Modeling social, environmental and biological determinants of TB

Murray, M., Oxlade, O. and Lin, H.H., 2011. Modeling social, environmental and biological determinants of tuberculosis. The International Journal of Tuberculosis and Lung Disease, 15(6), pp.S64-S70. [TB0040]

  • Mathematical models have improved understanding of infectious disease dynamics and are useful for comparing control scenarios when interventional studies are not feasible or ethical.
  • HIV has significantly impacted TB incidence rates over the past decades. Among HIV-infected individuals, low CD4 counts and high viral loads increase TB risk, while highly active antiretroviral therapy reduces it.
  • Tobacco-associated illness and premature death create major economic burdens in low- and middle-income countries (LMICs). Higher rates of TB infection, disease, and mortality are observed among smokers.
  • There is a potential increased risk of TB among solid-fuel users.
  • Patients with diabetes mellitus (DM) are more than three times more likely to have TB than controls.
  • TB disease rates are about three times higher, and pulmonary TB is four times more frequent, in heavy drinkers compared to controls.
  • TB incidence increases exponentially as body mass index (BMI) decreases.
  • Lifelong urban residents are 1.5 times more likely to test positive for TB than lifelong rural residents.
  • Migrants from high TB burden countries are at increased risk of TB after arriving in low-burden countries, especially within the first year.
  • Aging populations may have increased TB risk due to cumulative exposure and progression risk. Elderly institutionalization can lead to nosocomial TB, with high rates in settings like nursing homes.
  • TB infection is diagnosed by measuring the host’s immune response via tuberculin skin test (TST) or interferon-gamma release assays. Risk factors for TB can reduce immune response, leading to false-negative tests.
  • Removing a TB determinant prevents both primary and secondary cases, reducing overall disease burden. Failing to account for the indirect effect of risk factor reduction on secondary cases underestimates the attributable risk and potential intervention impact.

    •  

    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