A META-ANALYSIS ON THE IMPACT OF HIV, MALNUTRITION, AND SMOKING ON THE RISK OF PULMONARY TUBERCULOSIS.

JPUMHS;2024:14:04,234-242. http://doi.org/10.46536/jpumhs/2024/14.04.583

Abstract

BACKGROUND: Pulmonary tuberculosis PTB remains a major global health challenge,
especially in low- and middle-income countries. There are many factors contributing to the
risk of developing PTB, among which HIV infection, malnutrition, and smoking catch the
most attention. It is pertinent to understand these factors' combined impact on PTB risk for
better prevention and intervention strategies. AIMS: The aim of this meta-analysis was to
evaluate the impact of HIV infection, malnutrition, and smoking on the risk of developing
pulmonary tuberculosis by synthesizing data from studies conducted globally. METHODS:
A systematic search was made on PubMed, Scopus, and Google Scholar's databases for
studies published from 2000 up to 2023. Studies assessing the relationship among HIV,
malnutrition, smoking, and incidence of PTB were included in the analysis. The effect sizes
were calculated, and odds ratios or relative risks were extracted and pooled using a random
effects model. The extent of heterogeneity was assessed using I2. RESULTS: A significant
association for an increase in developing pulmonary tuberculosis due to HIV infection,
malnutrition, and smoking were analysed. The maximum risk was observed in people
infected with HIV plus malnutrition; smoking was found to have moderate risk.
CONCLUSION: HIV, malnutrition, and smoking are major modifiable risk factors for
pulmonary tuberculosis that can be targeted for intervention in reducing the global burden of
PTB; targeted interventions can greatly reduce the incidence rates of PTB. Causes of these
conditions must be prioritized in public health strategies so as to reduce their burden on TB
incidence.