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.


Comments

Post a Comment

Popular posts from this blog

Nutritional status in patients with TB and DM

Patel, D.G., Baral, T., Kurian, S.J., Malakapogu, P., Saravu, K. and Miraj, S.S., 2024. Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study.  Journal of Clinical Tuberculosis and Other Mycobacterial Diseases ,  35 , p.100428. Cardiovascular disease prevalence was highest in the DM group, followed by the TB-DM group. Anaemia was more prevalent in the TB-DM group. Smoking and alcohol use were most common in the TB group, followed by the TB-DM group. See also: TB and kidney function impairment In the TB-DM group, HbA1c levels indicated poor diabetic control (10.47%), higher than in the DM group (8.17%). FBS was also above normal in the TB-DM group, followed by the DM group. Although there were no significant differences in nutritional parameters like albumin, globulin, and total proteins, vitamin B12 levels were highest in the TB-DM group. Notably, 95.83% of patients in the TB-DM group had HbA1c > 6.5, with similarly high FBS and RB
Read more

Impact of diabetes on tuberculosis and MDRTB susceptibility

There is a significant association between diabetes mellitus (DM) and multidrug-resistant tuberculosis (MDR-TB). TB patients without DM have a lower risk of developing MDR-TB compared to those with DM. Factors contributing to MDR-TB emergence in TB patients with DM include: Impaired immune function Altered microbial genomics Uncontrolled glucose levels, increasing susceptibility to MDR-TB Compromised phagocytic activity and reduced chemotactic response Increased oxidative species and microbe proliferation Altered drug disposition Higher likelihood of non-adherence to treatment TB patients with DM also experience higher treatment failure rates compared to those without DM. Most information on these associations is based on self-reported data or patient health records, which may introduce assessment errors Rehman Au, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, Shakeel S, Hayat K, Hussain R, Alhazmi GA, Alshomrani AO, Alalawi MI, Alghamdi S, Imam MT, Almarzoky Abuhussain SS, Khayya
Read more

Scientific advances and the end of tuberculosis

Reid, M., Agbassi, Y.J.P., Arinaminpathy, N., Bercasio, A., Bhargava, A., Bhargava, M., Bloom, A., Cattamanchi, A., Chaisson, R., Chin, D. and Churchyard, G., 2023. Scientific advances and the end of tuberculosis: a report from the Lancet Commission on Tuberculosis.  The Lancet ,  402 (10411), pp.1473-1498. Progress toward ending tuberculosis varies greatly across countries, with some achieving substantial improvements and others making minimal progress. Key challenges include frail health systems, underinvestment, and reliance on one-size-fits-all approaches. Insufficient case finding and diagnosis remain the most significant issues in high-burden countries, where only 38% of all tuberculosis cases were tested with WHO-recommended rapid molecular diagnostics in 2021. Two-thirds of tuberculosis deaths occurred in just eight countries, with over half of these in India, Indonesia, and Nigeria. Despite these challenges, some sub-Saharan African countries have seen improvements in tubercul
Read more