Malnutrition: Modulator of Immune Responses in Tuberculosis

Padmapriyadarsini, Chandrasekaran; Natarajan, Saravanan; Bethunaickan, Ramalingam; Tripathy, Srikanth

doi:10.3389/fimmu.2017.01316

Cited by 91 publications

(84 citation statements)

References 59 publications

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“…is might be due to undernutrition or nutritional deficiency that impairs cell-mediated immunity which can lead to progression of latent infection to active TB disease. e differences in the socioeconomic status, lifestyle, and feeding patterns of the household contacts might also explain these differences [30,31].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia

Adane¹,

Damena

Weldegebreal

et al. 2020

Tuberculosis Research and Treatment

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Background. Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. It still remains a major public health problem which affects all age groups. Risk of exposure is higher in household contact than members of the general population. Objective. The aim of this study was to assess the prevalence and associated factors of tuberculosis among adult household contacts of smear positive pulmonary tuberculosis in Haramaya district, Oromia Region, Eastern Ethiopia from February to March, 2019. Method. A community based cross-sectional study design was conducted. A total of 454 study participants were selected using systematic sampling method from all adult household contacts of smear positive pulmonary tuberculosis patients treated from July 2017 to December 2018. Data were collected using a pretested and structured questionnaire; and laboratory examination was processed using fluorescent smear microscope. Logistic regression analysis was used to identify the factors associated with the infection of pulmonary tuberculosis and a statistically significant association was declared at P-value < 0.05. Result. The overall prevalence of pulmonary tuberculosis among adult household contacts was 7.8% (95% CI: 5.8–10.0). The risk factors for tuberculosis infection among household contacts were eating meals less than three times per day (AOR = 4.31; 95% CI: 1.61, 11.55), drinking raw milk (AOR = 4.12; 95% CI: 1.43, 11.90), having family history of tuberculosis with more than one index case (AOR = 2.7; 95% CI: 1.02, 6.92), living in poor ventilated houses (AOR = 4.02; 95% CI: 1.38, 11.76), and living in inadequate size of living room (AOR = 3.4; 95% CI: 1.30, 8.86). Conclusion. In this study, the prevalence of tuberculosis among adult household contacts of smear positive pulmonary tuberculosis is high. Eating meals less than three times per day, drinking raw milk, living in poor ventilated houses, and inadequate sizes of the rooms were identified as contributing factors. Therefore, we recommend that the transmission of tuberculosis can potentially be reduced by a better contact tracing and treatment strategies along with appropriate health education.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia

Adane¹,

Damena

Weldegebreal

et al. 2020

Tuberculosis Research and Treatment

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“…As for the treatment of COPD, early detection and smoking cessation can prevent disease progression and improve outcomes. 28 Moreover, poor oral hygiene due to xerostomia or trismus may increase respiratory infections. Indeed, smoking cessation intervention is effective for HNC survivors, especially in the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

“…24,27 Malnutrition leads to immunodeficiency and may increase the risk of respiratory infection. 28 Moreover, poor oral hygiene due to xerostomia or trismus may increase respiratory infections. 29 Therefore, management of oral hygiene should be considered among HNC survivors.…”

Section: Discussionmentioning

confidence: 99%

Adverse respiratory outcomes among head and neck cancer survivors in the Utah Cancer Survivors Study

Kawakita

Abdelaziz

Chen

et al. 2019

Cancer

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BACKGROUND: The number of head and neck cancer (HNC) survivors has been increasing because of improving survival in the United States. The aim of this study was to evaluate the incidence of respiratory disease diagnoses in HNC survivors in comparison with cancerfree individuals. A second aim was to investigate risk factors for respiratory disease among HNC survivors. METHODS: Patients with HNC diagnosed from 1996 to 2012 were identified in the Utah Cancer Registry (n = 1901). Up to 5 cancer-free individuals from the general population (n = 7796) were matched to each HNC survivor by birth year, sex, birth state, and follow-up time. Electronic medical records and statewide health care facility data were used to identify a disease diagnosis after the cancer diagnosis. Cox proportional hazards models were used to estimate the risks of respiratory diseases. RESULTS: The median follow-up times were 4.5 years for HNC survivors and 7.8 years for the general population cohort. The risks of respiratory infection (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.40-1.90), chronic obstructive pulmonary diseases and bronchiectasis (HR, 2.65; 95% CI, 2.13-3.29), and aspiration pneumonitis (HR, 6.21; 95% CI, 3.98-9.68) were higher among HNC survivors than the general population cohort more than 5 years after the cancer diagnosis. Age at diagnosis, baseline body mass index, sex, baseline smoking status, treatment modality, primary site, and stage were associated with the risk of adverse respiratory outcomes among HNC survivors. CONCLUSIONS: The risk of adverse respiratory outcomes was much higher among HNC survivors than the general population cohort. Multidisciplinary care is needed to prevent the occurrence of adverse respiratory outcomes among HNC survivors. Cancer 2020;126:879-885.

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“…Concomitant and weakening physical conditions in older people blunt inflammatory responses which then constrain cavitation [ 33]. The increased risk of cavitation and smear positivity in undernourished patients could be either way: under-nutrition led to immune-deficiency and enhanced disease progression [ 34,35] or the disease itself might lead to under-nutrition [ 36]. Moreover, other evidences revealed diabetes, smoking, low income and absence of HIV [37][38][39] as independent predictors of cavitation and smear positivity.…”

Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia

Getnet

Demissie

Yalew

et al. 2019

Preprint

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Background To comprehend the effect of delayed care on risk of tuberculosis (TB) transmission in a TB prevalent but low case detection area, this study examined the association of diagnosis delay with patient infectiousness (cavitation and smear positivity) and determined the threshold delay that optimizes infectiousness. It also assessed transmission drivers in Somali region of Ethiopia, an area with ample pastoralist population. Methods A cross-sectional study was conducted using 434 new pulmonary TB patients, aged ≥15 years, who were recruited prospectively in five major facilities between December 2017 and October 2018. Data were collected on delays in diagnosis, socio-demographics, clinical and epidemiological information using interview, record-review, anthropometry, sputum microscopy and chest radiography techniques. Log-binomial regression models were used to reveal predictors of cavitation and smear positivity at p<0.05 using Stata/SE®14. C-statistics was applied to determine predictive ability and threshold delay that classifies infectiousness. Results Median age of participants was 30 years. Majorities were male (62.9%), nearly half (46.5%) were pastoralist and 2.3% TB/HIV co-infected. Median delay from debut of illness to diagnosis was 49 days (IQR=37). Among all cases, 45.6% [95%CI: 40.9-50.4] had pulmonary cavity and 42.0% [95%CI: 37.3˗46.9] were smear positive. On multivariable analysis, cavitation was higher in patients delayed over a month [P<0.001], ≤35 years [APR (95%CI) =1.3(1.01-1.6)], with chronic diseases [APR (95%CI) =1.8(1.2-2.6)] and low MUAC*female [APR (95%CI) =1.8(1.2-2.8)]. Smear positivity was higher in patients delayed >49 days [p=0.02], ≤35 years [APR (95%CI) =1.4(1.1-1.8)], low BMI [APR (95%CI) =1.3(1.01-1.7)] and low MUAC [APR (95%CI) =1.5(1.2-1.9)]. Delay discriminates cavitation [AUC (95%CI) =0.67(0.62-0.72)] at 43 days optimal cutoff and 74.6% sensitivity. Conclusion This study highlights that delay in diagnosis of pulmonary TB remains high and is associated with increased risk of cavitation and smear positivity in pastoral setting in Ethiopia. In pastoral settings, this may call upon a socio-cultural tailored TB prevention and control strategies.

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Malnutrition: Modulator of Immune Responses in Tuberculosis

Cited by 91 publications

References 59 publications

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia

Adverse respiratory outcomes among head and neck cancer survivors in the Utah Cancer Survivors Study

Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia

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