RESUMO
Tuberculosis (TB) and its co-morbid conditions have become a burden on global health economies. It is well understood that susceptibility of the host to TB infection/disease is influenced by both genetic and environmental factors and their interactions. The aims of this pilot case-control study are to characterize the sociodemographic and environmental factors related to active TB disease (TB/case) and latent TB infection (LTBI/control) status, and to identify risk factors associated with progression from LTBI to TB. We recruited 75 cases with TB (mean age=46.3y; females=41%) and 75 controls with LTBI (mean age=39.0y; females=37%), from the Mestizo population of Cuidad Juárez, Mexico. In addition to the determination of case/control status, information on environmental variables was collected (e.g., socioeconomic status, smoking, alcohol consumption, substance abuse, nutritional status, household demographics, medical histories and presence of type 2 diabetes [T2DM]). The data were analyzed to identify the environmental correlates of TB and LTBI using univariate and multivariate statistical approaches. Following multivariate logistic regression analysis, TB was associated with poor nutrition, T2DM, family history of TB, and non-Chihuahua state of birth. These preliminary findings have relevance to TB control at the Mexico-United States border, and contribute to our future genetic study of TB in Mexicans.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Emigração e Imigração/estatística & dados numéricos , Desnutrição/epidemiologia , Mycobacterium tuberculosis/isolamento & purificação , Fumar/epidemiologia , Tuberculose/epidemiologia , Adulto , Antituberculosos/uso terapêutico , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Progressão da Doença , Características da Família , Feminino , Predisposição Genética para Doença/epidemiologia , Humanos , Imunidade Inata , Tuberculose Latente/epidemiologia , Masculino , Desnutrição/complicações , México/epidemiologia , Projetos Piloto , Fatores de Risco , Fumar/efeitos adversos , Inquéritos e QuestionáriosRESUMO
In the United States, multidrug-resistant tuberculosis (MDR-TB) is more commonly seen among foreign-born patients. We report outcomes for 46 patients with MDR-TB who were born in Mexico and treated along the United States-Mexico border. According to our definition, 30 were cured, 3 showed treatment failure, 3 died, and 10 abandoned treatment. Multidrug-resistant tuberculosis can be successfully treated on an ambulatory basis.