Association of DM, smoking, and alcohol use with subclinical-to-symptomatic spectrum of TB

Hamada, Y., Quartagno, M., Law, I., Malik, F., Bonsu, F.A., Adetifa, I.M., Adusi-Poku, Y., D'Alessandro, U., Bashorun, A.O., Begum, V. and Lolong, D.B., 2023. Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys. EClinicalMedicine, 63. [TB0042]

·       WHO recommends systematic screening for active TB in specific populations or settings.

·       Screening aims to identify both symptomatic and asymptomatic TB cases.

·       Males are more likely to have TB but are underrepresented in screenings.

·       Surveys should systematically collect NCD-related variables to develop TB risk prediction models.

·       History of TB, HIV, self-reported diabetes, and current smoking can indicate higher TB risk.

·       The risk magnitude is approximately 1.5-fold for current smoking and self-reported diabetes.

·       Screening policies should target individuals with these risk factors.

·       Current smokers could be prioritized for chest X-ray screening alongside symptom screening.

·       Up to 50% of TB cases can be subclinical; smokers are more likely to have subclinical TB.

·       Self-reported diabetes is linked to symptomatic TB but not subclinical TB.


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