Risks for tuberculosis in Kazakhstan: implications for prevention

Abstract

Summary Setting Four regions in Kazakhstan where participants were recruited from June 2012 to May 2014. Objective To examine associations between incarceration history and tobacco, alcohol, and drug consumption, and human immunodeficiency virus (HIV) infection and diabetes mellitus (DM) with TB. Design This matched case-control study included 1600 participants who completed a survey on sociodemographics, history of incarceration, tobacco, alcohol and drug use, and HIV and DM diagnosis. Conditional logistic regression analysis was used to examine associations between a TB diagnosis and risk factors. Results Participants who had ever smoked tobacco (aOR 1.73, 95%CI 1.23–2.43, P ≤ 0.01), ever drank alcohol (aOR 1.41, 95%CI 1.03–1.93, P ≤ 0.05), were HIV-positive (aOR 36.37, 95%CI 2.05–646.13, P ≤ 0.05) or had DM (aOR 13.96, 95%CI 6.37–30.56, P ≤ 0.01) were more likely to have TB. Conclusions The association between TB and tobacco use, alcohol use, HIV and DM in Kazakhstan suggests a need for comprehensive intervention and prevention approaches that also address tobacco and alcohol use, DM and HIV.

The impact of smoking on clinical characteristics and treatment outcome of patients with pulmonary tuberculosis

“…Patients treated for TB who were included in our study were mostly smokers (57.7%). This is a higher percentage of smokers than in studies conducted in different parts of the world, including countries with high PTB prevalence [9,10,15]. A similar number of smokers suffering from TB were recorded in Russia (49%) and Spain (48%).…”

“…Several lifestyle factors are associated with an increased risk of PTB, including smoking and alcohol abuse [15,16]. Smoking and excessive alcohol consumption are major health risks globally and are targets for interventions to reduce the global burden of disease.…”

“…Chronic alcohol use can reduce the response of macrophages and the immune system [15]. Body mass index value under 18.5 kg/m 2 is seen as a marker for malnutrition, and malnutrition can reduce immune response either through the interaction of monocyte-macrophages and T-lymphocytes and their cytokines or the secondary immune deficiency that increases the susceptibility of the host to infection [16].…”

Risk of active tuberculosis among people with diabetes mellitus: systematic review and meta‐analysis

“…After reading the full text, 57 studies were excluded for various reasons mentioned in Figure . Thus, 14 studies (eight cohort studies and six case‐control studies), published between 1992 and 2017, which involved 22 616 623 participants, met the eligibility criteria for this analysis .…”

“…This may partly explain the result of meta‐regression grouped by TB type: PTB group had a higher effect estimate (RR;3.63) than All‐TB group (RR;2.08). Five studies relied exclusively on self‐report for the diagnosis of DM , which could result in differential misclassification of exposure either by under‐reporting or under‐diagnosis of DM. A previous review reported that nearly half of adult DM patients globally were undiagnosed .…”