Smoking and pulmonary tuberculosis treatment failure: a case-control study

J Bras Pneumol. 2019 Apr 25;45(2):e20180359. doi: 10.1590/1806-3713/e20180359.
[Article in English, Spanish]

Abstract

Objective: To determine the association between smoking and pulmonary tuberculosis treatment failure.

Methods: This was a case-control study conducted at the Brazilian Institute for Tuberculosis Research in the city of Salvador, Brazil, between 2007 and 2015. We evaluated 284 patients treated for pulmonary tuberculosis, comparing 50 cases of treatment failure with 234 control cases in which the final outcome was cure.

Results: Treatment failure was attributed to smoking and age rather than to gender, income, level of education, alcohol consumption, or marital status. Therefore, even after adjustment for age, the risk of treatment failure was 2.1 times (95% CI: 1.1-4.1) higher among the patients with a history of smoking. In addition, being over 50 years of age was found to increase the likelihood of treatment failure by 2.8 times (95% CI: 1.4-6.0).

Conclusions: Smoking and aging are both associated with pulmonary tuberculosis treatment failure. Therefore, as part of a tuberculosis control program, health personnel should be prepared to offer strategies to promote smoking cessation and should be more careful with older patients.

Objetivo:: Determinar la asociación entre el tabaquismo y el fracaso del tratamiento de la tuberculosis pulmonar.

Metodología:: Este es un estudio caso - control, realizado en el Instituto Brasilero para la Investigación de la Tuberculosis en Salvador, Brasil entre 2007 y 2015. Se compararon 50 casos de fracaso en el tratamiento con 234 controles de pacientes con diagnóstico de tuberculosis pulmonar y con resultado final de cura.

Resultados:: Se atribuyó el fracaso del tratamiento al tabaquismo y a la edad, y no al sexo, salario, escolaridad, consumo de alcohol o estado civil. Así, aun después del ajuste por edad, los pacientes con antecedentes de tabaquismo tienen 2,1 (IC95% 1,1-4,1) veces más chance de fracaso en el tratamiento de la tuberculosis. Además, tener una edad mayor de 50 años mostró que la posibilidad de fracaso aumenta 2,8 (IC95% 1,4-6,0) veces más.

Conclusiones:: El tabaquismo está relacionado con el fracaso del tratamiento de la tuberculosis pulmonar, así como también el envejecimiento. Por tal motivo, como parte del control de la tuberculosis, el personal de salud debe estar preparado para ofrecer estrategias que promuevan la cesación tabáquica y tener un mayor cuidado con pacientes de grupos etarios superiores.

MeSH terms

  • Adult
  • Age Factors
  • Alcohol Drinking / adverse effects
  • Brazil
  • Case-Control Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects*
  • Socioeconomic Factors
  • Treatment Failure
  • Tuberculosis, Pulmonary / therapy*