Bovine ownership and reduced pulmonary tuberculosis risk in Nepal: A case-control study.
Bovine ownership and reduced pulmonary tuberculosis risk in Nepal: A case-control study.
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尼泊尔的牛所有权和降低肺结核风险：一项病例对照研究。
DOI：
10.1111/zph.12854
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发表时间：
2021
影响因子：
2.4
通讯作者：
Verma,SharatC
中科院分区：
文献类型：
--
作者：
Bates,MichaelN;Pope,Karl;Sijali,TulaR;Albers,AutumnE;Verma,SharatC
这项病例对照研究试图确认和更深入地调查以前发现的牛(牛和水牛)所有权与降低人类肺结核(PTB)和潜在结核病感染(LTBI)风险的保护性关联。这项研究从尼泊尔卡斯基区的一个诊断中心和一个频率匹配的社区控制组招募了男性和女性肺结核病例。对对照进行LTBI状态测试，并根据LTBI状态进行单独的嵌套病例对照研究。收集了关于参与者家庭动物拥有情况的数据。采用Logistic回归分析，研究动物所有权与肺结核和下丘脑损伤的关系。数据来自570例肺结核患者和1224名对照组，后者提供了396名LTBI阳性和692名LTBI阴性受试者。结果提供了证据，表明拥有牛的肺结核和LTBI阳性的几率都降低了。最有力的证据是预防感染，而不是激活对肺结核的感染。影响最大的是女性，她们通常在尼泊尔管理动物，而且与养牛的数量存在暴露-反应关系。结果表明，接触牛对LTBI和肺结核具有保护作用。一种可能的机制包括增强卡介苗(卡介苗)接种的效果，特别是在预防结核感染方面。需要通过更广泛的数据收集进行更多的研究，以证实观察到的关联。
This case–control study sought to confirm and investigate in more depth protective associations previously found of bovine (cattle and water buffalo) ownership with reduced risk of both pulmonary tuberculosis (PTB) and latent tuberculosis infection (LTBI) in humans. The study recruited male and female PTB cases from a diagnostic centre and a frequency‐matched community‐based control group in Kaski District, Nepal. Controls were tested for LTBI status and a separate nested case–control study was conducted based on LTBI status. Data were collected on participant household animal ownership. Using logistic regression, animal ownership was investigated for associations with both PTB and LTBI. Data were obtained from 570 PTB cases and 1,224 controls, the latter group providing 396 LTBI‐positive and 692 LTBI‐negative subjects. Results provided evidence of decreased odds of both PTB and LTBI positivity associated with owning bovines. The evidence was strongest for protection against infection, rather than activation of infection to PTB. Effects were strongest in women, who usually manage the animals in Nepal, and there were exposure‐response relationships with numbers of bovines owned. Results suggest that exposure to bovines is protective against LTBI and PTB. A possible mechanism involves boosting the effect of BCG (Bacillus Calmette‐Guerin) vaccination, particularly in protecting against tuberculous infection. Additional studies with more extensive data collection are needed to confirm the observed associations.