Tobacco smoking clusters in households affected by tuberculosis in an individual participant data meta-analysis of national tuberculosis prevalence surveys : time for household-wide interventions?
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Public Library of Science
Abstract
Tuberculosis (TB) and non-communicable diseases (NCD) share predisposing risk factors. TB-associated NCD might cluster within households affected with TB requiring shared prevention and care strategies. We conducted an individual participant data meta-analysis of national TB prevalence surveys to determine whether NCD cluster in members of households with TB. We identified eligible surveys that reported at least one NCD or NCD risk factor through the archive maintained by the World Health Organization and searching in Medline and Embase from 1 January 2000 to 10 August 2021, which was updated on 23 March 2023. We compared the prevalence of NCD and their risk factors between people who do not have TB living in households with at least one person with TB (members of households with TB), and members of households without TB. We included 16 surveys (n = 740,815) from Asia and Africa. In a multivariable model adjusted for age and gender, the odds of smoking was higher among members of households with TB (adjusted odds ratio (aOR) 1.23; 95% CI: 1.11–1.38), compared with members of households without TB. The analysis did not find a significant difference in the prevalence of alcohol drinking, diabetes, hypertension, or BMI between members of households with and without TB. Studies evaluating household-wide interventions for smoking to reduce its dual impact on TB and NCD may be warranted. Systematically screening for NCD using objective diagnostic methods is needed to understand the actual burden of NCD and inform comprehensive interventions.
Description
SUPPORTING INFORMATION :
CHECKLIST S1. PRISMA-IPD checklist of items to include when reporting a systematic review and meta-analysis of individual participant data (IPD).
APPENDIX S1. Search strategy.
APPENDIX S2. Supplementary methods.
TABLE S1. List of variables requested.
TABLE S2. Categorisations of current alcohol drinking by surveys.
TABLE S3. Characteristics of participants by survey.
TABLE S4. Quality of individual surveys.
TABLE S5. Association between NCD or their risk factors in people with TB and those in members of households with TB, adjusted for age and gender of TB patients and household members.
TABLE S6. Sensitivity analysis- the association between any alcohol drinking and TB status.
TABLE S7. Sensitivity analysis- prevalence of NCD/NCD risk factors in members of households with TB compared to those without TB.
TABLE S8. Sensitivity analysis- association between NCD or their risk factors in people with TB and those in members of households with TB, adjusted for age and gender of TB patients.
TABLE S9. Sensitivity analysis- association between NCD or their risk factors in people with TB and those in members of households with TB, adjusted for age and gender of TB patients and household members.
FIGURE S1. Results of the updated literature search.
FIGURE S2. Proportion of missing data by variable and survey.
FIGURE S3. Current smoking in members of households with TB compared to those without TB.
FIGURE S4. Current smoking in members of households with TB compared to those without TB, by region.
FIGURE S5. Alcohol drinking twice per week or more in members of households with TB compared to those without TB.
FIGURE S6. Diabetes in members of households with TB compared to those without TB.
FIGURE S7. Hypertension in members of households with TB compared to those without TB.
FIGURE S8. BMI in members of households with TB compared to those without TB.
FIGURE S9. Association between current smoking of people with TB and the same in their household members.
FIGURE S10. Association between alcohol drinking of people with TB and the same in their household members.
FIGURE S11. Association between diabetes of people with TB and the same in their household members.
FIGURE S12. Association between hypertension of people with TB and the same in their household members.
FIGURE S13. Association between BMI of people with TB and the same in their household members.
FIGURE S14. Sensitivity analysis-impact of misclassification of diabetes on its association with members of households with TB.
FIGURE S15. Sensitivity analysis-impact of misclassification of hypertension on its association with members of households with TB.
DATA AVAILABILITY STATEMENT : The IPD database is housed in the UCL Data Repository. The IPD from prevalence surveys that were utilized in our study falls under a specific data sharing agreement established with the original investigators. According to this agreement, these data are not to be distributed or made publicly available without explicit permission from these investigators. Requests to access the dataset can be addressed to igh.tb-ipd@ucl.ac.uk. The data will be shared upon approval from the authors of the original studies.
DATA AVAILABILITY STATEMENT : The IPD database is housed in the UCL Data Repository. The IPD from prevalence surveys that were utilized in our study falls under a specific data sharing agreement established with the original investigators. According to this agreement, these data are not to be distributed or made publicly available without explicit permission from these investigators. Requests to access the dataset can be addressed to igh.tb-ipd@ucl.ac.uk. The data will be shared upon approval from the authors of the original studies.
Keywords
Tuberculosis (TB), Non-communicable diseases (NCD), Risk factors, Households
Sustainable Development Goals
SDG-03: Good health and well-being
Citation
Hamada, Y., Quartagno, M., Law, I., Malik, F., Bonsu, F.A., Adetifa, I.M.O., et al. (2024) Tobacco smoking clusters in households affected by tuberculosis in an individual participant data meta-analysis of national tuberculosis prevalence surveys: Time for household-wide interventions? PLOS Global Public Health 4(2): e0002596. https:// doi.org/10.1371/journal.pgph.0002596.