Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan

Abstract

BackgroundSputum smear-positive tuberculosis (TB) patients have a high risk of transmission and are of great epidemiological and infection control significance. Little is known about the smear-positive populations in high TB burden regions, such as Kazakhstan. The objective of this study is to characterize the smear-positive population in Kazakhstan and identify associated modifiable risk factors.MethodsData on incident TB cases’ (identified between April 2012 and March 2014) socio-demographic, risk behavior, and comorbidity characteristics were collected in four regions of Kazakhstan through structured survey and medical record review. We used multivariable logistic regression to determine factors associated with smear positivity.ResultsOf the total sample, 193 (34.3%) of the 562 study participants tested smear-positive. In the final adjusted multivariable logistic regression model, sex (adjusted odds ratio (aOR) = 2.0, 95% CI:1.3–3.1, p < 0.01), incarceration (aOR = 3.6, 95% CI:1.2–11.1, p = 0.03), alcohol dependence (aOR = 2.6, 95% CI:1.2–5.7, p = 0.02), diabetes (aOR = 5.0, 95% CI:2.4–10.7, p < 0.01), and physician access (aOR = 2.7, 95% CI:1.3–5.5p < 0.01) were associated with smear-positivity.ConclusionsIncarceration, alcohol dependence, diabetes, and physician access are associated with smear positivity among incident TB cases in Kazakhstan. To stem the TB epidemic, screening, treatment and prevention policies should address these factors.

Diagnostic performances of the Xpert MTB/RIF in Brazil

“…Interestingly, while different studies were able to describe association between alcohol abuse and TB [17][18][19], we are the first to describe the relationship between alcohol abuse and Xpert performances.…”

High prevalence of self‐reported tuberculosis and associated factors in a nation‐wide census among prison inmates in Peru

“…In the final multilevel model adjusted per CF and overcrowding at the second level, no sociodemographic characteristics lost association. Young adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) were 93% more likely (PRa 1.93; 95% CI: 1.49-2.51) to be diagnosed with srTB than older adults (>55), and male participants had 10 times more chance to be diagnosed with srTB (PRa 10.06; 95% CI: 3.86-26.25). Those who born in the capital were 28% more likely to have srTB (PRa 1.28; 95% CI: 1.09-1.50) compared to other provinces.…”

Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs

“… 45 The authors found that alcohol consumption (≥ 2 drinks per day) were associated with an increased risk of tuberculosis when accompanied by smoking (hazard ratio = 1.51; 95% CI: 1.11-2.05), which is another risk factor for the development of active tuberculosis. 46 …”

“…Individuals with AUD are considered more infectious because AUD has been associated with the finding of cavitary disease on chest X-rays and therefore with smear positivity. 46 , 47 In addition, AUD has been associated with higher rates of treatment default (OR = 1.99; 95% CI: 1.04-3.81) and relapse (OR = 3.9; 95% CI: 2.5-6.1). 48 , 49 There are several reasons for that, including precarious living conditions and the increased risk of hepatotoxicity due to tuberculosis treatment in this group of patients.…”