Bay Julie Glerup, Patsche Cecilie Blenstrup, Svendsen Nicoline Marie, Gomes Victor Francesco, Rudolf Frauke, Wejse Christian
TB research unit, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau; GloHAU, Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
TB research unit, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau; GloHAU, Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Int J Infect Dis. 2022 Nov;124 Suppl 1:S50-S55. doi: 10.1016/j.ijid.2022.07.067. Epub 2022 Jul 30.
Both tuberculosis (TB) and tobacco smoking are preventable health hazards. Few studies have examined the relationship between TB and tobacco smoking in an African setting, where the two health burdens collide heavily. This study aimed to describe the severity of TB disease and treatment outcomes among smokers with TB compared with nonsmokers with TB in Guinea-Bissau.
We conducted a prospective follow-up study between 2003-2017 in Guinea-Bissau, enrolling adult patients with TB classified as nonsmokers or smokers. Disease severity was assessed using the Bandim TBscore. Multivariate logistic and Cox proportional hazard regressions were used to analyse treatment outcomes.
Of 1780 included patients, 385 were smokers who had smoked for a median 10 years (interquartile range [IQR] 5-20). No difference in disease severity at the time of diagnosis was observed. Smokers were not significantly more prone to a nonsuccessful treatment outcome, although a trend was seen (adjusted odds ratio [OR] 1.24, 95% confidence interval [CI] 0.91-1.70), and smokers tended to be more often lost to follow-up, but this also was not a significant finding (adjusted hazard ratio [HR] 2.09, 95% CI 0.89-4.94).
In a TB high-endemic setting with few tobacco smokers, smoking was not associated with disease severity or worse outcome, possibly because of socioeconomic confounders.
结核病（TB）和吸烟都是可预防的健康危害因素。在非洲地区，这两种健康负担严重交织，但很少有研究探讨结核病与吸烟之间的关系。本研究旨在描述几内亚比绍结核病吸烟者与非吸烟者相比，结核病的严重程度和治疗结果。
我们在2003年至2017年期间在几内亚比绍进行了一项前瞻性随访研究，纳入被分类为非吸烟者或吸烟者的成年结核病患者。使用班迪姆结核病评分评估疾病严重程度。采用多变量逻辑回归和Cox比例风险回归分析治疗结果。
在纳入的1780例患者中，385例为吸烟者，中位吸烟时间为10年（四分位间距[IQR]5 - 20年）。诊断时疾病严重程度无差异。吸烟者治疗结果不成功的倾向并不显著，尽管存在一种趋势（调整优势比[OR]1.24，95%置信区间[CI]0.91 - 1.70），且吸烟者失访的情况更常见，但这也不是一个显著的发现（调整风险比[HR]2.09，95%CI 0.89 - 4.94）。
在结核病高流行且吸烟者较少的环境中，吸烟与疾病严重程度或较差的治疗结果无关，这可能是由于社会经济混杂因素导致的。
