Tuberculosis and comorbidities in urban areas in Argentina. A gender and age perspective

Alberto Echazarreta, Elsa Zerbini, José De Sandro, César Sáenz, Leyla Yessi, Romina Saad, Gabriela Manonelles, Mónica Cuello, .

Keywords: Tuberculosis, comorbidity, gender identity, age groups, acquired immunodeficiency syndrome, risk factors, Argentina.

Abstract

Introduction: Tuberculosis continues to be a major health problem in the world with an incidence of more than 10 million cases in 2015. There are factors that change the risk of developing the disease after infection, as well as the presentation of the disease.
Objective: To determine the main comorbidities and demographic, clinical and microbiological characteristics of tuberculosis adult patients in Argentina from a gender and age perspective.
Materials and methods: We conducted a cross-sectional study in urban referral hospitals for patients with tuberculosis. We included tuberculosis patients of 15 years or more of age who were hospitalized or treated in outpatient clinics with bacteriologically confirmed pulmonary or extrapulmonary forms of the disease, as well as those who, although not bacteriologically confirmed, had clinical and radiological characteristics consistent with tuberculosis. The study period was from August 1st, 2015 to August 31st, 2016.
Results: We included 378 patients. The median age was 37 years. Male gender was associated with extrapulmonary tuberculosis, hospitalization, smoking, drug addiction and alcoholism. Tuberculosis and aids (22.6%) was related to drug use, admission into hospital, extrapulmonary tuberculosis, nonaddiction to tobacco, non-pathological radiology, absence of cavitation, and negative sputum smear microscopy. Patients less than 40 years of age had a higher rate of drug addiction and low weight, while those aged 40 or over had a higher proportion of diabetes, alcoholism and chronic obstructive pulmonary disease (COPD).
Conclusions: This study will help recognize tuberculosis patients’ characteristics and comorbidities influencing the development and evolution of the disease from an age and gender perspective to enable the development of social and community-based strategies.

Downloads

Download data is not yet available.
  • Alberto Echazarreta Sección de Tuberculosis, Asociación Argentina de Medicina Respiratoria, Ciudad de Buenos Aires, Argentina Deceased
  • Elsa Zerbini Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”, Administración Nacional de Laboratorios e Institutos de Salud - ANLIS, Santa Fe, Argentina
  • José De Sandro Hospital San Martín, La Plata, Argentina
  • César Sáenz Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina
  • Leyla Yessi Hospital San Juan de Dios, La Plata, Argentina
  • Romina Saad Hospital Presidente Perón, Avellaneda, Argentina
  • Gabriela Manonelles Programa de Control y Tratamiento de la Tuberculosis, Río Gallegos, Argentina
  • Mónica Cuello Hospital Carrasco, Rosario, Argentina

References

World Health Organiation. Global tuberculosis report 2016. Geneva: WHO; 2016. Accessed: May 3rd, 2017. Available in: http://reliefweb.int/sites/reliefweb.int/files/resources/gtbr2016_main_text.pdf

Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni”. Notificación de casos de tuberculosis en la República Argentina, período 1980-2015. Santa Fe: INER; 2016. Accessed: May 3rd, 2017. Available in: http://www.anlis.gov.ar/iner/wp-content/uploads/2016/11/Notificacionde-casos-de-Tuberculosis-en-la-Republica-Argentina-Periodo-1980-2015.pdf

Caminero J. Guía de la tuberculosis para médicos especialistas. Paris: UICTER; 2003. Accessed: May 3rd, 2017]. Available in: http://www.theunion.org/what-wedo/publications/technical/spanish/pub_guia_medicos_especialistas_spa.pdf

Kim SY, Lee SM, Yim JJ, Yoo CG, Kim YW, Han SK, et al. Treatment response and adverse reactions in older tuberculosis patients with immunocompromising comorbidities. Yonsei Med J. 2013;54:1227-33. https://doi.org/10.3349/ymj.2013.54.5.1227

Kirenga BJ, Ssengooba W, Muwonge C, Nakiyingi L, Kyaligonza S, Kasozi S, et al.Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: Implications for tuberculosis control. BMC Public Health.2015;15:13. https://doi.org/10.1186/s12889-015-1376-3

Wang JY, Lee LN, Hsueh PR. Factors changing the manifestation of pulmonary tuberculosis. Int J Tuberc Lung Dis. 2005;9:777-83.

El Sahly HM, Wright JA, Soini H, Bui TT, Williams-Bouyer N, Escalante P, et al. Recurrent tuberculosis in Houston, Texas: A population-based study. Int J Tuberc Lung Dis. 2004;8:333-40.

Yen YF, Yen MY, Lin YS, Lin YP, Shih HC, Li LH, et al. Smoking increases risk of recurrence after successful antituberculosis treatment: A population-based study. Int J Tuberc Lung Dis. 2014;18:492-8. https://doi.org/10.5588/ijtld.13.0694

Yüceege M, Sanisoğlu B, Baran R. Gender difference in clinical presentation of Turkish patients with pulmonary tuberculosis. Acta Medica Iranica. 2014;52:52-5.

Díaz-Mesa E, García-Portilla P, Fernández-Artamendi S, Sáiz P, BobesBascarán T, Casares MJ, et al. Diferencias de género en la gravedad de la adicción. Adicciones. 2016;28:221-30.

Bottorff J, Haines-Saah R, Kelly M, Oliffe J, Torchalla I, Poole N, et al. Gender, smoking and tobacco reduction and cessation: A scoping review. Int J Equity in Health. 2014;13:114. https://doi.org/10.1186/s12939-014-0114-2

Minutillo A, Pacifici R, Scaravelli G, De Luca R, Palmi I, Mortali C, et al. Gender disparity in addiction: An Italian epidemiological sketch. Ann Ist Super Sanità. 2016;52:176-83. https://doi.org/10.4415/ANN_16_02_08

Fescina P, Membriani E, Limongi L, Putruele A. Incidencia de la resistencia a drogas en tuberculosis y su asociación a comorbilidades en pacientes tratados en un hospital universitario. Rev Am Med Resp. 2013;2:64-70.

Rivera L, VarujanKevorkof G, Oviedo E, Acosta MA, Najo M, Granados M, et al. Características epidemiológicas de pacientes con tuberculosis en el Hospital Tránsito Cáceres de Allende. Rev Am Med Resp. 2014;14:404-11.

Organización Panamericana de la Salud. Marco de trabajo para el control de la tuberculosis en grandes ciudades de Latinoamérica y el Caribe. Washington, D.C.: OPS; 2016. Accessed: May 3rd, 2017. Available in: http://www.paho.org/hq/index.php?option=com_topics&view=article&id=59&Itemid=40776&lang=es

Marais B, Lönnroth K, Lawn S, Migliori G, Mwaba P, Glaziou P et al. Tuberculosis comorbidity with communicable and non-communicable diseases: Integrating health services and control efforts. Lancet Infect Dis. 2013;13:436-448. https://doi.org/10.1016/S1473-3099(13)70015-X

World Health Organization/The Union. TB and tobacco control: Joining efforts to control two related global epidemics. Geneva: WHO, 2007. Accessed: May 3rd, 2017. Available in: http://apps.who.int/iris/bitstream/10665/43812/1/9789241596220_eng.pdf

Hassmiller KM. The association between smoking and tuberculosis. Salud Pública Mex. 2006;48:S201-16. https://doi.org/10.1590/S0036-36342006000700024

Cruz-Hervert L, García-García L, Ferreyra-Reyes L, Bobadilla-Del Valle M, Cano-Arellano B, Canizales-Quintero S, et al. Tuberculosis in ageing: High rates, complex diagnosis and poor clinical outcomes. Age Ageing. 2012;41:488-95. https://doi.org/10.1093/ageing/afs028

Mahfouz M, Alsanosy R, Gaffar A, Makeen A. Tobacco use among university students of Jazan region: Gender differences and associated factors. Biomed Res Int. 2014;2014:279231. https://doi.org/10.1155/2014/279231

Ministerio de Salud de Argentina. Encuesta Mundial de tabaquismo en adultos 2012. Buenos Aires: 2013. Accessed: May 3rd, 2017. Available in: http://www.msal.gob.ar/tabaco/images/stories/info-para-ciudadanos/pdf/2013-07_GYTS-2012-resumen-ejecutivo.pdf

Underner M, Perriot J, Peiffer G, Meurice JC, Dautzenberg B. Smoking and adherence to anti-tuberculosis treatment. Rev Mal Respir. 2016;33:128-44. Accessed: August 25th, 2017. Available in: http://www.em-consulte.com/rmr/article/1037819/

Ministerio de Salud de Argentina. Boletín sobre el VIHsida e ITS en Argentina. Buenos Aires, 2015. Accessed: 3rd May 2017. Available in: http://www.msal.gob.ar/images/stories/bes/graficos/0000000852cnt-2015-11-18_boletinvih-sida-2015.pdf

Velásquez G, Cegielski J, Murray M, Yagui M, Asencios L, Bayona J, et al. Impact of HIV on mortality among patients treated for tuberculosis in Lima, Perú: A prospective cohort study. BMC Infect Dis. 2016;16:45. https://doi.org/10.1186/s12879-016-1375-8

Deiss RG, Rodwell TC, Garfein RS. Tuberculosis and illicit drug use: Review and update. Clin Infect Dis. 2009;48:72-82. https://doi.org/10.1086/594126

Story A, Bothamley G, Hayward A. Crack cocaine and infectious tuberculosis. Emerg Infect Dis. 2008;14:1466-9. https://doi.org/10.3201/eid1409.070654

Zachariah R, Spielmann MP, Harries AD, Salaniponi FM. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2002;96:291-4.

Yen YF, Chuang PH, Yen MY, Lin SY, Chuang P, Yuan MJ, et al. Association of body mass index with tuberculosis mortality a population-based follow-up study. Medicine (Baltimore). 2016;95:e2300. https://doi.org/10.1097/MD.0000000000002300

Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med. 2008;5:e152. https://doi.org/10.1371/journal.pmed.0050152

Zahr R, Peterson R, Polgreen L, Cavanaugh J, Hornick D, Winthrop K, et al. Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA. BMJ Open Diabetes Res Care. 2016;4:e000268. http://dx.doi.org/10.1136/bmjdrc-2016-000268

Pal R, Ansari M, Hameed S, Fatima Z. Diabetes mellitus as hub for tuberculosis infection: A snapshot. Int J Chronic Dis. 2016;2016:5981574. https://doi.org/10.1155/2016/5981574

Ministerio de Salud, Instituto Nacional de Estadísticas y Censos de Argentina. Tercera Encuesta Nacional de Factores de Riesgo para Enfermedades No transmisibles, Argentina 2013. Buenos Aires, 2015. Accessed: May 3rd, 2017. Available in: http://www.msal.gob.ar/images/stories/bes/graficos/0000000544cnt-2015_09_04_encuesta_nacional_factores_riesgo.pdf

How to Cite
1.
Echazarreta A, Zerbini E, De Sandro J, Sáenz C, Yessi L, Saad R, et al. Tuberculosis and comorbidities in urban areas in Argentina. A gender and age perspective. biomedica [Internet]. 2018 Jun. 15 [cited 2024 May 10];38(2):180-8. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/3904

Some similar items:

Published
2018-06-15
Section
Original articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code