Article

Tobacco and tuberculosis: A qualitative systematic review and meta-analysis

The International Union Against Tuberculosis and Lung Disease, Paris, France.
The International Journal of Tuberculosis and Lung Disease (Impact Factor: 2.32). 11/2007; 11(10):1049-61.
Source: PubMed

ABSTRACT

To assess the strength of evidence in published articles for an association between smoking and passive exposure to tobacco smoke and various manifestations and outcomes of tuberculosis (TB). Clinicians and public health workers working to fight TB may not see a role for themselves in tobacco control because the association between tobacco and TB has not been widely accepted. A qualitative review and meta-analysis was therefore undertaken.
Reference lists, PubMed, the database of the International Union Against Tuberculosis and Lung Disease and Google Scholar were searched for a final inclusion of 42 articles in English containing 53 outcomes for data extraction. A quality score was attributed to each study to classify the strength of evidence according to each TB outcome. A meta-analysis was then performed on results from included studies.
Despite the limitations in the data available, the evidence was rated as strong for an association between smoking and TB disease, moderate for the association between second-hand smoke exposure and TB disease and between smoking and retreatment TB disease, and limited for the association between smoking and tuberculous infection and between smoking and TB mortality. There was insufficient evidence to support an association of smoking and delay, default, slower smear conversion, greater severity of disease or drug-resistant TB or of second-hand tobacco smoke exposure and infection.
The association between smoking and TB disease appears to be causal. Smoking can have an important impact on many aspects of TB. Clinicians can confidently advise patients that quitting smoking and avoiding exposure to others' tobacco smoke are important measures in TB control.

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Available from: Kristen Hassmiller Lich, Jul 02, 2014
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    • "These two global epidemics amplify each other's negative impact on population health. Tobacco smoking increases the risk of acquiring TB infection, developing disease and worsening outcomes, including death, treatment failure and relapse (Bates et al., 2007; Lin, Ezzati, & Murray, 2007; Siddiqi & Lee, 2009; Slama et al., 2007). In many low-and-middle income countries (LMICs), where TB burden is high, Address for correspondence: Omara Dogar, MBBS; MPH (Epi), Research Fellow, Department of Health Sciences, University of York Room 105, ARRC, Heslington YO10 5DD, York, UK. "
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    • "The association of smoking with TB infection and disease have been corroborated by other meta-analyses [20] [21]. In addition to tobacco smoke, the association of indoor air pollution, caused by smoke from the burning of biomass fuel, with COPD has been well documented [18] [23]. "
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is emerging as the third largest cause of human mortality worldwide after heart disease and stroke. There is growing evidence of a co-morbidity between COPD and tuberculosis (TB), the leading cause of death globally due to respiratory infection. Thus, the increase in the burden of COPD over the coming decades, as predicted by the World Health Organisation, is of concern with respect to the control of TB. A better understanding of the interactions between these two diseases is essential for the design of complementary preventive and control strategies. In this review, some of the known risk factors that are common to both diseases are discussed. Furthermore, we examine how impairment of the innate immune system, and corticosteroid therapy, in COPD patients may increase the risk of TB manifestation. Conversely, we review how TB lung pathology may heighten susceptibility to subsequent development of COPD, even after completion of effective TB treatment. Growing evidence appears to point towards a bi-directional relationship between these two lung diseases where each may act as an independent risk factor for the other. This has important implications for the respective long-term management of TB and COPD.
    Full-text · Article · Sep 2015 · Tuberculosis
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    • "There is an inter-relationship between respiratory disease and tobacco that can be seen both in morbidity and mortality. For TB, this association is found at every stage from initial infection (Bates et al., 2007; Yach, 2001) conversion (Slama et al., 2007) and development of disease (Bates et al., 2007) to outcomes; as smokers are less likely to adhere to TB treatment, more likely to relapse after completing treatment or need re-treatment (Chiang et al., 2007) and have a higher chance of dying due to their tobacco use (Slama et al., 2007). In South East Asia, deaths attributed to tobacco accounted for 8% of all TB deaths (WHO, 2012b). "
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