"More than ever before, we understand how tobacco harms people who have already been successfully treated for TB," said Dr Chung-Yeh Deng of National Yang-Ming University in Taipei, an author of the study. "No one should undergo the long, complex treatment for TB only to unknowingly place themselves at heightened risk of getting the disease again. With this research we can inform national tobacco control policies and educate patients about the risks that smoking tobacco poses.
" The researchers followed a large sample of 5,567 TB patients in Taiwan, each of whom had TB confirmed through bacteriologic testing and went on to successfully complete TB treatment. Of those patients, 1.5 percent developed a recurrent case of TB, with regular tobacco smokers twice as likely to develop recurrent TB compared with former smokers and with individuals who had never smoked tobacco. Regular tobacco smokers were defined as individuals who smoked 10 or more cigarettes—equivalent to half a pack—per day.
"Until this study was published, we didn't have a clear sense of how smoking tobacco posed risks to TB patients who have put in the hard work of completing their treatment. This is a robust study with important implications for patients, public health programmes and policy-makers alike," said Dr Paula Fujiwara, Scientific Director of the International Union Against Tuberculosis and Lung Disease (The Union), which publishes the journal.
The research was announced on 24 March to coincide with World TB Day, which marks the anniversary of Prof Robert Koch's discovery of the bacteria that cause tuberculosis in Berlin. More than a century later, Koch's discovery is still considered among the most revolutionary in the history of medicine, since it paved the way to finding a cure for the disease known in the 19th century as "The White Plague".
"You often see tuberculosis still referred to as an 'ancient' disease, but this study is further evidence that TB is a fully modern illness that is impacting people in new ways," said José Luis Castro, Interim Executive Director of The Union. "Unless we adapt our TB control strategies to respond to newly ascertained risks, such as smoking tobacco, the global rise in diabetes, and the overcrowding we see in cities as the world urbanises, we will always remain two steps behind the bacteria that cause this disease."
Dr Surya Kant, Professor and Head of Pulmonary Medicine department of KGMU said that he has noticed in his clinical experience spanning over two decades that smoking and tobacco use increases risk of TB. Tobacco control measures such as tobacco cessation clinics and anti-tobacco campaigns must complement TB control programmes. Effective control of diabetes is required for management of TB as diabetes increases TB risk 2-3 fold, said Dr Surya Kant. We have not done enough on diabetes and TB collaborative activities despite alarming incidence of diabetes in our population.
Vote For Health campaign coordinator Rahul Dwivedi said that tobacco cessation services should be integrated into existing healthcare services. WHO Director-General’s Awardee Professor (Dr) Rama Kant said that clinicians and other healthcare providers must include tobacco control in their daily medical practice, by taking tobacco history of every patient and counseling patient and relatives to quit tobacco use if required.
Tuberculosis is an infectious disease that is transmitted from person to person through the air, typically through coughing or sneezing. According to the World Health Organization, in 2012 an estimated 8.6 million people became sick with TB, and 1.3 million people died from TB or TB-related causes—more deaths than any other infectious disease except HIV/AIDS. Current treatment regimens require a patient to take several drugs for at least six months and up to two years or more for some drug-resistant cases.
Citizen News Service – CNS
March 2014
