Gyawali N, Gurung R, Poudyal N, Amatya R, Shrestha R, Khanal L K, Timilsina S, Bhattacharya S K
Nepal Med Coll J. 2013 Jun;15(2):125-8.
Tuberculosis is transmitted commonly by droplet nuclei and facilitated by weak immune system. Lowered immunity may be associated with cigarette smoking, tobacco chewing and alcohol consumption. The co-relationship between these all factors to TB should be explored. This study aims to detect the hidden household contacts (HC) cases early and to examine the relative contribution of tobacco and alcohol use to the risk of TB. Across-sectional study was in Dharan among HCs. From June 2009 to May 2010, 184 index cases with sputum smear positive for AFB and their 802 HCs were included. Three sputum specimens were collected from each HCs and examined microscopically for AFB detection. AFB were detected in sputum of 13 (1.6%) HCs. The association between habits (alcohol user and smoking) and TB was found except with chewing tobacco user (P > 0.05). The risk of contact TB was 4 and 8 times greater in smoker (OR = 3.94 95% CI = 1.26-12.26, P < 0.05) and alcoholic (OR = 8.23 95% CI = 2.71-24.98, P < 0.05) HCs respectively. This study has revealed smoking and alcohols as the risk factors for tuberculosis. Effective campaign to discourage use of alcohol and tobacco, and awareness programme about the mode of transmission of TB are needed in community.
结核病通常通过飞沫核传播，免疫系统薄弱会促使其传播。免疫力下降可能与吸烟、嚼烟和饮酒有关。应探究所有这些因素与结核病之间的相互关系。本研究旨在早期发现隐匿的家庭接触者（HC）病例，并研究烟草和酒精使用对结核病风险的相对影响。在达兰对家庭接触者进行了一项横断面研究。2009年6月至2010年5月，纳入了184例痰涂片抗酸杆菌阳性的索引病例及其802名家庭接触者。从每个家庭接触者收集三份痰标本，并进行显微镜检查以检测抗酸杆菌。在13名（1.6%）家庭接触者的痰中检测到抗酸杆菌。除嚼烟使用者外（P>0.05），发现了习惯（饮酒者和吸烟者）与结核病之间的关联。吸烟者（OR=3.94，95%CI=1.26-12.26，P<0.05）和饮酒者（OR=8.23，95%CI=2.71-24.98，P<0.05）家庭接触者患接触性结核病的风险分别高出4倍和8倍。本研究揭示吸烟和饮酒是结核病的风险因素。社区需要开展有效的活动来劝阻人们使用酒精和烟草，并开展关于结核病传播方式的宣传项目。
