Department of Public Health, College of Health Sciences, Arsi University, Asella, Ethiopia.
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2020 Sep 17;15(9):e0239333. doi: 10.1371/journal.pone.0239333. eCollection 2020.
Numerous studies have explored an effect of cigarette smoking on tuberculosis treatment outcomes but with dissimilar conclusions.
To determine the effect of cigarette smoking on tuberculosis treatment outcomes.
PubMed, Cochrane library and Google scholar databases were searched last on February 27, 2019. We applied the random-effects model for the analysis. Publication bias was assessed using funnel plot and Egger's regression. Furthermore, we performed Orwin's Fail-Safe N and cumulative meta-analysis to check for small studies' effect.
Out of 22 studies we included in the qualitative synthesis, 12 studies reported p-values less than 0.05 where smoking significantly favored poor treatment outcomes. The remaining 10 studies reported p-values larger than 0.05 implying that smoking does not affect the treatment outcomes. Twenty studies met the criteria for inclusion in a meta-analysis. The meta-analysis found that smoking significantly increased the likelihood of poor tuberculosis treatment outcomes by 51% (OR = 1.51; 95% CI = 1.30 to 1.75 and I-square = 75.1%). In a sub-group analysis, the effect was higher for low- and middle-income countries (OR = 1.74; 95% CI = 1.31 to 2.30) and upper-middle-income economies (OR = 1.52; 95% CI = 1.16 to 1.98) than for high-income ones (OR = 1.34; 95% CI = 1.03 to 1.75) even though the differences in the effects among the strata were not statistically significant as demonstrated by overlapping of confidence intervals of the effects. Meta-regression analysis, adjusted for income economies, found the effect of smoking has not significantly improved over the years (p = 0.92) and thus implying neither of the covariates were source of the heterogeneity. Egger's regression test indicated that publication bias is unlikely (p = 0.403).
Cigarette smoking is significantly linked with poor tuberculosis treatment outcomes.
许多研究探讨了吸烟对结核病治疗结果的影响，但结论不一致。
确定吸烟对结核病治疗结果的影响。
我们于 2019 年 2 月 27 日最后检索了 PubMed、Cochrane 图书馆和 Google 学者数据库。我们应用随机效应模型进行分析。使用漏斗图和 Egger 回归评估发表偏倚。此外，我们进行了 Orwin 的 Fail-Safe N 和累积荟萃分析，以检查小研究的影响。
在纳入定性综合分析的 22 项研究中，有 12 项研究报告的 p 值小于 0.05，表明吸烟显著有利于治疗结果不良。其余 10 项研究报告的 p 值大于 0.05，表明吸烟不影响治疗结果。20 项研究符合纳入荟萃分析的标准。荟萃分析发现，吸烟显著增加了结核病治疗结果不良的可能性，增加了 51%（OR=1.51；95%CI=1.30 至 1.75，I 平方=75.1%）。在亚组分析中，这种效应在低收入和中等收入国家（OR=1.74；95%CI=1.31 至 2.30）和中高收入经济体（OR=1.52；95%CI=1.16 至 1.98）中高于高收入国家（OR=1.34；95%CI=1.03 至 1.75），尽管效应在各层之间的差异没有统计学意义，因为置信区间重叠。对收入经济体进行调整的元回归分析发现，吸烟的影响在过去几年中没有显著改善（p=0.92），因此，没有一个协变量是异质性的来源。Egger 回归检验表明发表偏倚不太可能（p=0.403）。
吸烟与结核病治疗结果不良显著相关。
