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Dana NINDREAR, Rika SUSANTI, M INDIKAP, Alexander MAISAB, Muthia SUKMA, Linda ROSALINA, Astri WIDYA, Zuhrah TAUFIQA, Rahman AGUSTIAND, Rahmi FITHRIA, Nomira PUTRI, Setia NINGSIHDAW, Arif LUBISBL, Ainil MARDIAH, Octarini EZEDDINM, Nova LINDA, Tamia MARISAY, Sri RAHMIA, Permata SARIA, Mimin OKTAVIANA, Puspa HUMANIF, Fariz AMSALM. MODIFIABLE AND NON-MODIFIABLE RISK FACTORS FOR TUBERCULOSIS AMONG ADULTS IN INDONESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS. Afr J Infect Dis 2024; 18:19-28. [PMID: 38606192 PMCID: PMC11004781 DOI: 10.21010/ajidv18i2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 04/13/2024] Open
Abstract
Background Controlling tuberculosis (TB) determinant factors in Indonesia is one way to control TB in the community. A review is needed to explore risk factors for TB in Indonesia as the key strategies for accelerating the TB preventive program.The purpose of this review was to determine modifiable and non-modifiable risk factors for TB among adults in Indonesia. Materials and Methods A meta-analysis was undertaken to review current studies related to modifiable and non-modifiable risk factors for TB among adults in Indonesia. A search of PubMed, ProQuest, and Google Scholar for related articles published (January 2000 until December 2023). The Pooled Odds Ratio (POR) from the acquired data were calculated with a 95% CI. The fixed and random effects analysis was performed. The results were presented as forest plots, and Begg's test and Egger's test were used to examine study bias. Review Manager (RevMan) 5.4 and Stata 14.2 were used to process and analyze all of the data. Results This study results revealed the POR of non-modifiable risk factor (family history of TB) for TB among adults in Indonesia was 6.08 (95% CI 2.99-12.34). Based on modifiable risk factors, it is known that household contact have the highest POR (6.01, 2.57-14.04), followed by malnutrition (5.86, 2.50-13.69), inappropriate ventilation (5.57, 1.74-17.86), diabetes mellitus (4.92, 3.04-7.96), smoking behavior (3.24, 2.22-4.72), and low-income level (2.34, 1.42-3.87). Conclusion Based on significant factors that are related to TB incidence, the results of this review may be valuable to the government in identifying the optimal strategy for TB prevention among adults.
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Affiliation(s)
- NINDREA Ricvan Dana
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - SUSANTI Rika
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
- Department of Forensic and Medicolegal, Faculty of Medicine, Universitas Andalas, Padang, Indonesia, 25127
| | - INDIKA Pudia M
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - MAISA Benny Alexander
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - SUKMA Muthia
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - ROSALINA Linda
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - WIDYA Astri
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - TAUFIQA Zuhrah
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - AGUSTIAN Dede Rahman
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - FITHRIA Rahmi
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - PUTRI Nomira
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | | | | | - MARDIAH Ainil
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - EZEDDIN Maudy Octarini
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - LINDA Nova
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - MARISA Yosa Tamia
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - RAHMI Afriyeni Sri
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - SARI Anggun Permata
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - OKTAVIANA Mimin
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - HUMANI Flori Puspa
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
| | - AMSAL Mochammad Fariz
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, 26181, Indonesia
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Wang BY, Song K, Wang HT, Wang SS, Wang WJ, Li ZW, Du WY, Xue FZ, Zhao L, Cao WC. Comorbidity increases the risk of pulmonary tuberculosis: a nested case-control study using multi-source big data. BMC Pulm Med 2024; 24:29. [PMID: 38212743 PMCID: PMC10782630 DOI: 10.1186/s12890-023-02817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Some medical conditions may increase the risk of developing pulmonary tuberculosis (PTB); however, no systematic study on PTB-associated comorbidities and comorbidity clusters has been undertaken. METHODS A nested case-control study was conducted from 2013 to 2017 using multi-source big data. We defined cases as patients with incident PTB, and we matched each case with four event-free controls using propensity score matching (PSM). Comorbidities diagnosed prior to PTB were defined with the International Classification of Diseases-10 (ICD-10). The longitudinal relationships between multimorbidity burden and PTB were analyzed using a generalized estimating equation. The associations between PTB and 30 comorbidities were examined using conditional logistic regression, and the comorbidity clusters were identified using network analysis. RESULTS A total of 4265 cases and 17,060 controls were enrolled during the study period. A total of 849 (19.91%) cases and 1141 (6.69%) controls were multimorbid before the index date. Having 1, 2, and ≥ 3 comorbidities was associated with an increased risk of PTB (aOR 2.85-5.16). Fourteen out of thirty comorbidities were significantly associated with PTB (aOR 1.28-7.27), and the associations differed by sex and age. Network analysis identified three major clusters, mainly in the respiratory, circulatory, and endocrine/metabolic systems, in PTB cases. CONCLUSIONS Certain comorbidities involving multiple systems may significantly increase the risk of PTB. Enhanced awareness and surveillance of comorbidity are warranted to ensure early prevention and timely control of PTB.
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Affiliation(s)
- Bao-Yu Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Ke Song
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Hai-Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Shan-Shan Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Wen-Jing Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Zhen-Wei Li
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Wan-Yu Du
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Fu-Zhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 250012, Jinan, China
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250002, China
| | - Lin Zhao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
| | - Wu-Chun Cao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dongda Street, Fengtai District, Beijing, 100071, China.
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Gupta P, Singh P, Das A, Kumar R. Determinants of tuberculosis: an example of high tuberculosis burden in the Saharia tribe. Front Public Health 2023; 11:1226980. [PMID: 37920577 PMCID: PMC10619692 DOI: 10.3389/fpubh.2023.1226980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023] Open
Abstract
Tuberculosis (TB) is a significant public health problem among the Saharia community, an underprivileged tribal group in the west-central part of India. There are several challenges for India's TB control program to curtail TB in the Saharia tribe. Malnutrition, poor health sector facilities, lower socio-economic status, and substance abuse are interconnected and synergistic factors contributing to a high burden of TB in the Saharia tribe. In this review, efforts are made to collate the findings of previous studies discussing the causes of high burden of TB in the Saharia tribe, social gaps for mitigating these preventable risk factors of TB in the Saharia tribe, and the plausible solutions for closing these gaps. The concept of Health in All Policies and intersectoral co-ordination is needed for the reduction of TB in the Saharia tribe and to make India TB-free by the year 2025.
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Affiliation(s)
| | | | | | - Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
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Hazarika CR, Babu BV. Prevalence of diabetes mellitus in Indian tribal population: a systematic review and meta-analysis. ETHNICITY & HEALTH 2023; 28:544-561. [PMID: 35469488 DOI: 10.1080/13557858.2022.2067836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Diabetes mellitus (DM), a significant public health problem across the nations, is among the top ten leading causes of death. More than 370 million indigenous people (referred to as tribal people in India) are spread across 90 countries. India has the largest tribal people of 104 million. Tribal populations are not exceptional to the threat of type 2 DM (T2DM) and other non-communicable diseases, and hence, public health programmes are addressing this problem. This paper reports the systematic review and meta-analysis of the literature on the prevalence of T2DM. METHODS We conducted a systematic review and meta-analysis of the literature to understand the prevalence of T2DM among the tribal populations of India, following the guidelines of the PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis. The gender-wise prevalence was recalculated by extracting the data wherever possible. Forest plots were depicted based on the prevalence, and other analyses were performed. RESULTS On initial searches from three databases, 5422 citations were identified, and ultimately 27 studies were included in the review. These studies were undertaken amongst different tribes in different parts of India. The pooled prevalence of T2DM among men, women and combined were 6.04% (95% confidence interval (CI): 5.55% to 6.57%), 6.48% (95% CI: 6.01% to 6.99%) and 4.94% (95% CI: 4.72% to 5.17%), respectively. Considerable heterogeneity was found among these studies. CONCLUSION This systematic review provides an overview of the prevalence of T2DM among the Indian tribal population. The pooled overall prevalence is slightly lower than the general population. This situation is worrisome as the epidemic of T2DM will affect the poor tribal communities, who can least afford to bear the health care costs. Hence, the public health care services must be strengthened in all tribal areas. This review further warrants establishing surveillance of T2DM in tribal areas.
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Affiliation(s)
- Chaya R Hazarika
- Socio-Behavioral & Health Systems Research Division, Indian Council of Medical Research, New Delhi, India
| | - Bontha V Babu
- Socio-Behavioral & Health Systems Research Division, Indian Council of Medical Research, New Delhi, India
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Nair SB, Krishnan AKI, Thomas B. Knowledge about tuberculosis among tribal population in Kerala in the backdrop of TB elimination goal by 2025. Indian J Tuberc 2023; 70:77-86. [PMID: 36740322 DOI: 10.1016/j.ijtb.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 03/09/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Kerala is one among the States in India with least prevalence of tuberculosis and is reportedly aiming to be the first State to reach the target of 'Zero TB' by 2025. But knowledge about TB among the vulnerable groups plays a critical role in controlling the spread and achieving the target of eliminating TB. MATERIALS AND METHODS Drawing on a collaborative research program in India to estimate the burden of TB among tribal population, the level of knowledge and its possible links between life style of tribals, their customs and practices is examined Multi stage cluster sampling technique was adopted and 3 wards were selected in three districts in Kerala: Wayanad, Idukki and Palakkad which encompasses major share of the tribal population by probability proportional to size sampling method to draw a sample of 2600 individuals. RESULTS Awareness about TB among Tribal population in Kerala is impressive. However, in-depth knowledge on how TB is caused and spread, the symptoms, place of treatment and the cost are not so appreciable. Misconceptions and also lack of knowledge still prevail on who is prone to TB, how TB is spread and the causative agent. The IEC activities have had its effect in sensitizing the tribal population on how to identify the symptoms of TB. The average knowledge score was 5.06 points (72.2 percent, SD: 1.81) out of a total possible score of 7 points. The individual mean knowledge score is 0.65 overall considering all the knowledge domains where the maximum value is 1 and minimum is 0. The mean knowledge score among the Malayarayan Christians and Hindus is relatively higher but poor among Kattunayaka and Irular tribes. Mean knowledge score decreases significantly with increasing age. Gender differential in mean knowledge score is absent but greater educational attainment is associated with higher knowledge scores. However knowledge is not translated to practice of all preventive aspects of TB. CONCLUSION Knowledge deficit poses challenges in the efforts to eliminate TB in Kerala because the State is progressing towards zero TB target. Hence spreading awareness on these vital aspects need better focus among the tribal population.
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Affiliation(s)
- Sajini B Nair
- Social Scientist, Population Research Centre Kerala, Ministry of Health and Family Welfare, Government of India, University of Kerala, Kariavattom, Thiruvananthapuram, Kerala, India.
| | | | - Beena Thomas
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
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Shrivastava S, Kumar R, Khan S, Kavishwar A, Gupta A, Kaur H, Das M, Sharma R, Chakma T. Health profile of people living in the Gare Palma mining area of Tamnar block, Raigarh, Chhattisgarh, India. Front Public Health 2023; 11:1010025. [PMID: 37026149 PMCID: PMC10072258 DOI: 10.3389/fpubh.2023.1010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/24/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction A community-based health survey was conducted in Tamnar block, Raigarh district of Chhattisgarh, India. Methodology A total of 909 individuals (adults) were selected from 909 households from 33 sampled villages from March 2019 to February 2020. All individuals were clinically examined, and observations were recorded. Results Among adults older than 18 years, hypertension was observed in 21.7%. Type II diabetes was observed in only 4.0% of individuals. Tuberculosis was seen in 23 (2.5%) individuals. Discussion Common morbidities were similar in tribal and non-tribal communities living in the same area. For communicable diseases, being male, having nutritional deficiencies, and smoking were independent risk factors. For non-communicable diseases, the independent significant risk factors identified were being male, an altered body mass index, disturbed sleep, smoking, and nutritional deficiencies.
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Affiliation(s)
| | - Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Sirin Khan
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Arvind Kavishwar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Ashok Gupta
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Harpreet Kaur
- Indian Council of Medical Research, New Delhi, India
| | | | - Ravendra Sharma
- Indian Council of Medical Research National Institute of Medical Statistics (NIMS), New Delhi, India
| | - Tapas Chakma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
- *Correspondence: Tapas Chakma
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Ma L, Chen X, Gao M. Analysis on the Risk Factors of Malnutrition in Type 2 Diabetes Mellitus Patients with Pulmonary Tuberculosis. Infect Drug Resist 2022; 15:7555-7564. [PMID: 36575673 PMCID: PMC9790157 DOI: 10.2147/idr.s381392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/10/2022] [Indexed: 12/29/2022] Open
Abstract
Objective To explore the risk factors of malnutrition in type 2 diabetes mellitus combined with pulmonary tuberculosis (PTB-T2DM) patients and further to provide a clinical research basis for the identification and prevention of malnutrition. Methods From January 2020 to February 2022, 307 adult patients diagnosed with PTB-T2DM were enrolled in this retrospective study. According to whether malnutrition occurred after 6 months of treatment, patients were divided into malnutrition group (n = 123) and non-malnutrition group (n = 184). The nutritional status of patients was evaluated according to the Micro-Nutrition Assessment Scale (MNA). Evaluation of indicators was performed, including general information, disease characteristics of PTB-T2DM and laboratory indicators. Results Univariate logistic regression analysis showed that drinking, divorced, BMI <18.5kg/m2, weight <45kg, waist circumference <79cm, hip circumference <88cm, waist-to-hip ratio <69.99, calf circumference <26kg, grip strength <28kg, NRS score ≥3, Hb <106g/L, Alb <29.00g/L, PA <48.00μmol/L, GHB <3.40%, serum transferrin <1.37 mmol/L, serum potassium <3.18mmol/L, serum sodium <142.95 mmol/L, FEV1 ≥67.90% and RV <2.89% were risk factors for malnutrition in PTB-T2DM patients (all P < 0.05). The results of multivariate logistic regression analysis showed that drinking, divorced, weight <45kg, BMI <18.5kg/m2, NRS score ≥3, Hb <106g/L, Alb <29.00g/L, PA <48.00μmol/L, serum transferrin <1.37mmol/L, FEV1 ≥67.90% and RV <2.89% were independent risk factors for malnutrition in PTB-T2DM patients (all P < 0.05). Conclusion Drinking, divorced, weight <45kg, BMI <18.5kg/m2, NRS score ≥3, Hb <106g/L, Alb <29.00g/L, PA <48.00μmol/L, serum transferrin <1.37mmol/L, FEV1 ≥67.90% and RV <2.89% may be independent risk factors for malnutrition in PTB-T2DM patients, and timely identification of high-risk groups could improve the prognosis of PTB-T2DM patients.
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Affiliation(s)
- Liangliang Ma
- Department of Infectious Diseases, Beijing Geriatric Hospital, Beijing, 100095, People’s Republic of China,Correspondence: Liangliang Ma, Department of Infectious Diseases, Beijing Geriatric Hospital, No. 118 Wenquan Road, Haidian District, Beijing, 100095, People’s Republic of China, Tel +86-18610672953, Email
| | - Xuelin Chen
- Department of Infectious Diseases, Beijing Geriatric Hospital, Beijing, 100095, People’s Republic of China
| | - Maolong Gao
- Department of Science and Technology, Beijing Geriatric Hospital, Beijing, 100095, People’s Republic of China
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Chinnaiyan S, Palanisamy B, Ayyasamy L. Prevalence of diabetes mellitus in Indian tribal population: a systematic review and meta-analysis. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gilmour B, Alene KA, Clements A. The prevalence of tuberculosis and malaria in minority indigenous populations of South- East Asia and the Western Pacific Region: a systematic review and meta-analysis. Pathog Glob Health 2022; 116:201-219. [PMID: 34904538 PMCID: PMC9132423 DOI: 10.1080/20477724.2021.2011579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infectious diseases have been shown to disproportionately affect indigenous populations. Tuberculosis (TB) and malaria continue to impose a significant burden on humanity and are among the infectious diseases targeted within the 2030 Agenda for Sustainable Development. A systematic review and meta-analyses were undertaken to evaluate the prevalence of TB and malaria infections within minority indigenous populations of the South-East Asia and Western Pacific Regions. The review was undertaken in accordance with The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines following a published protocol. A random effects meta-analysis was used to calculate the pooled prevalence of TB and malaria. A meta-regression analysis was applied to quantify associations with study covariates and a sub-group analysis undertaken where studies provided comparative data between minority indigenous and other population groups. From the 3,275 unique publications identified, 24 on TB, and 39 on malaria were included in the final analysis. The pooled prevalence of TB was 2.3% (95% CI: 1.7, 2.9) and the pooled prevalence of malaria was 19.9% (95% CI: 15.9, 24.2). There was significant (p = 0.000) heterogeneity (I2) between studies. Significant difference was not observed in TB and malaria prevalence between minority indigenous and other population groups, although the odds ratio of malaria infection in minority indigenous populations was 1.15 (95% CI 0.99, 1.34: p-value 0.06) compared to other population groups. The review identified a paucity of data on TB and malaria in minority indigenous populations despite the significant prevalence and burden of these diseases within these regions.
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Affiliation(s)
- Beth Gilmour
- Faculty of Health Sciences, Curtin University, Western Australia, Australia
| | - Kefyalew Addis Alene
- Faculty of Health Sciences, Curtin University, Western Australia, Australia
- Geospatial Health & Development, Telethon Kids Institute, Nedlands, WA, Australia
| | - Archie Clements
- Faculty of Health Sciences, Curtin University, Western Australia, Australia
- Geospatial Health & Development, Telethon Kids Institute, Nedlands, WA, Australia
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Diriba K, Awulachew E. Associated risk factor of tuberculosis infection among adult patients in Gedeo Zone, Southern Ethiopia. SAGE Open Med 2022; 10:20503121221086725. [PMID: 35356810 PMCID: PMC8958711 DOI: 10.1177/20503121221086725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Tuberculosis remains a major global health problem causing death among millions of people each year. Even though many of the World Health Organization recommended tuberculosis control strategies were implemented, there is still a major gap in tuberculosis case detection and treatment which resulted in rapid transmission of the cases in high burden countries. This study aimed to provide updated information on the contributing factors for the development of tuberculosis. Methods: A case–control study was carried out in Gedeo Zone from February to July 2021 to assess the risk factors of tuberculosis. Cases were confirmed pulmonary tuberculosis patients with age ⩾18 years, while controls were participants who were confirmed to be pulmonary tuberculosis negative with the same age. Multivariate logistic regression models were used to assess the associated risk factor. Results: A total of 368 individuals (173 cases and 173 controls) were included in this study. Based on the multivariable logistic regression analysis, we identified six variables as independent risk factors for the development of tuberculosis after controlling possible confounders. Those were patients with income <1500 Ethiopian birr per month (adjusted odds ratio = 2.35; 95% confidence interval: 1.22–3.97), patients with no educational background (illiterate) (adjusted odds ratio = 2.10; 95% confidence interval: 1.17–2.51), patients smoking cigarette (adjusted odds ratio = 2.89; 95% confidence interval: 2.10–3.82), patients chewing khat (adjusted odds ratio = 2.86; 95% confidence interval: 1.28–3.79), patients in close contact with known tuberculosis cases (adjusted odds ratio = 3.63; 95% confidence interval: 2.24–4.46), and patients being positive for HIV (adjusted odds ratio = 3.01; 95% confidence interval: 1.07–3.52) who were found to be significantly associated with tuberculosis development, while Bacille Calmette-Guérin vaccination had a protective effect against the development of tuberculosis (adjusted odds ratio = 0.52; 95% confidence interval: 0.21–0.88). Conclusion: The priority should be given to the identified contributing factors through application of coordinated efforts on screening of patients suspected for pulmonary tuberculosis and all contacts of pulmonary tuberculosis patients and treatment of known tuberculosis cases, and appropriate control methods to reduce Mycobacterium tuberculosis cases.
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Affiliation(s)
- Kuma Diriba
- Department of Medical Laboratory Sciences, Health Science and Medical College, Dilla University, Dilla, Ethiopia
| | - Ephrem Awulachew
- Department of Medical Laboratory Sciences, Health Science and Medical College, Dilla University, Dilla, Ethiopia
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Diriba K, Churiso G. The prevalence of Mycobacterium tuberculosis using Gene Xpert among tuberculosis suspected patients in Gedeo Zone, Southern Ethiopia. Eur J Med Res 2022; 27:24. [PMID: 35151350 PMCID: PMC8840317 DOI: 10.1186/s40001-022-00650-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Tuberculosis (TB) is a communicable disease remains a major global health problem and the leading cause of death from a single infectious agent. Even though many of the WHO recommended TB control strategies were implemented; there is still a major gap in TB case detection and treatment. This study aimed to determine the prevalence of Mycobacterium tuberculosis among presumptive TB patients in Gedeo Zone, Southern Ethiopia. Methods A cross-sectional study was conducted on 384 TB suspected patients in Gedeo Zone from February to July 2021. Data were collected using a pretested structured questionnaire. Laboratory examination was processed using Xpert-MTB/RIF assay. Data entry was made using Epi info version 7 and analyzed by SPSS version 24. Logistic regression models were used to determine the risk factors. Results Out of 384 study participants suspected with TB, M. tuberculosis was isolated from 103 giving an overall prevalence of 26.8%. Males (AOR) = 1.95; 95% CI 1.56–2.65, P = 0.01) were more likely to develop TB than females. Study participants who were illiterate (AOR 2.10; 95% CI 1.17–2.51, P = 0.014) were more likely to develop TB than the educated ones. Cigarette smokers (AOR 2.89; 95% CI 2.10–3.84, P = 0.01), khat chewers (AOR 2.86; 95% CI 1.28–3.79, P = 0.01), vaccination (AOR 0.52; 95% CI 0.21–0.88, P = 0.02), close contact (AOR 3.42; 95% CI 2.24–4.50, P = 0.01) and being positive for HIV (AOR 2.01; 95% CI 1.07–3.52, 0.01) were more likely to develop TB. Conclusion Despite implementation of national and international TB control strategies, TB still remains one of the major public health problems in the country especially in the study area. The high prevalence of MTB was reported different risk groups. Early case detection and management of TB should be given special attention to strengthen and an appropriate control and prevention methods to reduce the emergence and increasing of MTB cases.
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Ter Beek L, Bolhuis MS, Jager-Wittenaar H, Brijan RXD, Sturkenboom MGG, Kerstjens HAM, de Lange WCM, Tiberi S, van der Werf TS, Alffenaar JWC, Akkerman OW. Malnutrition assessment methods in adult patients with tuberculosis: a systematic review. BMJ Open 2021; 11:e049777. [PMID: 35344503 PMCID: PMC8719177 DOI: 10.1136/bmjopen-2021-049777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/19/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Malnutrition is associated with a twofold higher risk of dying in patients with tuberculosis (TB) and considered an important potentially reversible risk factor for failure of TB treatment. The construct of malnutrition has three domains: intake or uptake of nutrition; body composition and physical and cognitive function. The objectives of this systematic review are to identify malnutrition assessment methods, and to quantify how malnutrition assessment methods capture the international consensus definition for malnutrition, in patients with TB. DESIGN Different assessment methods were identified. We determined the extent of capturing of the three domains of malnutrition, that is, intake or uptake of nutrition, body composition and physical and cognitive function. RESULTS Seventeen malnutrition assessment methods were identified in 69 included studies. In 53/69 (77%) of studies, body mass index was used as the only malnutrition assessment method. Three out of 69 studies (4%) used a method that captured all three domains of malnutrition. CONCLUSIONS Our study focused on published articles. Implementation of new criteria takes time, which may take longer than the period covered by this review. Most patients with TB are assessed for only one aspect of the conceptual definition of malnutrition. The use of international consensus criteria is recommended to establish uniform diagnostics and treatment of malnutrition. PROSPERO REGISTRATION NUMBER CRD42019122832.
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Affiliation(s)
- Lies Ter Beek
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathieu S Bolhuis
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - René X D Brijan
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marieke G G Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Huib A M Kerstjens
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wiel C M de Lange
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
| | - Simon Tiberi
- Department of Infection, Barts Health NHS Trust, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
| | - Tjip S van der Werf
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan-Willem C Alffenaar
- Faculty of Medicine and Health, University of Sydney, School of Pharmacy, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Onno W Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
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13
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Hamada Y, Fong CJ, Copas A, Hurst JR, Rangaka MX. Risk for development of active tuberculosis in patients with chronic airway disease-a systematic review of evidence. Trans R Soc Trop Med Hyg 2021; 116:390-398. [PMID: 34383072 PMCID: PMC9070518 DOI: 10.1093/trstmh/trab122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Reports suggest an increased risk of tuberculosis (TB) in people with chronic airway diseases (CADs) such as chronic obstructive pulmonary disease (COPD), but evidence has not been systematically reviewed. We performed a systematic review by searching MEDLINE and Embase for studies published from 1 January 1993 to 15 January 2021 reporting the association between the incident risk of TB in people with CADs (asthma, COPD and bronchiectasis). Two reviewers independently assessed the quality of individual studies. We included nine studies, with two from low-income high TB burden countries. Three cohort studies reported a statistically significant independent association between COPD and the risk of TB in high-income countries (n=711 389). Hazard ratios for incident TB ranged from 1.44 to 3.14 adjusted for multiple confounders including age, sex and comorbidity. There was large between-study heterogeneity (I2=97.0%) across studies. The direction of effect on the TB risk from asthma was inconsistent. Chronic bronchitis or bronchiectasis studies were limited. The small number of available studies demonstrated an increased risk of TB in people with COPD; however, the magnitude of the increase varies by setting and population. Data in high TB burden countries and for other CADs are limited.
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Affiliation(s)
- Yohhei Hamada
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | | | - Andrew Copas
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, NW3 2PF, UK
| | - Molebogeng X Rangaka
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.,University of Cape Town, 7701 Cape Town, South Africa
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14
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Nigam S, Sharma RK, Yadav R, Rao VG, Mishra P, Lingala MA, Bhat J. Experiences and needs of patients with MDR/XDR-TB: a qualitative study among Saharia tribe in Madhya Pradesh, Central India. BMJ Open 2021; 11:e044698. [PMID: 34385228 PMCID: PMC8362723 DOI: 10.1136/bmjopen-2020-044698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/27/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB) continues to be a major public health threat posing a critical challenge to TB treatment and control worldwide. The present study was conducted among patients with DR-TB of the Saharia tribe residing in Madhya Pradesh state of Central India to document their experiences and needs, and to identify gaps for treatment adherence as this population is known to be poor because of migration and other factors. METHODS We conducted 16 in-depth interviews on purposively selected patients with DR-TB among the Saharia tribe using a predesigned open-ended in-depth interview guide, which included questions on domains like general physical health, diagnosis, treatment adherence, side-effects of drugs and experience related to the health facility. Out of these interviews, various subthemes were extracted. The obtained qualitative data were subjected to thematic analysis. RESULTS The study helped to understand the experiences and needs of the patients with DR-TB in various stages from diagnosis to treatment. Also, there was the impact of factors like lack of education and awareness, poor living conditions and lack of healthcare facilities on predominance of the disease in the community. Poor access to a healthcare facility, high pill burden and related side-effects, longer duration of treatment, financial burden, misbeliefs and misconceptions were prominent issues posing a challenge to treatment adherence. The narratives pointed out their struggle at every stage be it with diagnosis, treatment initiation or treatment adherence. CONCLUSION It is paramount to address the needs and experiences of patients with DR-TB to develop a patient-centric and context-specific approach conducive to the sociocultural set-up of tribal people. This will scale down the attrition rate of tribal patients while adhering to the complete treatment process and reducing the high burden of TB among the Saharia community. In addition, tribal patients should be counselled at regular intervals to increase their confidence in the treatment.
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Affiliation(s)
- Samridhi Nigam
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Ravendra K Sharma
- ICMR- National Institute of Medical Statistics, New Delhi, Delhi, India
| | - Rajiv Yadav
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Vikas Gangadhar Rao
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Prashant Mishra
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Mercy Aparna Lingala
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Jyothi Bhat
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
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15
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Rao VG, Muniyandi M, Sharma RK, Yadav R, Bhat J. Long-term survival of patients treated for tuberculosis: a population-based longitudinal study in a resource-poor setting. Trop Med Int Health 2021; 26:1110-1116. [PMID: 34109699 DOI: 10.1111/tmi.13636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We assessed the long-term survival of TB patients belonging to the Saharia tribe, a high TB burden community in Shivpuri district, Madhya Pradesh, central India. METHODS Population-based, longitudinal study conducted among 9756 Saharia population in 2013, and a resurvey done 2 years later in 2015 using the same methods. The status of the individuals during resurvey was recorded as non-TB, relapse and death. The deaths recorded in this period were used to measure the mortality among TB-affected population and the non-TB population in this cohort. RESULTS The standardised mortality ratio for the study cohort was 122.9 per 1000 population; males had higher mortality than females (129.9 vs. 96.8). The expected mortality among the non-TB population was 30.2, and the observed mortality among TB-affected population was 122.9 per 1000 population. CONCLUSION In the Saharia tribe, post-treatment mortality in the TB-affected population is significantly higher than in the general population. This highlights an urgent need for implementation of effective public health strategies to prevent disproportionate deaths among TB-affected individuals in resource-poor settings, and the importance of periodic follow-up of patients after cure/completion of treatment, especially in vulnerable populations.
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Affiliation(s)
- V G Rao
- National Institute of Research in Tribal Health, Jabalpur, India
| | - M Muniyandi
- National Institute for Research in Tuberculosis, Chennai, India
| | - R K Sharma
- National Institute of Medical Statistics, New Delhi, India
| | - R Yadav
- National Institute of Research in Tribal Health, Jabalpur, India
| | - Jyothi Bhat
- National Institute of Research in Tribal Health, Jabalpur, India
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16
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Das A. Aiming for a tuberculosis-free India: Perspective of a highly endemic Particularly Vulnerable Tribal Group (PVTG). CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bhat J, Yadav R, Sharma RK, Muniyandi M, Rao VG. Tuberculosis elimination in India's Saharia group. LANCET GLOBAL HEALTH 2019; 7:e1618. [PMID: 31708142 DOI: 10.1016/s2214-109x(19)30418-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jyothi Bhat
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India.
| | - Rajiv Yadav
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
| | - Ravendra K Sharma
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
| | - Malaisamy Muniyandi
- ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India
| | - Vikas G Rao
- ICMR-National Institute of Research in Tribal Health, Nagpur Road, Jabalpur-482003, India
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18
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Yadav J, Verma S, Chaudhary D, Jaiwal PK, Jaiwal R. Tuberculosis: Current Status, Diagnosis, Treatment and Development of Novel Vaccines. Curr Pharm Biotechnol 2019; 20:446-458. [PMID: 31208308 DOI: 10.2174/1389201020666190430114121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 12/26/2022]
Abstract
Tuberculosis (TB) is an infectious disease that mainly affects the lungs and spreads to other organs of the body through the haematogenous route. It is one of the ten major causes of mortality worldwide. India has the highest incidence of new- and multidrug-resistant (MDR) - TB cases in the world. Bacille Calmette-Guerin (BCG) is the vaccine commonly available against TB. BCG does offer some protection against serious forms of TB in childhood but its protective effect wanes with age. Many new innovative strategies are being trailed for the development of effective and potent vaccines like mucosal- and epitope-based vaccines, which may replace BCG or boost BCG responses. The use of nanotechnology for diagnosis and treatment of TB is also in the pipeline along with many other vaccines, which are under clinical trials. Further, in-silico models were developed for finding new drug targets and designing drugs against Mycobacterium tuberculosis (Mtb). These models offer the benefit of computational experiments which are easy, inexpensive and give quick results. This review will focus on the available treatments and new approaches to develop potent vaccines for the treatment of TB.
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Affiliation(s)
- Jyoti Yadav
- Department of Zoology, M.D. University, Rohtak-124001, India
| | - Sonali Verma
- Department of Zoology, M.D. University, Rohtak-124001, India
| | | | - Pawan K Jaiwal
- Centre for Biotechnology, M.D. University, Rohtak-124001, India
| | - Ranjana Jaiwal
- Department of Zoology, M.D. University, Rohtak-124001, India
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19
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Sarvi F, Moghimbeigi A, Mahjub H, Nasehi M, Khodadost M. Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data. Epidemiol Health 2019; 41:e2019032. [PMID: 31319655 PMCID: PMC6713850 DOI: 10.4178/epih.e2019032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/09/2019] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran. METHODS This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages. RESULTS The risk of mortality from TB was found to increase with the unemployment rate (β^=0.02), illiteracy (β^=0.04), household density per residential unit (β^=1.29), distance between the center of the county and the provincial capital (β^=0.03), and urbanization (β^=0.81). The following other risk factors for TB mortality were identified: diabetes (β^=0.02), human immunodeficiency virus infection (β^=0.04), infection with TB in the most recent 2 years (β^=0.07), injection drug use (β^=0.07), long-term corticosteroid use (β^=0.09), malignant diseases (β^=0.09), chronic kidney disease (β^=0.32), gastrectomy (β^=0.50), chronic malnutrition (β^=0.38), and a body mass index more than 10% under the ideal weight (β^=0.01). However, silicosis had no effect. CONCLUSIONS The results of this study provide useful information on risk factors for mortality from TB.
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Affiliation(s)
- Fatemeh Sarvi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Moghimbeigi
- Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mahjub
- Research Center for Health Sciences, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahshid Nasehi
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodadost
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shimeles E, Enquselassie F, Aseffa A, Tilahun M, Mekonen A, Wondimagegn G, Hailu T. Risk factors for tuberculosis: A case-control study in Addis Ababa, Ethiopia. PLoS One 2019; 14:e0214235. [PMID: 30939169 PMCID: PMC6445425 DOI: 10.1371/journal.pone.0214235] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background Tuberculosis remains a major public-health problem in the world, despite several efforts to improve case identification and treatment compliance. It is well known cause of ill-health among millions of people each year and ranks as the second leading cause of death from infectious disease worldwide. Despite implementation of the World health organization recommended strategy, the reductions in the incidence of TB have been minimal in high burden countries. Objectives and methods A case control study was carried out to assess the risk factors of TB, where cases were newly registered bacteriologically confirmed pulmonary TB patients with age greater than 15 years who present at twenty health centres in Addis Ababa. Controls were age and sex matched attendees who presented in the same health centers for non-TB health problems. Results A total of 260 cases and 260 controls were enrolled in the study and 45.8% of cases and 46.2% of controls were in the 26–45 years age bracket. According to the multivariable logistic regression analysis, seven variables were found to be independent predictors for the occurrence of TB after controlling possible confounders. Patients who live in house with no window or one window were almost two times more likely to develop tuberculosis compared to people whose house has multiple windows (AOR = 1.81; 95% CI:1.06, 3.07). Previous history of hospital admission was found to pose risk almost more than three times (AOR = 3.39; 95% CI: 1.64–7.03). Having a household member who had TB was shown to increase risk of developing TB by three fold (AOR = 3.00; 95% CI: 1.60, 5.62). The study showed that illiterate TB patients were found to be more than twice more likely to develop TB compared to subjects who can atleast read and write (AOR, 95% CI = 2.15, 1.05, 4.40). Patients with household income of less than 1000 birrs per month were more than two times more likely to develop TB compared to those who had higher income (AOR = 2.2; 95% CI: 1.28, 3.78). Smoking has also been identified as important risk factor for developing TB by four times (AOR = 4.43; 95% CI: 2.10, 9.3). BCG was found to be protective against TB reducing the risk by one-third (AOR = 0.34; 95% CI: 0.22, 0.54). Conclusion This study showed that TB is more common among the most agile and economically active age group, and number of windows, history of hospital admission, a household member who had TB, illiteracy, low household income and smoking and lack of BCG scar were identified as independent risk factors. Therefore it is imperative that the TB control effort need a strategy to address socio economic issues such as poverty, overcrowding, smoking, and infection control at health care facilities level is an important intervention to prevent transmission of TB within the facilities.
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Affiliation(s)
- Ezra Shimeles
- Armauer Hanson Research Institute, ALERT Compound, Addis Ababa, Ethiopia
- School of Public health, College of Health Sciences, Addis Ababa University, Black Lion Hospital, Addis Ababa, Ethiopia
- * E-mail:
| | - Fikre Enquselassie
- School of Public health, College of Health Sciences, Addis Ababa University, Black Lion Hospital, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hanson Research Institute, ALERT Compound, Addis Ababa, Ethiopia
| | - Melaku Tilahun
- Armauer Hanson Research Institute, ALERT Compound, Addis Ababa, Ethiopia
| | - Alemayehu Mekonen
- Ethiopian Public Health Association, Kirkos Sub City, Addis Ababa, Ethiopia
| | | | - Tsegaye Hailu
- Armauer Hanson Research Institute, ALERT Compound, Addis Ababa, Ethiopia
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21
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Rao VG, Bhat J, Yadav R, Sharma RK, Muniyandi M. Declining tuberculosis prevalence in Saharia, a particularly vulnerable tribal community in Central India: evidences for action. BMC Infect Dis 2019; 19:180. [PMID: 30786860 PMCID: PMC6383441 DOI: 10.1186/s12879-019-3815-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background In spite of an alarmingly high tuberculosis (TB) burden amongst the Saharia tribe of central India, there is hardly any study to investigate the impact of DOTS implementation on the magnitude of tuberculosis disease and the changes over time. This article present the findings of TB prevalence surveys conducted amongst this indigenous population in two different time periods to know the change in the prevalence of TB. Methods A cross sectional survey was conducted among Saharia population in Shivpuri district, Madhya Pradesh during February 2013 to May 2013 and resurvey during March 2015 to July 2015. All individuals (≥15 years) were examined for chest symptoms suggestive of TB. Sputum samples were collected from all presumptive TB cases and were confirmed by laboratory examination by Ziehl-Neelsen smear microscopy and solid media culture methods. All detected cases were referred to health facility for anti-tuberculosis treatment as per RNTCP guidelines. Results There was significant reduction (trend Chi square 19.97; OR = 1.521; p = 0.000) in the prevalence of TB at the endline (1995 per 100,000) as compared to baseline (3003 per 100,000). The reduction was significant among males as compared to females (OR 1.55; p = 0.000) and in the age group of 25–34 years (OR 2.0; p = 0.007) and 45–54 years (OR 4.39; p = 0.003). There was significant reduction in the prevalence in both smear (OR 1.29; p = 0.02) and culture positive (OR 1.57; p = 0.000) TB at the endline survey. Conclusion The study findings highlight a reduction in the prevalence of TB among Saharia tribal population. Further studies are needed to identify the factors associated with reduction in prevalence among this population and also further surveys to monitor the prevalence trend over a period.
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Affiliation(s)
- V G Rao
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India.
| | - J Bhat
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R Yadav
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - R K Sharma
- ICMR -National Institute of Research in Tribal Health, (Indian Council of Medical Research), Nagpur Road, P.O. Garha, Jabalpur, 482 003, India
| | - M Muniyandi
- ICMR -National Institute for Research in Tuberculosis, (Indian Council of Medical Research), No. 1, Mayor Sathiyamoorthy Road, Chetpet, Chennai, 600031, India
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22
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Singh SK, Kashyap GC, Puri P. Potential effect of household environment on prevalence of tuberculosis in India: evidence from the recent round of a cross-sectional survey. BMC Pulm Med 2018; 18:66. [PMID: 29724218 PMCID: PMC5934826 DOI: 10.1186/s12890-018-0627-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/18/2018] [Indexed: 11/14/2022] Open
Abstract
Background Tuberculosis (TB) has been a major health problem globally since ages, and even today, it is a major cause of morbidity in millions of people each year. In 2015 alone, TB accounted for about 1.4 million deaths globally, with India carrying the biggest burden of the disease. The physical environment of the household, an individual living in, has a significant influence on the incidence of TB. Thus, an understanding of the socio-economic, demographic and environmental factors that individuals are exposed to is of importance. The objective of present study is to examine the association of household environment with the prevalence of Tuberculosis in India. Methods The study utilizes data from the fourth round of National Family Health Survey (NFHS-4), 2015-16, which was collected from self-reported information pertaining to Tuberculosis in the household questionnaire. The specific question was, “Does any usual resident of your household suffer from tuberculosis?” the response to which helped in the detection of Tuberculosis. Binary Logistic regression was performed from which appropriate inferences are drawn on the association of household environment with Tuberculosis. Results Prevalence of TB was found to be the highest among elderly people (0.9%), no education (0.4%) and people belonging to the poorest wealth quintile (0.53%). Family members who were regularly (daily) exposed to smoke (second-hand smoke) inside the house were more prone to getting tuberculosis (OR = 1.49; CI = 1.39-1.61) as compared with households where people do not smoke inside the house. Further, households having a finished wall (OR = 0.7; CI = 0.6-0.8) are less likely to get TB than the households with mud walls. Households that shared their toilets with other households are more likely to get hold of Tuberculosis (OR = 1.2; CI = 1.1-1.4). Conclusions Results strongly suggest that a contaminated household environment increases the risk of tuberculosis in India. There are multiple risk factors that are strongly associated with Tuberculosis: smoke inside house, type of cooking fuel, separate kitchen, floor, roofing and wall material, number of persons sleeping in a room, sharing toilet and potable water with other households; and individual characteristics such as age, sex, educational attainment, marital status, place of residence and wealth index. Electronic supplementary material The online version of this article (10.1186/s12890-018-0627-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S K Singh
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar Mumbai, 400088, India
| | - Gyan Chandra Kashyap
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar Mumbai, 400088, India.
| | - Parul Puri
- International Institute for Population Sciences, Govandi Station Road, Deonar Mumbai, 400088, India
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