Association between Smoking and Latent Tuberculosis in the U.S. Population An Analysis of the National Health and Nutrition Examination Survey 英文参考文献.docVIP

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Association between Smoking and Latent Tuberculosis in the U.S. Population An Analysis of the National Health and Nutrition Examination Survey 英文参考文献.doc

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Association between Smoking and Latent Tuberculosis in the U.S. Population An Analysis of the National Health and Nutrition Examination Survey 英文参考文献

AssociationbetweenSmokingandLatentTuberculosisin theU.S.Population:AnAnalysisoftheNationalHealth andNutritionExaminationSurvey DavidJHorne1*,MonicaCampo1,JustinROrtiz1,2,EyalOren3,4,MatthewArentz1,KristinaCrothers1., MasahiroNarita1,3,4. 1DivisionofPulmonaryandCriticalCareMedicine,DepartmentofMedicine,UniversityofWashington,Seattle,Washington,UnitedStatesofAmerica,2Departmentof GlobalHealth,UniversityofWashington,Seattle,Washington,UnitedStatesofAmerica,3PublicHealth-SeattleKingCounty,TBControlProgram,Seattle,Washington, UnitedStatesofAmerica,4DepartmentofEpidemiology,UniversityofWashington,Seattle,Washington,UnitedStatesofAmerica Abstract Background: Evidence of an association between cigarette smoking and latent tuberculosis infection (LTBI) is based on studiesinspecialpopulationsand/orfromhighprevalencesettings.WesoughttoevaluatetheassociationbetweenLTBI and smoking in a low prevalence TB setting using population-based data from the National Health and Nutrition ExaminationSurvey(NHANES). Methods:In1999–2000,NHANESassessedLTBI(definedasatuberculinskintestmeasurement$10mm)inparticipants, andthose$20yearsofagewerequeriedregardingtheirtobaccouseandserumcotininewasmeasured.Weevaluatedthe associationofLTBIwithself-reportedsmokinghistoryandsmokingintensityinmultivariablelogisticregressionmodelsthat adjustedforknownconfounders(gender,age,birthplace,race/ethnicity,poverty,education,historyofBCGvaccination,and historyofhouseholdexposuretotuberculosisdisease). Results:EstimatedLTBIprevalencewas5.3%amongthose$20yearsofage.TheLTBIprevalenceamongneversmokers, currentsmokers,andformersmokerswas4.1%,6.6%,and6.2%,respectively.Inamultivariablemodel,currentsmokingwas associated with LTBI (OR 1.8; 95% CI, 1.1–2.9). The association between smoking and LTBI was strongest for Mexican- Americanandblackindividuals.Inmultivariateanalysisstratifiedbyrace/ethnicity,cigarettepacksperdayamongMexican- Americansmokersandcotininelevelsamongblacksmokers,weresignificantlyassociatedwithLTBI. Concl