Tb and smoking pdf

Download references. We would like to thank the director general of Health Malaysia for his permission to publish this study. The researchers are grateful to all the paramedic staff who helped them out with data collection in the centers. You can also search for this author in PubMed Google Scholar. AHK: collected, analyzed, and interpreted the data. LCM: Revised the manuscript critically after analysis. MOU: Revised the manuscript critically after analysis and English editing.

All the authors have read and approved the final manuscript. Correspondence to Amer Hayat Khan. Due to the study nature, patient consent was not applicable. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.

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Reprints and Permissions. Khan, A. Effect of smoking on treatment outcome among tuberculosis patients in Malaysia; a multicenter study. BMC Public Health 20, Download citation. Received : 21 July Accepted : 05 May Published : 04 June Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Smoking plays a key role in the development of tuberculosis TB infection and is also a predictor of poor TB treatment prognosis and outcomes. Methods A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor.

Results Of all patients with TB , the prevalence of smokers was Methods Study design and location A multicenter retrospective study was conducted among the TB patients in four states of Malaysia Sabah, Sarawak, Selangor, and Penang — two representative states from west Malaysia and two from peninsular Malaysia — selected based on the highest burden of TB patients [ 14 ].

Data collection A purpose-developed pre-validated data collection form was used to collect demographic and clinical data. Table 1 Sociodemographic distribution of TB patients according to smoking habit Full size table. Table 2 Distribution of TB patients according to smoking habit based on multivariate analysis Full size table. Table 4 Unsuccessful treatment outcomes among smokers and non-smokers patients groups with Binary logistic regression Full size table.

Conclusion In conclusion, smoking is a risk factor for the occurrence of tuberculosis. References 1. Google Scholar 2. Article Google Scholar 3. Google Scholar 5. Google Scholar 6. Article Google Scholar 7. PubMed Google Scholar 8. Article Google Scholar 9. Article Google Scholar Google Scholar CAS Google Scholar PubMed Google Scholar Google Scholar Download references. Please cite this paper as:. Association Between Tuberculosis and Smoking. DOI: R Alavi-Naini carried out the design, coordinated the study and prepared the manuscript.

B Sharifi-Mood provided assistance in the design of the study and statistical analysis. Maliheh Metanat edited the manuscript.

All authors have read and approved the content of the manuscript. Financial Disclosure:. This study was a part of a research project that was financially supported by the Research Council of Zahedan University. National Center for Biotechnology Information , U. Published online Jul Author information Article notes Copyright and License information Disclaimer.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. Abstract Background The association between smoking and tuberculosis TB , which has been proven in multiple studies with different study population ethnicity, has not yet received sufficient attention in terms of TB control.

Objectives The aim of the present study was to determine the association between TB and cigarette smoking in southeastern Iran, an endemic area for tuberculosis.

Conclusions The present study evidenced the association between TB and smoking. Keywords: Tuberculosis, Smoking. Background Tuberculosis TB is one of the leading causes of death worldwide and remains a major public health burden in many developing countries.

Patients and Methods This prospective case-control study was conducted at a university-affiliated hospital Boo-Ali Hospital, Zahedan, and southeastern Iran from March to March Results Among the TB patients, Table 1. General Characteristics of Tuberculosis Patients and Controls a. TB b Patients, No. Open in a separate window. Table 2. Discussion As mentioned previously, smoking is a well-recognized major risk factor for the development of lung cancer, chronic obstructive pulmonary disease and other respiratory infections, especially TB Acknowledgments We want to express our thanks to the Deputy of Research of the Zahedan University of Medical Sciences, for financial support.

Financial Disclosure: None declared. References 1. Cigarette smoking as a risk factor for tuberculosis in young adults: a case-control study. Tuberc Lung Dis ; 77 : —6. Passive smoking and risk of tuberculosis in children immediately following infection. A case-control study. Tuberc Lung Dis ; 77 : — Alveolar macrophages from humans and rodents selectively inhibit T-cell proliferation but permit T-cell activation and cytokine secretion.

Immunology ; 84 : —7. HIV-1 infection does not impair human alveolar macrophage phagocytic function unless combined with cigarette smoking. Chest ; : —6. Acute cigarette smoke exposure induces apoptosis of alveolar macrophages. Infection by Mycobacterium tuberculosis promotes human alveolar macrophage apoptosis.

Infect Immun ; 65 : — Human alveolar macrophages: comparison of phagocytic ability, glucose utilization and ultrastructure in smokers and non-smokers. J Clin Invest ; 69 : — Cigarette smoke triggers macrophage adhesion and activation of lipid peroxidation products and scavenger receptor. Free Radic Biol Med ; 35 : — Nouri-Shirazi M , Guinet E. Evidence for the immunosuppressive role of nicotine on human dendritic cell functions. Immunology ; : — Lung ; : — Chronic smoke exposure alters the phenotype pattern and the metabolic response in human alveolar macrophages.

Clin Exp Immunol ; : — Bermudez LE , Goodman J. Mycobacterium tuberculosis invades and replicates within type II alveolar cells. Infect Immun ; 64 : —6. Activation of bronchial epithelial cells in smokers without airways obstruction and patients with COPD. Chest ; : — Interleukin levels in induced sputum are reduced in asthmatic and normal smokers. Clin Exp Allergy ; 34 : — Effects of nicotine on the immune response. Chronic exposure to nicotine impairs antigen-receptor-mediated signal transduction in lymphocytes.

Funding: The authors received no specific funding for this work. Introduction Tobacco is responsible for one in 10 deaths around the world [ 1 ] and the prevalence of smoking tobacco is declining slowly, especially in low- and middle-income countries [ 2 ]. Materials and methods Inclusion and exclusion We defined inclusion criteria for articles to include in our search as including clinical trials, quasi-experimental, cohort, case-control and cross-sectional studies, that measured the effect of smoking on tuberculosis treatment outcomes.

We considered studies for the analysis when they measured TB treatment outcomes according to the WHO definitions [ 19 ] below: Died. In this specific review; Participants in the studies were tuberculosis patients who were receiving anti-TB treatment The intervention was smoking cessation or no history of smoking by the participant The controls are tuberculosis patients who are smokers or have exposure to second-hand smoke Outcomes included any of the tuberculosis treatment outcomes defined above First, we searched PubMed, the Cochrane library and google scholar databases using free-text and Medical Subject-Heading MeSH terms for tuberculosis, treatment outcome and smoking without restrictions as to study period.

Screening of studies We eliminated duplicate records using EndNote software. Data extraction A. Methodological quality assessment We assessed the quality of non-randomized studies using the Newcastle Ottawa Quality Assessment Scale [ 20 ].

Data analysis We executed most of the statistical analyses using the meta package add-on in Stata software version Download: PPT. Fig 1. Flow chart for selecting studies for the systematic review and meta-analysis.

Risk of bias assessment The overall scores for the risk of bias assessment of observational studies according to the Newcastle-Ottawa scale were 7 and greater except for two cross-sectional studies; one conducted in Iran [ 26 ] and the other in Fiji [ 27 ] that scored 4 and 5, respectively.

Characteristics of the included studies We pinpointed twenty-two studies eligible for the qualitative synthesis. Table 1. Characteristics of studies included in the review and values of their effect measures with corresponding p-values. Association of smoking with TB treatment outcomes Sample sizes of the studies included the meta-analysis ranged from 86 [ 29 ] to 21, in the largest study [ 37 ]. Fig 2. A forest plot displaying the effect of smoking on TB treatment outcomes. Sensitivity analysis We performed a sensitivity analysis to investigate the influence of each individual study on the overall summary odds ratio by omitting each study turn by turn and re-estimating the summary odds ratio.

Fig 3. Influential analysis for studies included in the meta-analysis. Fig 4. Subgroup meta-analysis for the effect of smoking on TB treatment outcomes by income economies.

Fig 5. Sub-group analysis for the effect of smoking on TB treatment outcomes according to study timing. Fig 6. Sub-group analysis according to the proportion of study participants living with HIV. Publication bias According to the funnel plot shown in Fig 7 , the studies appear visually to be distributed symmetrically about the mean effect size represented by the solid vertical line. Fig 7. Funnel plot of the studies of the effect of smoking on TB treatment outcomes.

Fig 8. Contour enhanced funnel plot of studies of effect of smoking on TB treatment outcomes. Table 2. Cumulative meta-analysis In order to restrict the analysis to larger studies only, we sorted the 20 studies from most precise to least precise which roughly correspond to sorting from largest to smallest sample size. Fig 9. Cumulative meta-analysis of the effect of smoking on TB treatment outcomes. Discussion This systematic review and meta-analysis aimed to evaluate the association between smoking and TB treatment outcomes.

Limitations This review has relied entirely on searching free electronic study databases. Conclusion Smoking is significantly linked with poor tuberculosis treatment outcomes, particularly in lower-middle-income and upper-middle-income countries as compared to high-income countries though the difference was not statistically significant. Supporting information. S1 Annex. Summary of output from databases searches for a systematic review and meta-analysis on the effect of smoking on TB treatment outcomes.

S2 Annex. Data-extraction sheet for a systematic review and meta-analysis on the effect of smoking on TB treatment outcomes.

S1 Table. Risk of bias assessment of the included studies using the Newcastle-Ottawa quality assessment scale. S2 Table. Meta-regression of the study timing and income category on the effect of smoking on tuberculosis treatment outcomes. S3 Table. S1 Text. Acknowledgments The authors would like to thank all the authors of articles included in this review. References 1. World Health Organization.

WHO report on the global tobacco epidemic, monitoring tobacco use and prevention policies: World Health Organization; Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from countries.

The Lancet , — View Article Google Scholar 4. Impacts of cigarette smoking on immune responsiveness: Up and down or upside down?

Oncotarget , 8 1 Smoking and tuberculosis an association overlooked. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease , 6 11 — View Article Google Scholar 6.

Effects of cigarette smoking on the immune system. Follow-up studies in normal subjects after cessation of smoking. The Medical journal of Australia , 2 9 — Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med , 20 — High prevalence of smoking among patients with suspected tuberculosis in South Africa. The European respiratory journal , 38 1 — Tobacco smoking and tuberculosis treatment outcomes: a prospective cohort study in Georgia.

Bulletin of the World Health Organization , 93 6 — Tanaffos , 10 2 — Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Archives of internal medicine , 4 — Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies. PLoS Med , 12 6 :e; discussion e