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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Albadrani M. Exploring the Impact of Silicosis Incidence on Tuberculosis Mortality and Morbidity: A Multi-Country Study. Med Sci (Basel) 2023; 11:63. [PMID: 37873748 PMCID: PMC10594424 DOI: 10.3390/medsci11040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 10/25/2023] Open
Abstract
INTRODUCTION There are several risk factors attributed to tuberculosis (TB) mortality and morbidity. There are few studies and systematic reviews showing the association of silicosis and tuberculosis at a country level. Very limited studies have been conducted using multi-country data in studying the association of incidence of silicosis with TB mortality and morbidity. Hence, the aim of this research was to explore the association of incidence of silicosis and other important risk factors with TB mortality and morbidity using multi-country data. METHODS Data from 217 WHO region countries were utilized, sourcing TB-related statistics from the Institute of Health Metrics and Evaluation and additional risk factors from the Demographic and Health Survey, Global Burden of Disease, and World Bank for 2019. Regression analysis was conducted to examine the association between silicosis incidence and TB outcomes. RESULTS The study found an average silicosis incidence of 121.92 per 100,000 population. Additionally, 62.69% of the sample population are exposed to air pollution from solid fuel cooking. Sanitation access stands at an average of 59.67%. Regression outcomes indicate that while alcohol consumption's influence on TB is not statistically significant, a unit increase in silicosis incidence significantly elevates TB deaths (235.9, p = 0.005), YLL (9399.3, p = 0.011), and YLD (910.8, p = 0.002). CONCLUSION The burden of silicosis is found to be one of the important determinants of deaths, YLL, and YLD due to tuberculosis. Country-specific strategies to prevent and control silicosis is a need of the hour.
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Affiliation(s)
- Muayad Albadrani
- Department of Family and Community Medicine, College of Medicine, Taibah University, Al-Madinah al-Munawwarah 42353, Saudi Arabia
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Abstract
Background Tuberculosis (TB) is a global health issue that has long threatened and continues to threaten human health. While previous studies are important in the search for a cure for TB, to eradicate the disease it is also crucial to analyze environmental influences. Therefore, this study determined the potential effect of inadequate housing on TB and the magnitude of the effect. Methods This is a systematic review of the effects of inadequate housing on TB. Between Jan 1, 2011 and Oct 25, 2020, we searched four electronic databases using the search terms “housing AND tuberculosis” or “housing AND TB”. The target population comprised residents of inadequate housing and the homeless. Results We found 26 eligible studies. The distribution of the studies across continents was uneven, and the housing issues of interest seemed to vary depending on the economic level of the country. The eight steps identified in TB development and the consequences thereof were more strongly associated with housing affordability than with housing quality. Conclusions This is the first systematic review to identify the effects of inadequate housing on TB and to categorize inadequate-housing-related exposure to TB in terms of affordability and quality. The steps identified in TB development and the consequences thereof had a greater association with housing affordability than with housing quality. Therefore, public health interventions regarding housing affordability could be more diverse, and interventions that support affordable housing for residents of inadequate housing and the homeless should proceed simultaneously to improve housing quality. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12879-6.
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Affiliation(s)
- Ju-Yeun Lee
- The Department of Public Health, Graduate School of Public Health, Building 220, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Namhee Kwon
- The Department of Health Care Management and Policy, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ga-Yeon Goo
- The Department of Public Administration, Graduate School of Public Administration, Seoul National University, Seoul, Republic of Korea
| | - Sung-Il Cho
- The Department of Public Health, Graduate School of Public Health, Building 220, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea. .,Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
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Bhat J, Yadav R, Sharma RK, Muniyandi M, Rao VG. High incidence of pulmonary tuberculosis in an indigenous Saharia tribe in Madhya Pradesh, central India-A prospective cohort study. PLOS Glob Public Health 2022; 2:e0000039. [PMID: 36962266 PMCID: PMC10022087 DOI: 10.1371/journal.pgph.0000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 05/11/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Lack of TB incidence data is an important evidence gap among Saharia-a high TB burden indigenous community in Madhya Pradesh, central India. The present study was undertaken to calculate the incidence of pulmonary tuberculosis in this tribe. OBJECTIVE To calculate the incidence of pulmonary tuberculosis (PTB) among the Saharia tribal population in Madhya Pradesh, central India. METHODS A prospective cohort study was conducted among the Saharia tribal population (aged 15 years and above) of Shivpuri district in Madhya Pradesh state in central India. A total of 9,756 individuals were screened for TB in the baseline TB prevalence survey during 2012-13. All available household members were screened for symptoms suggestive of pulmonary TB (presumptive TB). Two sputum specimens were collected from persons having symptoms suggestive of TB and examined by smear and culture tests. A cohort of all non-TB individuals in the baseline survey was followed-up for one year and re-screened for the sysmptoms of PTB in the year 2014-15. Based on the data collected, the incidence of TB over one year period was estimated per 100,000 population. RESULTS A total of 9756 and 9044 individuals (≥ 15 years) were screened for symptoms suggestive of PTB during baseline and endline surveys respectively. The sputum specimens of presumptive TB cases were collected and examined by smear and culture tests. The overall incidence of bacteriologically positive (smear and/or culture) PTB over one year period was 1504 (95% Confidence Interval (CI): 1273-1776) per 100,000 in the study population, the incidence of smear-positive PTB was 1106 (95% CI: 910-1343), and the incidence of culture-positive PTB was 1084 (95% CI: 890-1319) per 100,000 population. The incidence for both smear and culture-positive PTB was 686 (95% CI: 535-878) per 100,000 population in the year 2014-15. The incidence of PTB was 2.8 times higher in males compared to females (2259 vs 807 per 100,000) and was positively correlated with age. CONCLUSION The findings of the study, the first of its kind in the Saharia tribal population, indicate a high incidence of TB in this tribal community thereby highlighting the urgent need for focused and intensified efforts to achieve the goal of TB elimination in the country.
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Affiliation(s)
- Jyothi Bhat
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
- ICMR- National Institute of Traditional Medicine, Belgavi, India
| | - Rajiv Yadav
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | | | | | - V G Rao
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Seshadri T, Velho N, Narasimhamurti NS, Srinivas PN. Examining tribal health inequalities around three forested sites in India: Results of a cross-sectional survey. J Family Med Prim Care 2020; 9:4788-4796. [PMID: 33102260 PMCID: PMC7116252 DOI: 10.4103/jfmpc.jfmpc_508_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/25/2020] [Accepted: 05/27/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The data available for the health of Scheduled Tribes (ST) in India are often coarse-scale snapshots at district and state levels and fine-scale comparison within and across site is often not possible. In this paper, we examine the health inequalities between the ST and non-ST populations in two forested sites and compare the healthcare parameters for ST populations across three forested sites. METHODS We conducted a cross-sectional household survey in three sites in and around three tiger reserves in Karnataka, Madhya Pradesh (MP) and Arunachal Pradesh (AP). In each site, multi-stage sampling and cluster analysis provided a representative sample of households across villages of 859 ST and non-ST households. We examined the sociodemographic and health-related information including self-reported illnesses and healthcare utilisation; from these, we explored the within-site health inequality patterns for the two sites and intersite differences among the ST households of the three sites. RESULTS In Karnataka, the ST and non-ST differences favoured the latter with regard to socio-economic characteristics with no difference in self-reported illness/injuries or healthcare utilisation. In MP, both groups were similar with regard to socio-economic characteristics and healthcare utilisation. AP ST households reported the highest healthcare utilisation, while MP ST households reported the lowest care seeking at hospitals and relied on home networks and health workers. High tobacco consumption was noted among ST groups in all the sites. CONCLUSIONS The ST and non-ST inequality patterns at a fine-scale were different between Karnataka and MP. The absence of health inequalities in MP indicates a uniform socio-geographical disadvantage while poor healthcare utilisation by ST people in Karnataka indicates health inequities. The ST households of AP reported the highest utilisation while those of MP reported the lowest. Programmes addressing the health inequalities of STs need to consider site-specific assessments of socio-geographical and health system factors.
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Affiliation(s)
- Tanya Seshadri
- Tribal Health Resource Centre, Vivekananda Girijana Kalyana Kendra, BR Hills, Karnataka, India
| | - Nandini Velho
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, New York, USA
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Bhat J, Yadav R, Sharma RK, Muniyandi M, Rao VG. Tuberculosis elimination in India's Saharia group. Lancet Glob Health 2019; 7:e1618. [PMID: 31708142 DOI: 10.1016/s2214-109x(19)30418-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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