Francesco Di Gennaro1, Damiano Pizzol2, Bonifacio Cebola3, Brendon Stubbs4, Laura Monno1, Annalisa Saracino1, Claudio Luchini5, Marco Solmi6, Giulia Segafredo7, Giovanni Putoto7, Nicola Veronese8. 1. Clinic of Infectious Diseases, University of Bari, Bari, Italy. 2. Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique. Electronic address: d.pizzol@cuamm.org. 3. Scientific Direction, Central Hospital of Beira, Mozambique. 4. Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; South London and Maudsley NHS Foundation Trust, UK. 5. Department of Pathology and Diagnostics, Verona University and Hospital Trust, Verona, Italy; Azienda Provinciale per i Servizi Sanitari (APSS) Trento, Trento, Italy. 6. Department of Neurosciences, University of Padova, Italy; Local Health Unit (ULSS) 17, Mental Health Department, Monselice, Padova, Italy; Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy. 7. Operational Research Unit, Doctors with Africa Cuamm, Padova, Italy. 8. Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy; Department of Medicine (DIMED)-Geriatrics Section, University of Padova, Italy.
Abstract
BACKGROUND: Social determinants influence health and the development of tuberculosis (TB). However, a paucity of data is available considering the relationship of social determinants influencing therapy failure and multi drug resistance (MDR). We conducted a review investigating the relationship of common social determinants on therapy failure and MDR in people with TB. METHODS: PubMed and SCOPUS were searched without language restrictions until February 02, 2016 for studies reporting the association between socioeconomic factors (income, education and alcohol abuse) and therapy failure or MDR-TB. The association between social determinants and outcomes was explored by pooling data with a random effects model and calculating crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs). RESULTS: Fifty studies with 407,555 participants with TB were included. Analysis demonstrated that low income (unadjusted OR = 2.00 (95% CI: 1.69-2.38; I2 = 88%; 33 studies, adjusted OR 1.77, p < 0.0001), low education (unadjusted OR 2.11, 95% CI 1.55-2.86, 26 studies, adjusted OR 1.69, p < 0.0001) and alcohol abuse (unadjusted OR = 2.43 (95% CI: 1.56-3.80, 16 studies, adjusted OR 2.13, p < 0.0001) were associated with therapy failure. Similarly, low income (unadjusted OR = 1.67; 95% CI: 1.12-2.41, p = 0.006; 14 studies, adjusted OR 2.16, p < 0.0001) and alcohol abuse (unadjusted OR = 1.88; 95% CI: 1.18-3.00, 7 studies, adjusted OR 1.43, p = 0.06) were associated with MDR-TB. Increasing age of the population was able to explain a consistent part of the heterogeneity found.
BACKGROUND: Social determinants influence health and the development of tuberculosis (TB). However, a paucity of data is available considering the relationship of social determinants influencing therapy failure and multi drug resistance (MDR). We conducted a review investigating the relationship of common social determinants on therapy failure and MDR in people with TB. METHODS: PubMed and SCOPUS were searched without language restrictions until February 02, 2016 for studies reporting the association between socioeconomic factors (income, education and alcohol abuse) and therapy failure or MDR-TB. The association between social determinants and outcomes was explored by pooling data with a random effects model and calculating crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs). RESULTS: Fifty studies with 407,555 participants with TB were included. Analysis demonstrated that low income (unadjusted OR = 2.00 (95% CI: 1.69-2.38; I2 = 88%; 33 studies, adjusted OR 1.77, p < 0.0001), low education (unadjusted OR 2.11, 95% CI 1.55-2.86, 26 studies, adjusted OR 1.69, p < 0.0001) and alcohol abuse (unadjusted OR = 2.43 (95% CI: 1.56-3.80, 16 studies, adjusted OR 2.13, p < 0.0001) were associated with therapy failure. Similarly, low income (unadjusted OR = 1.67; 95% CI: 1.12-2.41, p = 0.006; 14 studies, adjusted OR 2.16, p < 0.0001) and alcohol abuse (unadjusted OR = 1.88; 95% CI: 1.18-3.00, 7 studies, adjusted OR 1.43, p = 0.06) were associated with MDR-TB. Increasing age of the population was able to explain a consistent part of the heterogeneity found.
Authors: A Jiamsakul; M-P Lee; K V Nguyen; T P Merati; D D Cuong; R Ditangco; E Yunihastuti; S Ponnampalavanar; F Zhang; S Kiertiburanakul; A Avihingasanon; O T Ng; B L H Sim; W-W Wong; J Ross; M Law Journal: Int J Tuberc Lung Dis Date: 2018-02-01 Impact factor: 2.373
Authors: Damiano Pizzol; Nicola Veronese; Claudia Marotta; Francesco Di Gennaro; Jorge Moiane; Kajal Chhaganlal; Laura Monno; Giovanni Putoto; Walter Mazzucco; Annalisa Saracino Journal: BMC Res Notes Date: 2018-02-05
Authors: Claudia Marotta; Francesco Di Gennaro; Damiano Pizzol; Geoffrey Madeira; Laura Monno; Annalisa Saracino; Giovanni Putoto; Alessandra Casuccio; Walter Mazzucco Journal: Int J Environ Res Public Health Date: 2018-06-27 Impact factor: 3.390
Authors: Damiano Pizzol; Francesco Di Gennaro; Kajal D Chhaganlal; Claudia Fabrizio; Laura Monno; Giovanni Putoto; Annalisa Saracino Journal: Afr Health Sci Date: 2017-09 Impact factor: 0.927