Smoking in tuberculosis patients increases the risk of infection in their contacts

Godoy, Pere; Caylà, Joan A.; Carmona, Glòria; Camps, Neus; Álvarez, Jaime; Alsedà, Miquel; Minguell, Sofía; Rodés, Anna; Altet, Neus; Pina, Jaime; Barrabeig, Irene; Orcau, Àngels; Parrón, I.; March, Jaume; Follia, Núria; Sabater, Mikel; Domı́nguez, Àngela

doi:10.5588/ijtld.12.0696

Cited by 26 publications

(19 citation statements)

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“…Numerous studies have found individuals with latent TB infection (LTBI) are more likely to be smokers or exposed to second‐hand smoke (SHS) (Table ) . The strength of the associations between LTBI and SHS or direct CS exposure is summarized in Figure a.…”

Section: Tb Infection With Cs Exposurementioning

confidence: 93%

“…Numerous studies have found individuals with latent TB infection (LTBI) are more likely to be smokers or exposed to second-hand smoke (SHS) ( Table 1). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The strength of the associations between LTBI and SHS 15,17,18,21 or direct CS 8,9,11,12,14,16,22,23 exposure is summarized in Figure 1a. There also appears to be an association between the degree of cigarette smoking-as measured by duration or intensity of smoking-and LTBI (Fig.…”

Section: Tb Infection With Cs Exposurementioning

confidence: 99%

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Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

et al. 2015

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The geographic overlap between the prevalence of cigarette smoke (CS) exposure and tuberculosis (TB) in the world is striking. In recent years, relatively large number of studies has linked cigarette or biomass fuel smoke exposure and various aspects of TB. Our goals are to summarize the significance of the known published studies, graphically represent reports that quantified the association and discuss their potential limitations. PubMed searches were performed using the key words 'tuberculosis' with 'cigarette', 'tobacco', 'smoke' or 'biomass fuel smoke.' The references of relevant articles were examined for additional pertinent papers. A large number of mostly case-control and cross-sectional studies significantly associate both direct and second-hand smoke exposure with tuberculous infection, active TB, and/or more severe and lethal TB. Fewer link biomass fuel smoke exposure and TB. While a number of studies interpreted the association with multivariate analysis, other confounders are often not accounted for in these analyses. It is also important to emphasize that these retrospective studies can only show an association and not any causal link.We further explored the possibility that even if CS exposure is a risk factor for TB, several mechanisms may be responsible. Numerous studies associate cigarette and biomass smoke exposure with TB but the mechanism(s) remains largely unknown. While the associative link of these two health maladies is well established, more definitive, mechanistic studies are needed to cement the effect of smoke exposure on TB pathogenesis and to utilize this knowledge in empowering public health policies.

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Section: Tb Infection With Cs Exposurementioning

confidence: 93%

Section: Tb Infection With Cs Exposurementioning

confidence: 99%

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

et al. 2015

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“…The effect of smoking on risk of LTBI after adjusting for other risk factors remained strong with an elevated OR of 7·1 (95% CI, 2·8–18). Smoking tobacco increases the risk of acquisition of TB infection [19], development of TB disease [20], and is associated with increased TB mortality [21]. This finding underscores the importance of smoking cessation in this population.…”

Section: Discussionmentioning

confidence: 89%

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

et al. 2014

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BackgroundThe incidence rate of active tuberculosis (TB) disease in the Canadian Territory of Nunavut has shown a rising trend over the past 10 years. In 2010 it was 60 times greater than the national incidence rate. The objective of the Taima (translates to “stop” in Inuktitut) TB study was to implement and evaluate a public health campaign to enhance existing TB prevention efforts in Nunavut.MethodsA TB awareness campaign followed by a door-to-door screening campaign was carried out in Iqaluit, Nunavut. The aim of the campaign was to raise awareness about TB, and to provide in-home screening and treatment for people living in residential areas at high risk for TB. Screening was based on geographic location rather than on individual risk factors.ResultsDuring the general awareness campaign an increase in the number of people who requested TB testing at the local public health clinic was observed. However, this increase was not sustained following cessation of the awareness campaign. Targeted TB screening in high risk residential areas in Iqaluit resulted in 224 individuals having TSTs read, and detection of 42 previously unidentified cases of latent TB, (overall yield of 18.8% or number needed to screen = 5.3). These cases of latent TB infection (LTBI) were extra cases that had not been picked up by traditional screening practices (34% relative increase within the community). This resulted in a 33% relative increase in the completion of LTBI treatment within the community. The program directly and indirectly identified 5/17 new cases of active TB disease in Iqaluit during the study period (29.5% of all incident cases).ConclusionsWhile contact tracing investigations remain a cornerstone of TB prevention, additional awareness, screening, and treatment programs like Taima TB may contribute to the successful control of TB in Aboriginal communities.

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“…Our estimate of household income may reflect people who were not tax filers but at the same time may underestimate all incomes as per tax laws. Smoking is a well known risk factor for the acquisition of LTBI,17 development of active TB disease18 and death due to TB 19. The prevalence of smoking is high in this population compared with the rest of Canada.…”

Section: Discussionmentioning

confidence: 99%

Social determinants of health among residential areas with a high tuberculosis incidence in a remote Inuit community

Kilabuk

Momoli

Mallick

et al. 2019

J Epidemiol Community Health

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BackgroundTuberculosis (TB) remains a significant health burden among Inuit in Canada. Social determinants of health (SDH) play a key role in TB infection, disease and ongoing transmission in this population. The objective of this research was to estimate the prevalence of social determinants of Inuit health as they relate to latent TB infection (LTBI) among people living in residential areas at high risk for TB in Iqaluit, Nunavut.MethodsInperson home surveys were conducted among those who lived in predetermined residential areas at high risk for TB identified in a door-to-door TB prevention campaign in Iqaluit, Nunavut in 2011. Risk ratios for SDH and LTBI were estimated, and multiple imputation was used to address missing data.Results261 participants completed the questionnaire. Most participants identified as Inuit (82%). Unadjusted risk ratios demonstrated that age, education, smoking tobacco, crowded housing conditions and Inuit ethnicity were associated with LTBI. After adjusting for other SDH, multivariable analysis showed an association between LTBI with increasing age (relative risk, RR 1.07, 95% CI 1.04 to 1.11), crowded housing (RR 1.48, 95% CI 1.10 to 2.00) and ethnicity (RR 2.76, 95% CI 1.33 to 5.73) after imputing missing data.ConclusionAmong high-risk residential areas for TB in a remote Arctic region of Canada, crowded housing and Inuit ethnicity were associated with LTBI after adjusting for other SDH. In addition to strong screening and treatment programmes, alleviating the chronic housing shortage will be a key element in the elimination of TB in the Canadian Inuit Nunangat.

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Smoking in tuberculosis patients increases the risk of infection in their contacts

Abstract: Index case smoking increases the risk of LTBI and should be systematically investigated. A reduction in smoking could lower the risk of infection substantially.

Cited by 26 publications

References 0 publications

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

TAIMA (Stop) TB: The Impact of a Multifaceted TB Awareness and Door-to-Door Campaign in Residential Areas of High Risk for TB in Iqaluit, Nunavut

Social determinants of health among residential areas with a high tuberculosis incidence in a remote Inuit community

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