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Pulmonary Tuberculosis and Delay in Anti-Tuberculous Treatment Are Important Risk Factors for Chronic Obstructive Pulmonary Disease

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  • Chih-Hsin Lee
  • Ming-Chia Lee
  • Hsien-Ho Lin
  • Chin-Chung Shu
  • Jann-Yuan Wang
  • Li-Na Lee
  • Kun-Mao Chao

Abstract

Objective: Tuberculosis (TB) remains the leading cause of death among infectious diseases worldwide. It has been suggested as an important risk factor of chronic obstructive pulmonary disease (COPD), which is also a major cause of morbidity and mortality. This study investigated the impact of pulmonary TB and anti-TB treatment on the risk of developing COPD. Design, Setting, and Participants: This cohort study used the National Health Insurance Database of Taiwan, particularly the Longitudinal Health Insurance Database 2005 to obtain 3,176 pulmonary TB cases and 15,880 control subjects matched in age, sex, and timing of entering the database. Main Outcome Measures: Hazard ratios of potential risk factors of COPD, especially pulmonary TB and anti-TB treatment. Results: The mean age of pulmonary TB cases was 51.9±19.2. The interval between the initial study date and commencement of anti-TB treatment (delay in anti-TB treatment) was 75.8±65.4 days. Independent risk factors for developing COPD were age, male, low income, and history of pulmonary TB (hazard ratio 2.054 [1.768–2.387]), while diabetes mellitus was protective. The impact of TB persisted for six years after TB diagnosis and was significant in women and subjects aged >70 years. Among TB patients, delay in anti-TB treatment had a dose-response relationship with the risk of developing COPD. Conclusions: Some cases of COPD may be preventable by controlling the TB epidemic, early TB diagnosis, and prompt initiation of appropriate anti-TB treatment. Follow-up care and early intervention for COPD may be necessary for treated TB patients.

Suggested Citation

  • Chih-Hsin Lee & Ming-Chia Lee & Hsien-Ho Lin & Chin-Chung Shu & Jann-Yuan Wang & Li-Na Lee & Kun-Mao Chao, 2012. "Pulmonary Tuberculosis and Delay in Anti-Tuberculous Treatment Are Important Risk Factors for Chronic Obstructive Pulmonary Disease," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-8, May.
  • Handle: RePEc:plo:pone00:0037978
    DOI: 10.1371/journal.pone.0037978
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    Cited by:

    1. Chun-Yu Lin & Tun-Chieh Chen & Po-Liang Lu & Chung-Chih Lai & Yi-Hsin Yang & Wei-Ru Lin & Pei-Ming Huang & Yen-Hsu Chen, 2013. "Effects of Gender and Age on Development of Concurrent Extrapulmonary Tuberculosis in Patients with Pulmonary Tuberculosis: A Population Based Study," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-9, May.
    2. Ta-Chien Chan & Hsuan-Wen Wang & Tzu-Jung Tseng & Po-Huang Chiang, 2015. "Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD)," IJERPH, MDPI, vol. 12(12), pages 1-12, December.

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