TB in Taiwan, Kazakhstan, Madagascar, etc.

1. Smoking and TB Risk

• Recent smoking cessation among pulmonary TB patients significantly reduced TB infection risk in child household contacts compared to continued smoking.
• Highlights the effectiveness of smoking cessation as a TB control measure within households.

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2. Alcohol Use and TB Risk in T2DM

• Heavy alcohol consumption (≥20g/day) significantly increased TB risk (aHR 1.21).
• Mild-to-moderate alcohol use (especially <5g/day) was linked to lower TB risk (aHR 0.85), particularly in:
• Among current smokers, even mild alcohol use increased TB risk (aHR 1.08); risk was highest with combined heavy drinking and smoking (aHR 1.36).
• Suggests a complex interaction between alcohol, smoking, and TB risk in T2DM.

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3. TB Risk from Medications

• Use of proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) was associated with increased TB risk, particularly soon after starting therapy.
• Combination of PPI and H2RA posed higher risk than H2RA alone.
• TB cases often occurred at low doses and early in therapy, indicating possible non-gastric-acid-related mechanisms.

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4. TB Incidence Trends in Kazakhstan (2000–2023)

• TB cases declined 80% nationally (from 22,700 to 6,800 cases).
• Urban TB incidence: 166.3 → 33.9 per 100,000; rural: 136.7 → 36.0.
• Regions with highest 2000 incidence (e.g., Kyzylorda, Mangystau) showed the greatest declines, but some recent increases noted in Kyzylorda and North Kazakhstan.
• Highlights progress with disparities and need for reinforced control measures in select areas.

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5. TB Treatment Duration and Host Factors (Taiwan Study)

• 28.7% of patients underwent extended treatment (>270 days).
• Host-related factors significantly associated with longer treatment:
• Main reasons for extended therapy:
• Adverse drug events (esp. from pyrazinamide) often led to treatment interruption and extension.

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6. Nutritional Support for TB Patients (Madagascar Study)

• Majority of TB patients were undernourished, especially adults (81.3%) and children under 5 (55.4%).
• Nutritional support included monthly rations but had limited impact:
• Indicates current nutritional interventions are insufficient, particularly for young children.
• Calls for more comprehensive nutrition programs for TB-affected populations.

See also: Yoseph Leonardo Samodra

References:

1. Chu, A.L., Lecca, L.W., Calderón, R.I., Contreras, C.C., Yataco, R.M., Zhang, Z., Becerra, M.C., Murray, M.B. and Huang, C.C., 2021. Smoking cessation in tuberculosis patients and the risk of tuberculosis infection in child household contacts. Clinical Infectious Diseases, 73(8), pp.1500-1506.
2. Chung, C., Lee, K.N., Han, K., Park, J., Shin, D.W. and Lee, S.W., 2024. Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes: a nationwide retrospective cohort study. Respiratory Research, 25(1), p.420.
3. Hong, K.J., Wang, T.C. and Tsui, K., 2025. Association of acid-suppressive therapy and tuberculosis: A causal or coincidental link to the infection?. Respiratory Investigation, 63(1), pp.27-32.
4. Kulmirzayeva, D., Prabakaran, I. and Javaid, M., 2025. Retrospective analysis of tuberculosis incidence in Kazakhstan for 2000-2023. Journal of Health Development, 60(1), pp.17-23.
5. Liu, C.Y., Chen, R.T., Shu, C.C. and Lin, S.Y., 2025. Prevalence, clinical reasons and associated factors of extended treatment duration for drug susceptible tuberculosis–a real-world experience. Scientific Reports, 15(1), pp.1-8.
6. Franke, M.A., Emmrich, J.V., Ranjaharinony, F., Ravololohanitra, O.G., Andriamasy, H.E., Knauss, S. and Muller, N., 2024. A cross-sectional analysis of the effectiveness of a nutritional support programme for people with tuberculosis in Southern Madagascar using secondary data from a non-governmental organisation. Infectious Diseases of Poverty, 13(1), p.13.

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