Clinical Epidemiology (Division of Health Sciences), ICMR - National Institute of Occupational Health (NIOH), Indian Council of Medical Research, Meghaninagar, Ahmedabad City, Gujarat, 380016, India.
Sci Rep. 2023 Feb 16;13(1):2785. doi: 10.1038/s41598-023-30012-4.
Globally, silicosis and tuberculosis (TB) have been targeted for elimination by 2030. The study's objectives were to determine the association of silicosis with unfavorable TB treatment outcomes, as well as to explore experts' perspectives on improving treatment outcomes among silico-tuberculosis patients. A retrospective cohort study evaluated TB treatment outcomes in Khambhat block, the western part of India, between 138 patients with silico-tuberculosis and 2610 TB patients without silicosis in February-March 2022. 'Unfavorable TB treatment outcomes' was defined as a patient stopping treatment for at least one month, a positive sputum smear at the end of treatment, or, a patient dying while on treatment. During April-July 2022, fifteen in-depth interviews with experts in the field of silicosis/tuberculosis were audio-recorded, transcribed, and analyzed to generate codes (thematic analysis). On multivariable logistic regression analysis, patients with silico-tuberculosis had a 2.3 (95% CI 1.6-3.4) times higher odds of unfavorable treatment outcomes. The experts recommended collaborative TB-silicosis activities for improving treatment outcomes of patients with silico-tuberculosis. I conclude from the study's findings that silicosis is associated with unfavorable TB treatment outcomes in this study setting. All patients with silicosis should be screened for TB and treated according to national TB program guidelines. All patients with TB who have a history of occupational dust exposure should be evaluated for silicosis and provided appropriate pulmonary/vocational rehabilitation.
全球范围内，矽肺和结核病（TB）已被定为 2030 年消除的目标。本研究的目的是确定矽肺与不利的结核病治疗结果之间的关联，并探讨专家对改善矽肺结核病患者治疗结果的看法。一项回顾性队列研究评估了 2022 年 2 月至 3 月期间印度西部 Khambhat 区矽肺和矽肺结核患者（138 例）与无矽肺结核病患者（2610 例）之间的结核病治疗结果。“不利的结核病治疗结果”定义为患者至少停止治疗一个月、治疗结束时痰涂片阳性或患者在治疗期间死亡。2022 年 4 月至 7 月期间，对矽肺/结核病领域的 15 名专家进行了 15 次深入访谈，对访谈内容进行了录音、转录和分析，以生成代码（主题分析）。在多变量逻辑回归分析中，矽肺结核病患者发生不利治疗结果的可能性是单纯结核病患者的 2.3 倍（95%CI 1.6-3.4）。专家建议开展结核病-矽肺合作活动，以改善矽肺结核病患者的治疗结果。本研究结果表明，在本研究环境中，矽肺与不利的结核病治疗结果有关。所有矽肺患者均应进行结核病筛查，并根据国家结核病规划指南进行治疗。所有有职业性粉尘暴露史的结核病患者均应评估矽肺，并提供适当的肺部/职业康复。
