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Indoor air pollution from solid fuel and tuberculosis

Lin, H.H., Suk, C.W., Lo, H.L., Huang, R.Y., Enarson, D.A. and Chiang, C.Y., 2014. Indoor air pollution from solid fuel and tuberculosis: a systematic review and meta-analysis. The International journal of tuberculosis and lung disease, 18(5), pp.613-621. Low Evidence for TB Link : The association between the use of solid fuels in households and tuberculosis (TB) is supported by very low levels of evidence. Health Risks from Toxic Pollutants : Burning solid fuels can be hazardous, particularly when stoves are inefficient and ventilation is poor, leading to health issues such as acute lower respiratory infections in children under five, chronic obstructive pulmonary disease, and lung cancer. Factors Affecting Pollutant Levels : The concentration of pollutants from burning solid fuels varies based on the stove type, burning location, and ventilation at the site. These factors help in quantifying pollutant concentrations. Need for More Research : High-quality studies are required to bett

The effect of type 2 DM on the presentation and treatment response of pulmonary TB

Alisjahbana, B., Sahiratmadja, E., Nelwan, E.J., Purwa, A.M., Ahmad, Y., Ottenhoff, T.H., Nelwan, R.H., Parwati, I., Meer, J.W.V.D. and Crevel, R.V., 2007. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clinical infectious diseases, 45(4), pp.428-435. Historical Context and Re-Emergence : Diabetes mellitus (DM) was historically known as a risk factor for tuberculosis (TB) but gained less attention in the latter half of the 20th century with advancements in treatment. However, with the recent global increase in type 2 DM, the association between DM and TB has resurfaced, impacting 10%–30% of TB patients. Epidemiological Data from Indonesia : Indonesia is ranked third worldwide for TB incidence and fourth for DM prevalence. Recent studies have highlighted the significant linkage between DM and TB within this demographic. Impact of Insulin on TB Outcomes : Before the introduction of insulin in 1922, DM patients frequently succ

Effect of diabetes on tuberculosis control in 13 countries with high tuberculosis

Pan, S.C., Ku, C.C., Kao, D., Ezzati, M., Fang, C.T. and Lin, H.H., 2015. Effect of diabetes on tuberculosis control in 13 countries with high tuberculosis: a modelling study. The lancet Diabetes & endocrinology, 3(5), pp.323-330. Diabetes is recognized as a significant risk factor in the global post-2015 tuberculosis strategy, yet effective collaboration between tuberculosis and diabetes programs is lacking in most countries. Thirteen countries, namely Afghanistan, Bangladesh, Brazil, Cambodia, China, India, Indonesia, Myanmar, Pakistan, Philippines, Russian Federation, Thailand, and Vietnam, account for 60% of the world's new tuberculosis cases. Stabilizing diabetes prevalence at 2015 levels in these countries could accelerate the reduction of tuberculosis incidence by 20.3% and mortality by 42.7% by 2035, potentially preventing 1.1 million tuberculosis deaths over 20 years. The impact of reducing diabetes prevalence on tuberculosis is highly sensitive to factors such as the

Health system delay among patients with TB in Taiwan

Chen, C.C., Chiang, C.Y., Pan, S.C., Wang, J.Y. and Lin, H.H., 2015. Health system delay among patients with tuberculosis in Taiwan: 2003–2010. BMC infectious diseases, 15, pp.1-9. TB diagnosis in Taiwan largely relies on detecting symptomatic patients, enhanced by contact tracing and active screening in high-risk groups. Health care workers might miss TB due to its non-specific symptoms, increasing the risk of delayed diagnosis and transmission. The decline in TB incidence and less frequent encounters with TB cases might make clinicians less proficient in recognizing the disease. Health System Delay (HSD) is the time from the first consultation for respiratory issues to the start of TB treatment. HSD has potentially increased from 2003 to 2008 due to various factors like the complexity of diagnosing TB and changes in the health care system. Factors affecting HSD include the patient’s age, gender, type of health faci

Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China

Lin, H.H., Murray, M., Cohen, T., Colijn, C. and Ezzati, M., 2008. Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study. The Lancet, 372(9648), pp.1473-1483. Tobacco smoking and indoor air pollution from solid-fuel use are primary global risk factors for chronic obstructive pulmonary disease (COPD) and lung cancer. These factors significantly contribute to mortality from these diseases in developing countries. Smoking is an independent risk factor for tuberculosis, exacerbating the spread and severity of the disease. Implementing moderate to complete reductions in smoking and solid-fuel use through tobacco taxation, advertising bans, and fuel pricing could decrease deaths from COPD and lung cancer. Reduction in these risk factors would also significantly decrease tuberculosis incidence by minimizing the duration of infectiousness through effective treatment. These diseases pose substantial economic bu

Non-communicable diseases in TB household contacts

Hamada, Y., Lugendo, A., Ntshiqa, T., Kubeka, G., Lalashowi, J.M., Mwastaula, S., Ntshamane, K., Sabi, I., Wilson, S., Copas, A. and Velen, K., 2024. A pilot cross-sectional study of non-communicable diseases in TB household contacts. IJTLD OPEN, 1(4), pp.154-159. Integrating NCD screening, care, and prevention within TB contact tracing can leverage resources and enhance value for money. Household contacts (HHCs) may have a higher prevalence of NCDs than the general population due to shared risk factors. Screening for NCDs during TB contact investigations helps identify individuals unaware of their NCDs. Early identification and treatment of contacts with diabetes (DM) might reduce TB incidence. High prevalence of NCDs was found in both HHCs and neighborhood controls, suggesting the need for community-wide screening. The high prevalence of undiagnosed NCDs, particularly DM, among TB contacts and community members highlights the potential benefits of NCD screening during TB contact inve

Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India

Houben, R.M., Menzies, N.A., Sumner, T., Huynh, G.H., Arinaminpathy, N., Goldhaber-Fiebert, J.D., Lin, H.H., Wu, C.Y., Mandal, S., Pandey, S. and Suen, S.C., 2016. Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models. The Lancet Global Health, 4(11), pp.e806-e815. Aggressive scaling of a single intervention is not enough to meet the post-2015 End TB Strategy targets globally. In South Africa: A combination of targeted interventions could substantially reduce tuberculosis: Continuous isoniazid preventive therapy for individuals on antiretroviral therapy. Expanded facility-based screening for tuberculosis symptoms at health centers. Enhanced tuberculosis care. Using these interventions, significant reductions in tuberculosis are feasible, and meeting the 2025 targets is possible. For other high-burden countries like China and India, additional country-specific interventions are required: In Chin

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa

Menzies, N.A., Gomez, G.B., Bozzani, F., Chatterjee, S., Foster, N., Baena, I.G., Laurence, Y.V., Qiang, S., Siroka, A., Sweeney, S. and Verguet, S., 2016. Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models. The Lancet global health, 4(11), pp.e816-e826. Health Outcomes : Substantial health gains were observed in India, China, and South Africa following expanded access to tuberculosis care. Cost-Effectiveness : Most intervention approaches were highly cost-effective compared to current practices and conventional cost-effectiveness thresholds. Efforts to improve access to care proved to be notably beneficial and cost-effective in each setting analyzed. Policy Considerations : Significant differences in the effectiveness and efficiency of various approaches necessitate careful planning in service expansion. Implementing expanded services effectively would require substantial new funding.

Tuberculosis in Healthcare Workers

Pan S-C, Chen Y-C, Wang J-Y, Sheng W-H, Lin H-H, Fang C-T, et al. (2015) Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. PLoS ONE 10(12): e0145047. Tuberculosis (TB) is considered a significant occupational hazard for healthcare workers (HCWs) in Taiwan. The incidence of active TB among HCWs in the study hospital was higher than that of the general population in Taiwan when adjusted for age, sex, and diagnosis year. The outcomes of TB in HCWs were notably better compared to non-HCW patients treated in the same setting. Factors such as the healthy worker effect, more rapid diagnosis, and less delay in treatment contributed to lower TB mortality among HCWs.  

Ambient air pollution and risk of tuberculosis

Lai, T.C., Chiang, C.Y., Wu, C.F., Yang, S.L., Liu, D.P., Chan, C.C. and Lin, H.H., 2016. Ambient air pollution and risk of tuberculosis: a cohort study. Occupational and environmental medicine, 73(1), pp.56-61. Respirable risk factors such as active and passive smoking, and indoor air pollution from biomass, potentially impair airway defense mechanisms, increasing TB risk. High levels of ambient air pollution in developing countries correlate with continued high tuberculosis rates, necessitating further investigation into its impact on global TB control. Fine particles and traffic-related pollutants like nitrogen dioxide, nitrogen oxides, and carbon monoxide are linked to a higher risk of active tuberculosis. Laboratory and ecological studies suggest a positive association between ambient air pollution and TB incidence. The true relationship between ambient air pollution and TB might be underestimated due to potential residual confounding by area-level socioeconomic factors.