Chumchuen Kemmapon, Wichaidit Wit, Chongsuvivatwong Virasakdi
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
PLoS One. 2024 Dec 5;19(12):e0312139. doi: 10.1371/journal.pone.0312139. eCollection 2024.
In June 2022, Thailand legalized recreational cannabis. Currently, cannabis is now the most consumed drug. Cannabis usage can increase inflammatory responses in the respiratory tract. Sharing of cannabis waterpipes has been linked to increased tuberculosis risks. Using a national in-patient databank, we aimed to 1) describe the spatiotemporal correlation between cannabis-related and tuberculosis hospital admissions, and 2) compare the rate of subsequent pulmonary tuberculosis admission between those with prior admissions for cannabis-related causes and those without. Both admission types were aggregated to the number of admissions in monthly and provincial units. Temporal and spatial patterns were visualized using line plots and choropleth maps, respectively. A matched cohort analysis was conducted to compare the incidence density rate of subsequent tuberculosis admission and the hazard ratio. Throughout 2017-2022, we observed a gradual decline in tuberculosis admissions, in contrast to the increase in cannabis-related admissions. Both admissions shared a hotspot in Northeastern Thailand. Between matched cohorts of 6,773 in-patients, the incidence density rate per 100,000 person-years of subsequent tuberculosis admissions was 267.6 and 165.9 in in-patients with and without past cannabis-admission, respectively. After adjusting for covariates, we found that a cannabis-related admission history was associated with a hazard ratio of 1.48 (P = 0.268) for subsequent tuberculosis admission. Our findings failed to support the evidence that cannabis consumption increased pulmonary tuberculosis risk. Other study types are needed to further assess the association between cannabis consumption and pulmonary tuberculosis.
2022年6月，泰国将消遣性大麻合法化。目前，大麻是消费最多的毒品。大麻使用会增加呼吸道的炎症反应。共用大麻水烟管与结核病风险增加有关。我们利用一个全国住院数据库，旨在：1）描述大麻相关住院和结核病住院之间的时空相关性；2）比较既往因大麻相关原因住院者和未住院者后续肺结核住院率。两种住院类型都汇总到每月和省级单位的住院人数。分别使用折线图和分级统计图可视化时间和空间模式。进行匹配队列分析以比较后续结核病住院的发病率密度率和风险比。在2017年至2022年期间，我们观察到结核病住院人数逐渐下降，而大麻相关住院人数则有所增加。两种住院情况在泰国东北部都有一个热点地区。在6773名住院患者的匹配队列中，既往有大麻住院史和无大麻住院史的患者每10万人年后续结核病住院的发病率密度率分别为267.6和165.9。在对协变量进行调整后，我们发现大麻相关的住院史与后续结核病住院的风险比为1.48（P = 0.268）。我们的研究结果未能支持大麻消费会增加肺结核风险的证据。需要其他研究类型来进一步评估大麻消费与肺结核之间的关联。
