Pulmonary Tuberculosis and delay in anti-tuberculous treatment are important risk factors for chronic obstructive pulmonary disease
Journal
PLoS ONE
Journal Volume
7
Journal Issue
5
Pages
e37978
Date Issued
2012
Author(s)
Abstract
Objective: Tuberculosis (TB) remains the leading cause of death among infectious diseases worldwide. It has been suggested as an important risk factor of chronic obstructive pulmonary disease (COPD), which is also a major cause of morbidity and mortality. This study investigated the impact of pulmonary TB and anti-TB treatment on the risk of developing COPD. Design, Setting, and Participants: This cohort study used the National Health Insurance Database of Taiwan, particularly the Longitudinal Health Insurance Database 2005 to obtain 3,176 pulmonary TB cases and 15,880 control subjects matched in age, sex, and timing of entering the database. Main Outcome Measures: Hazard ratios of potential risk factors of COPD, especially pulmonary TB and anti-TB treatment. Results: The mean age of pulmonary TB cases was 51.9±19.2. The interval between the initial study date and commencement of anti-TB treatment (delay in anti-TB treatment) was 75.8±65.4 days. Independent risk factors for developing COPD were age, male, low income, and history of pulmonary TB (hazard ratio 2.054 [1.768-2.387]), while diabetes mellitus was protective. The impact of TB persisted for six years after TB diagnosis and was significant in women and subjects aged >70 years. Among TB patients, delay in anti-TB treatment had a dose-response relationship with the risk of developing COPD. Conclusions: Some cases of COPD may be preventable by controlling the TB epidemic, early TB diagnosis, and prompt initiation of appropriate anti-TB treatment. Follow-up care and early intervention for COPD may be necessary for treated TB patients. ? 2012 Lee et al.
Other Subjects
tuberculostatic agent; adult; age; aged; article; chronic obstructive lung disease; cohort analysis; controlled study; data base; diabetes mellitus; disease association; female; gender; human; lowest income group; lung tuberculosis; major clinical study; male; medical history; national health insurance; outcome assessment; patient attitude; patient compliance; patient participation; risk assessment; risk factor; Taiwan; therapy delay; tuberculosis; Adult; Age of Onset; Aged; Antitubercular Agents; Cohort Studies; Early Medical Intervention; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Risk Factors; Tuberculosis, Pulmonary
Type
journal article