Association between smoking and tuberculosis infection: A population survey in a high tuberculosis incidence area

Department of Paediatrics and Child Health, Stellenbosch University, Johannesburg, Gauteng, South Africa
Thorax (Impact Factor: 8.29). 07/2005; 60(7):555-7. DOI: 10.1136/thx.2004.030924
Source: PubMed


Associations between smoking and tuberculosis disease including death from tuberculosis have been reported, but there are few reports on the influence of smoking on the risk of developing Mycobacterium tuberculosis infection. The aim of this study was to determine the association between smoking and M tuberculosis infection.
In a cross sectional population survey, data on smoking and tuberculin skin test (TST) results of 2401 adults aged > or =15 years were compared.
A total of 1832 (76%) subjects had a positive TST (> or = 10 mm induration). Of 1309 current smokers or ex-smokers, 1070 (82%) had a positive TST. This was significantly higher than for never smokers (unadjusted OR 1.99, 95% confidence interval (CI) 1.62 to 2.45). A positive relationship with pack-years was observed, with those smoking more than 15 pack-years having the highest risk (adjusted OR 1.90, 95% CI 1.28 to 2.81).
Smoking may increase the risk of M tuberculosis infection.

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Available from: Martien W Borgdorff, Oct 01, 2015
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    • "Tobacco smoking is the single most important factor in the genesis of COPD [5] [6] and it seems to have also an association with tuberculosis [7]. Besides tobacco, other environmental risk factors are also well known for COPD, e.g. "
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    ABSTRACT: BACKGROUND AND OBJECTIVE: Data on chronic respiratory diseases (CRD) are scarce or unavailable in most African countries. We aimed to determine the prevalence of CRD and associated risk factors in Cape Verde, at the primary healthcare level. METHODS: In the frame of the Global Alliance Against Chronic Respiratory Diseases, a cross-sectional study was carried out in October 2006 in 3256 outpatients (2142 women) (median age of 30 years) seeking care at primary healthcare departments, through a standardized interview questionnaire during two weeks. RESULTS: The prevalence of emphysema, tuberculosis, chronic bronchitis, rhinoconjunctivitis and asthma were 0.7%, 2%, 4.5%, 12.3% and 6.2%, respectively. Current smoking was associated with emphysema (OR: 3.36; 95% CI: 0.97-11.40) and tuberculosis (OR: 2.14; 95% CI: 1.07-4.30), ever exposed to a dusty workplace with chronic bronchitis (OR: 2.20; CI 95%: 1.50-3.21) and rhinoconjunctivitis (OR: 1.56; CI 95%: 1.23-1.98) and cooking or heating using an open fire with asthma (OR: 1.59; CI 95%: 1.16-2.19). The estimates of attributable risks percent indicated that, in the sample, a noticeable part of CRD could be attributed to active smoking, exposure to dust and biomass. Results varied according to gender, particularly regarding current smoking which was more important for men. CONCLUSIONS: Tobacco smoking, exposure to dust at work and using an open fire were important risk factors for CRD. Our results suggest that if actions were taken in order to reduce the aforementioned exposures, an important CRD decrease could be achieved. Copyright © 2015 Elsevier Masson SAS. All rights reserved. PMID: 26386633 [PubMed - as supplied by publisher]
    Revue d Épidémiologie et de Santé Publique 09/2015; DOI:10.1016/j.respe.2015.06.007 · 0.59 Impact Factor
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    • "The remaining 11 household contacts were classified as healthy controls (HC). As noninfected control individuals were rare in the described TB endemic settings [28], we added 3 healthy nonhousehold contacts (community controls with no known previous TB exposure) with TST-indurations of 0 mm, normal chest X-rays and AFB-negative-assisted sputum samples to the healthy control group in order to increase the statistical power (í µí±› = 14; age range: 10.7– 55.2 years; 71.4% females). The Mantoux induration > 15 mm criterion was used for the definition of LTBI, as a large-scale study performed in a rural African population showed that the local environmental mycobacterial exposure is reflected in Mantoux indurations that cluster around 10 mm, whereas the M. tuberculosis exposures are reflected by indurations with a mode at 15–17 mm or larger [29]. "
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    ABSTRACT: Elevated antibody responses to Mycobacterium tuberculosis antigens in individuals with latent infection (LTBI) have previously been linked to an increased risk for progression to active disease. Studies in the field focussed mainly on IgG antibodies. In the present study, IgA and/or IgG responses to the mycobacterial protein antigens AlaDH, NarL, 19 kDa, PstS3, and MPT83 were determined in a blinded fashion in sera from 53 LTBI controls, 14 healthy controls, and 42 active TB subjects. Among controls, we found that elevated IgA levels against all investigated antigens were not randomly distributed but concentrated on a subgroup of <30%-with particular high levels in a small subgroup of ~5% comprising one progressor to active TB. Based on a specificity of 100%, anti-NarL IgA antibodies achieved with 78.6% sensitivity the highest accuracy for the detection of active TB compared to healthy controls. In conclusion, the consistently elevated IgA levels in a subgroup of controls suggest higher mycobacterial load, a risk factor for progression to active TB, and together with high IgG levels may have prognostic potential and should be investigated in future large scale studies. The novel antigen NarL may also be promising for the antibody-based diagnosis of active TB cases.
    Mediators of Inflammation 09/2015; 2015:364758. DOI:10.1155/2015/364758 · 3.24 Impact Factor
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    • "While active or former smoking has been associated with increased risk for LTBI [6], [7], [8], [9], [10], [11], [12], including a population-based national sample in the United States [13], fewer studies have investigated the association between passive smoking (secondhand smoke exposure) and LTBI in adults [14] or children [15], [16], [17]. All studies reported a positive association between passive smoking and LTBI, though some did not adjust for confounding variables [16], [17], and one study found no association after adjusting for confounding variables [15]. "
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    ABSTRACT: Few studies assessing the relationship between active and passive smoking and tuberculosis have used biomarkers to measure smoke exposure. We sought to determine the association between active and passive smoking and LTBI in a representative sample of US adults and children. We used the 1999-2000 US National Health and Nutrition Examination Survey (NHANES) dataset with tuberculin skin test (TST) data to assess the association between cotinine-confirmed smoke exposure and latent tuberculosis infection (LTBI) among adults ages ≥20 years (n = 3598) and children 3-19 years (n = 2943) and estimate the prevalence of smoke exposure among those with LTBI. Weighted multivariate logistic regression was used to measure the associations between active and passive smoking and LTBI. LTBI prevalence in 1999-2000 among cotinine-confirmed active, passive, and non-smoking adults and children was 6.0%, 5.2%, 3.3% and 0.3%, 1.0%, 1.5%, respectively. This corresponds to approximately 3,556,000 active and 3,379,000 passive smoking adults with LTBI in the US civilian non-institutionalized population in 1999-2000. Controlling for age, gender, socioeconomic status, race, birthplace (US vs. foreign-born), household size, and having ever lived with someone with TB, adult active smokers were significantly more likely to have LTBI than non-smoking adults (AOR = 2.31 95% CI 1.17-4.55). Adult passive smokers also had a greater odds of LTBI compared with non-smokers, but this association did not achieve statistical significance (AOR = 2.00 95% CI 0.87-4.60). Neither active or passive smoking was associated with LTBI among children. Among only the foreign-born adults, both active (AOR = 2.56 (95% CI 1.20-5.45) and passive smoking (AOR = 2.27 95% CI 1.09-4.72) were significantly associated with LTBI. Active adult smokers and both foreign-born active and passive smokers in the United States are at elevated risk for LTBI. Targeted smoking prevention and cessation programs should be included in comprehensive national and international TB control efforts.
    PLoS ONE 03/2014; 9(3):e93137. DOI:10.1371/journal.pone.0093137 · 3.23 Impact Factor
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