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Smoking and Infectious Disease. Tuberculosis and Legionnaires' Disease. Tuberculosis . Mycobacterium Tuberculosis  Aerosol transmission Latent vs. active tuberculosis. The association between smoking and tuberculosis has been investigated since 1918 . Tuberculosis Diagnosis .

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Smoking and infectious disease

Smoking and Infectious Disease

Tuberculosis and Legionnaires'

Disease


Tuberculosis
Tuberculosis 

  • Mycobacterium Tuberculosis 

  • Aerosol transmission

  • Latent vs. active tuberculosis



Tuberculosis diagnosis
Tuberculosis Diagnosis  investigated since 1918 

  • Latent TB granulomas can be seen on a chest xray

  •  Mantoux skin test

http://www.health.state.mn.us/divs/idepc/diseases/tb/tst.html

http://www.cmaj.ca/content/169/9/937.full


Tuberculosis treatment
Tuberculosis Treatment investigated since 1918 

  • Suggested treatment according to the CDC includes:

    • ACTIVE-- 

      • isoniazid (INH)

      • rifampin (RIF)

      • ethambutol (EMB)

      • pyrazinamide (PZA)

    • LATENT--

      • isoniazid (INH)


Tuberculosis prevalence
Tuberculosis Prevalence investigated since 1918 

  • Tuberculosis (TB) is one of the most important infectious diseases in the world in terms of morbidity and mortality

  • In 2008, the number of deaths due to TB was estimated at 1.8 million by the World Health Organization (WHO) 

  • In 2008, an estimated 0.48 million new cases occurred in South Africa and, currently, the country ranks third after India and China in terms of total number of annual incident cases of TB


Active Tuberculosis investigated since 1918 

Studies Reviewed


The reduction of tuberculosis risks by smoking cessation investigated since 1918 Wen, et al.--2010


Tobacco smoking and pulmonary tuberculosis kolappan gopi 2002
Tobacco smoking and pulmonary tuberculosis investigated since 1918 Kolappan, Gopi--2002


Latent investigated since 1918 

Tuberculosis

Studies Reviewed


High prevalence of smoking among patients with suspected tuberculosis in South AfricaBurnet, et al.--2011


The impact of smoking on adherence to treatment for latent tuberculosis infectionLavigne, et al.--2005


Relapse of tuberculosis infection

Tuberculosis

Studies Reviewed


Smoking increases the risk of relapse after successful tuberculosis treatment batista et al 2008
Smoking increases the risk of relapse after successful tuberculosis treatmentBatista, et al.--2008


Comparison of pulmonary and extrapulmonary tuberculosis in Nepal- a hospital-based retrospective studySreeramareddy, et al.--2008

  • Smokers less likely to have isolated extrapulmonary TB

  • History of TB associated with pulmonary TB

    • No identification if this was a relapse or reinfection

    • Reinfection more common in high burden countries


Mortality from Nepal- a hospital-based retrospective study

Tuberculosis

Studies Reviewed


Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean men and womenJee, et al.--2009


Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43 000 adult male deaths and 35 000 controlsGajalakshmi, et al.--2009


Barcelona in India: retrospective study of 43 000 adult male deaths and 35 000 controls

Tuberculosis Data

Reviewed/ Analyzed


Tuberculosis and recurrence and its associated risk factors among successfully treated patientsMillet, et al.--2009


Analysis of recent data collected by the barcelona public health agency
Analysis of recent data collected by the Barcelona Public Health Agency

  • Data collected on 5,141 males and females living in Barcelona

  • SPSS used to calculate frequencies and percentages for the following associations:

    • OUTCOME and:

      • sex, country of origin, diabetes status, alcohol, homelessness, DOT therapy, imprisonment status, HIV status, and smoking status

    • SMOKING STATUS and:

      • sex, country of origin, diabetes status, alcohol, homelessness, DOT therapy, imprisonment status, and HIV status


Legionnaires disease
Legionnaires Health Agency’ Disease

  • Legionella pneumophila

  • Low reporting rate

  • Can be lethal

  • Aerosol transmission

  • Risk factors:

    • Old age

    • Smoking

    • Chronic lung disease

    • Immunosuppression


Legionnaires diagnosis and treatment
Legionnaires Health Agency’ Diagnosis and Treatment

  • Diagnosis

    • Chest x-ray

    • Sputum culture

    • Urinary antigen test

    • Blood antibody test

  • Treatment

    • Antibiotics

http://www.wrongdiagnosis.com/phil/html/legionnaires-disease/192.html


Legionnaires Health Agency’ Disease Data

Reviewed/ Analyzed


Sporadic community-acquired Legionnaires Health Agency’ disease in France: a 2-year national matched case-control studyChe, et al.--2008


Analysis of recent data collected by the barcelona public health agency1
Analysis of recent data collected by the Barcelona Public Health Agency

  • Data collected on 1,018 males and females living in Barcelona

  • SPSS used to calculate frequencies and percentages for the following associations:

    • OUTCOME and:

      • sex, country of origin, diabetes status, alcohol, cardiopulmonary disease, immunosuppressive treatment and disease, renal transplant, cancer status, and smoking status

    • SMOKING STATUS and:

      • sex, country of origin, diabetes status, alcohol, cardiopulmonary disease, immunosuppressive treatment and disease, renal transplant, cancer status


Acknowledgements
Acknowledgements  Health Agency

  • Josep M. Antó, Carme Borrell, Joana Porcel and CREAL staff

  • Joan A. Caylà

  • Angeles Orcau

  • Cecilia Tortasada

  • Lourdes Baezconde-Garbanati

  • Kathleen Dwyer

  • Daniel Soto and Camille Dennard

  • Rosa Barahona


References
References Health Agency

  • Tuberculosis (TB) (2009, June 1). In Center for Disease Control and Prevention. Retrieved July 11, 2011, from http://www.cdc.gov/tb/topic/basics/default.htm

  •   Associations between tobacco and tuberculosis. Chiang CY, Slama K, Enarson DA. International Union Against Tuberculosis and Lung Disease, Paris, France. Int J Tuberc Lung Dis. 2007 Mar;11(3):258-62.   http://www.ncbi.nlm.nih.gov.libproxy.usc.edu/pubmed/17352089

  • Batista, J. L., Albuquerque, M. P., Ximenes, R. A., & Rodrigues, L. C. (2008, August). Smoking increases the risk of relapse after successful tuberculosis treatment. Int J Epidemiol, 37(4), 841-851. doi:10.1093/ije/dyn113

  • Brunet, L., Pai, M., Davids, V., Ling, D., Paradis, G., Lenders, L., & Meldau, R. (2011, July). High prevalence of smoking among patients with suspected tuberculosis in South Africa [Electronic version]. Eur Respir J., 38(1), 139-146.

  • Kolappan, C., & Gopi, P. G. Tobacco smoking and pulmonary tuberculosis. Thorax, 57(11), 964-966. Retrieved from PubMed (12403879).

  • Lavigne, M., Rocher, I., Steensma, C., & Brassard, P. (2006, March). The impact of smoking on adherence to treatment for latent tuberculosis infection [Electronic version]. BMC Public Health., 6, 66.

  • Sreeramareddy, C. T., Panduru, K. V., Verma, S. C., Joshi, H. S., & Bates, M. N. (2008, January). Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a  hospital-based retrospective study. BMC Infect Dis., 8, 8. doi:10.1186/1471-2334-8-8

  • Thomas, A., Gopi, P. G., Santha, T., Chandrasekaran, V., Subramani, R., Selvakumar, N., & Eusuff, S. I. (2005, May). Predictors of relapse among pulmonary tuberculosis patients treated in a DOTS programme in South India [Electronic version]. Int J Tuberc Lung Dis., 9(5), 556-561.

  • Gajalakshmi, V., Peto, R., Kanaka, T. S., & Jha, P. (2003, August 16). Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43000 adult male deaths and 35000 controls [Electronic version]. Lancet, 362(9383), 507-515.

  • Millet, J. P., Orcau, A., Garcia de Olalla, P., Casals, M., Rius, C., & Cayla, J. A. (2009). Tuberculosis recurrence and its associated risk factors among successfully treated patients. J Epidemiol Community Health, 63, 799-804. doi:10.1136/jech.2008.077560

  • Che, D., Campese, C., Santa-Olalla, P., Jacquier, G., Bitar, D., Bernillon, P., & Desenclos, J. C. (2008, December). Sporadic community-acquired Legionnaires' disease in France: a 2-year national matched case-control study [Electronic version]. Epidemiol Infect., 136(12), 1684-1690.

  • Patient Facts: Learn More about Legionnaires' disease. (2011, June). In Legionellosis Resource Site (Legionnaires' Disease and Pontiac Fever). Retrieved July 14, 2011, from http://www.cdc.gov/legionella/patient_facts.htm


Questions
Questions Health Agency


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