Increasing likelihood of advanced pulmonary tuberculosis at initial diagnosis in a low-incidence US state

Yang, Zhenhua; Gorden, T.; Liu, D. P.; Mukasa, Leonard; Patil, Naveen; Bates, Joseph H.

doi:10.5588/ijtld.17.0413

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…Whether alcohol may have an antagonistic, additive, or synergistic effect with these comorbidities or with other demographics is unclear. The four previous studies [9][10][11]33] that investigated alcohol and TB disease severity were in populations where women consume alcohol; one study reported 15% of those who consumed alcohol were female [10] compared to <1% in our cohort. Similarly, only one study reported comorbid diabetes [33]; 19% of their cohort had diabetes compared to 34% of our cohort.…”

Section: Plos Onementioning

confidence: 61%

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Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India

et al. 2020

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Setting Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. Objective To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. Design Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. Results Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7–1.4), cavitation (aOR 0.8, 95%CI 0.4–1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. Conclusions A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.

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Section: Plos Onementioning

confidence: 61%

“…Alcohol use has been associated with both progression to TB disease and poor TB treatment outcomes [5][6][7][8]. Studies have shown an association between alcohol use and both lung cavitation and smear positivity, but these studies are limited to low-burden settings and results have been conflicting [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India

et al. 2020

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“…This score was widely used in the validation and prediction of clinical results of severe patients in the ICU, and a previous study implied that this score could be used in TB patients [23] . Higher APACHE II score was associated with more serious conditions, poorer prognosis, and higher mortality rates for patients [6] , [24] . In our study, both the APACHE II score and levels of S100A9 in pulmonary TB patients with respiratory failure on ICU admission were higher in non-survivors than survivors.…”

Section: Discussionmentioning

confidence: 91%

High levels of plasma S100A9 at admission indicate an increased risk of death in severe tuberculosis patients

Liu

et al. 2021

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Highlights Severe TB patients had poor outcomes with no standard evaluation criteria, especially TB patients combined with respiratory failure. The levels of S100A9 has been employed for indicating inflammation in TB patients, However, it has not yet been evaluated as a biomarker for predicting outcomes in severe pulmonary TB patients. In this study we measured the plasma S100A9 levels in severe pulmonary TB patients at admission to ICU along with standard clinical parameters and APACHE II scores, analyzed the association with the survival of the patients, and compared their performance in predicting TB death which may help to improve the treatment outcome for TB patient.

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“…Pulmonary TB (PTB) often starts with minimum infiltrate and progresses to additional infiltrate; sputum smear positivity has been used previously as a proxy for delayed diagnosis ( 17 ). The occurrence of extrapulmonary TB (EPTB) often reflects the spread of M. tuberculosis outside of the lungs due to the host’s inability to contain the infection ( 23 ).…”

Section: Methodsmentioning

confidence: 99%

“…In the United States, race is a strong social determinant of health because it serves as a proxy for systemic and structural barriers to equitable opportunities for education, employment, earning, housing, and healthcare, which perpetuates racial discrimination and unjust distribution of resources that lead to adverse health outcomes ( 13 , 14 ). In this study from Arkansas, USA, a state with TB incidence below the national average of 2.4 cases/100,000 population, we quantify the racial/ethnic disparities in TB incidence at the population level using detailed racial/ethnic categorizations that have not been widely used in previous TB studies in Arkansas ( 15 – 17 ). This study will not only help map subpopulations at an increased risk for TB in a low-burden setting but also guide the development of targeted TB interventions in light of the underlying factors that differentially drive TB incidence across racial/ethnic groups.…”

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confidence: 99%

Racial and Ethnic Disparities in Tuberculosis Incidence, Arkansas, USA, 2010–2021

Humayun,

Mukasa,

et al. 2024

Emerg. Infect. Dis.

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We conducted an epidemiologic assessment of disease distribution by race/ethnicity to identify subpopulation-specific drivers of tuberculosis (TB). We used detailed racial/ethnic categorizations for the 932 TB cases diagnosed in Arkansas, USA, during 2010–2021. After adjusting for age and sex, racial/ethnic disparities persisted; the Native Hawaiian/Pacific Islander (NHPI) group had the highest risk for TB (risk ratio 173.6, 95% CI 140.6–214.2) compared with the non-Hispanic White group, followed by Asian, Hispanic, and non-Hispanic Black. Notable racial/ethnic disparities existed across all age groups; NHPI persons 0–14 years of age were at a particularly increased risk for TB (risk ratio 888, 95% CI 403–1,962). The risks for sputum smear–positive pulmonary TB and extrapulmonary TB were both significantly higher for racial/ethnic minority groups. Our findings suggest that TB control in Arkansas can benefit from a targeted focus on subpopulations at increased risk for TB.

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Increasing likelihood of advanced pulmonary tuberculosis at initial diagnosis in a low-incidence US state

Abstract: Measures to reduce the proportion of cases with advanced disease at first diagnosis may be helpful to achieve further decline in TB incidence in low-incidence settings.

Cited by 7 publications

References 21 publications

Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India

Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India

High levels of plasma S100A9 at admission indicate an increased risk of death in severe tuberculosis patients

Racial and Ethnic Disparities in Tuberculosis Incidence, Arkansas, USA, 2010–2021

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