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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    • "Recent epidemiologic and experimental findings show that cigarette smoking can be highly associated with the risk of getting lung cancer[7]and cardiovascular diseases[8]. Smoking has also been found to increase the risk of developing Mycobacterium tuberculosis infection, which accounts for high mortality in developing countries[9]. Therefore, smoking has become one of the major preventable indicators for mortality and morbidity. "
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    ABSTRACT: Background: Smoking is a global public health concern. Timor-Leste is facing a rapidly growing epidemic of tobacco use. The trend of smoking in Timor-Leste seems to be increasing and the magnitude of the problem affects people who smoke before reaching adulthood. One of the factors implicated in the continuously rising trend of smoking among young people in Timor-Leste is clearly due to unavailability of restrictive laws and regulations. Therefore, our study sought to analyze available dataset from the Global Youth Tobacco Survey (GYTS) for developing a comprehensive national smoking policy in order to lower smoking risks among young people in Timor-Leste. Methods: We conducted a secondary analysis of the 2009 GYTS in Timor-Leste. The 2009 GYTS assessed 1657 in-school students aged 13-15 years for current smoking prevalence and determinants of tobacco use. We used IBM SPSS version 21 software to analyze the data. Frequency analyses were computed to identify demographic characteristics of study participants. Bivariate logistic regression analysis was performed to examine the association between each demographic characteristic as well as each independent variable and the outcome of being current smokers. Results: Out of 1657 in-school students, 51 % were of ages less than 15; 53 % were girls; and 45 % were in grade 2. Prevalence of current cigarette smoking was found to be 51 %. The prevalence of current smoking among in-school students increased with ages (from 46 % in less than 15 to 57 % in 15 plus). Boys were more likely to be smokers than girls (59 % versus 28 %). Significant factors positively associated with current smoking included parental smoking; closed-peer smoking; number of days people smoked in the house; having family discussion about harmful effects of smoking; being smoking in areas such as school, public places and home; and having seen cigarette advertisements on billboard. Conclusion: Timor-Leste has higher prevalence of cigarette smoking among minors, especially among boys. Our analysis provides evidence-based information for developing comprehensive tobacco control programs - both education and policy interventions to reduce smoking rate among young people in Timor-Leste.
    Full-text · Article · Dec 2015 · BMC Public Health
    • "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]
    No preview · Article · Sep 2015 · Revue d Épidémiologie et de Santé Publique
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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.
    Full-text · Article · Sep 2015 · Mediators of Inflammation
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