt t lected data on both smoking and alcot t holism. We found that male patients who were both smokers and alcoholics had a higher SMR (10.7) than those who were either only smokers (3.7) or only alcoholics (6.0) demonstrating that smoking alone and alcoholism alone were not risk factors but smoking and alcoholism in combination became a risk factor.…”

mentioning

confidence: 99%

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Mortality and tuberculosis patients in Chennai, India

Kolappan

Subramani

Karunakaran

et al. 2006

Bull World Health Organ

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Objective We aimed to measure the mortality rate and excess general mortality as well as identify groups at high risk for mortality among a cohort of tuberculosis patients treated in Chennai Corporation clinics in south India. Methods In this retrospective cohort study we followed up 2674 patients (1800 males and 874 females) who were registered and treated under the DOTS strategy in Chennai Corporation clinics in 2000. The follow-up period from the date of start of treatment to either the date of interview, or death was 600 days. Findings The mortality rate among this cohort of tuberculosis patients was 60/1000 person-years. The excess general mortality expressed as standardized mortality ratio (SMR) was 6.1 (95% confidence interval (CI) = 5.4-6.9). Younger patients, men, patients with Category II disease, patients who defaulted on, or failed courses of treatment, and male smokers who were alcoholics, all had higher mortality ratios when compared to the rest of the cohort. Conclusion The excess mortality in this cohort was six times more than that in the general population. Young age, male sex, smearpositivity, treatment default, treatment failure and the combination of smoking and alcoholism were identified as risk factors for tuberculosis mortality. We suggest that mortality rate and excess mortality be routinely used as a monitoring tool for evaluating the efficiency of the national control programme.Bulletin of the World Health Organization 2006;84:555-560.Voir page 559 le résumé en français. En la página 560 figura un resumen en español. IntroductionTuberculosis (TB) is a major public health problem in India and most of the disease burden is due to premature mort t tality among TB patients.1 Mortality is measured either as true rate (personttime rate) or as risk of death within a specific time period of followtup (casetfatality rate). The casetfatality rate is the more commonly used mortality measure of the two. However, casetfatality rates among TB patients reported in the literature range from 12% to 44% and are not comparable because they were measured as cumulative incidence for different followtup periods.2-8 Risk factors such as smoking, alcoholism, irregular and incomplete antittuberculosis treatment as well as HIV infection are known to increase the mortality associated with TB. 2,4,5,7,9 WHO defines TB mortality as the number of TB cases dying during treatt t ment, regardless of the cause.10 This definition, however, does not reflect the actual TB mortality rate because it includes deaths due to cotmorbidities and accidents, excludes deaths among treatment defaulters who have a high risk for mortality and presupposes that TB mortality does not occur after the completion of treatment. A better, though indirect, measure of mortality would be the computation of excess mortality (or standardized mortality ratio (SMR)) occurring among TB pat t tients and comparing it to the mortalt t ity among the standard population (or the estimated national population for a certain year). Since 1999, the Chennai Cor...

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