Ferrara, Giovanni and Murray, Megan and Winthrop, Kevin and Centis, Rosella and Sotgiu, Giovanni and Migliori, Giovanni Battista and Maeurer, Markus and Zumla, Alimuddin (2012) Risk factors associated with pulmonary tuberculosis: smoking, diabetes and anti-TNFα drugs. Current Opinion in Pulmonary Medicine, Vol. 18 (3), p. 233-240. ISSN 1070-5287. Article.
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Purpose of review
Tuberculosis (TB) remains a global emergency and continues to kill 1.4 million people every year. The
interaction between noncommunicable and infectious diseases like TB has important implications with regard to the attainment of the Millennium Development Goals (MDGs). Smoking, diabetes mellitus, anti-TNFα drugs and other immunosuppressive therapies are well known major risk factors associated with TB. The purpose of this review is to summarize the recent literature on these risk factors and interventions that reduce the risk.
Mathematical models and aggregate data from the field show that smoking, diabetes and anti-TNFα drugs
independently increase the risk of developing active TB. There is consensus on the great need for screening
for active TB disease in patients with these conditions and targeted preventive interventions through a combined multidisciplinary approach.
Smoking, diabetes mellitus, anti-TNFa drugs and new immunosuppressive treatments represent important common risk factors for TB. A high degree of clinical awareness of the possibility of TB should be considered in patients with these risk factors, and active screening and prevention should be undertaken. Further operational research is needed to optimize screening for latent Mycobacterium tuberculosis infection, instituting preventive intervention measures.
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