Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis

<p>Abstract</p> <p>Background</p> <p>Disparities in outcomes associated with race and ethnicity are well documented for many diseases and patient populations. Tuberculosis (TB) disproportionately affects economically disadvantaged, racial and ethnic minority populations...

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Main Authors: Pasipanodya Jotam G, Vecino Edgar, Miller Thaddeus L, Munguia Guadalupe, Drewyer Gerry, Fernandez Michel, Slocum Philip, Weis Stephen E
Format: Article
Language:English
Published: BMC 2012-02-01
Series:BMC Public Health
Online Access:http://www.biomedcentral.com/1471-2458/12/119
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spelling doaj-8b709f2359084297a0413bea276152062020-11-24T21:07:50ZengBMCBMC Public Health1471-24582012-02-0112111910.1186/1471-2458-12-119Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosisPasipanodya Jotam GVecino EdgarMiller Thaddeus LMunguia GuadalupeDrewyer GerryFernandez MichelSlocum PhilipWeis Stephen E<p>Abstract</p> <p>Background</p> <p>Disparities in outcomes associated with race and ethnicity are well documented for many diseases and patient populations. Tuberculosis (TB) disproportionately affects economically disadvantaged, racial and ethnic minority populations. Pulmonary impairment after tuberculosis (PIAT) contributes heavily to the societal burden of TB. Individual impacts associated with PIAT may vary by race/ethnicity or socioeconomic status.</p> <p>Methods</p> <p>We analyzed the pulmonary function of 320 prospectively identified patients with pulmonary tuberculosis who had completed at least 20 weeks standard anti-TB regimes by directly observed therapy. We compared frequency and severity of spirometry-defined PIAT in groups stratified by demographics, pulmonary risk factors, and race/ethnicity, and examined clinical correlates to pulmonary function deficits.</p> <p>Results</p> <p>Pulmonary impairment after tuberculosis was identified in 71% of non-Hispanic Whites, 58% of non-Hispanic Blacks, 49% of Asians and 32% of Hispanics (<it>p </it>< 0.001). Predictors for PIAT varied between race/ethnicity. PIAT was evenly distributed across all levels of socioeconomic status suggesting that PIAT and socioeconomic status are not related. PIAT and its severity were significantly associated with abnormal chest x-ray, <it>p </it>< 0.0001. There was no association between race/ethnicity and time to beginning TB treatment, <it>p </it>= 0.978.</p> <p>Conclusions</p> <p>Despite controlling for cigarette smoking, socioeconomic status and time to beginning TB treatment, non-Hispanic White race/ethnicity remained an independent predictor for disproportionately frequent and severe pulmonary impairment after tuberculosis relative to other race/ethnic groups. Since race/ethnicity was self reported and that race is not a biological construct: these findings must be interpreted with caution. However, because race/ethnicity is a proxy for several other unmeasured host, pathogen or environment factors that may contribute to disparate health outcomes, these results are meant to suggest hypotheses for further research.</p> http://www.biomedcentral.com/1471-2458/12/119
collection DOAJ
language English
format Article
sources DOAJ
author Pasipanodya Jotam G
Vecino Edgar
Miller Thaddeus L
Munguia Guadalupe
Drewyer Gerry
Fernandez Michel
Slocum Philip
Weis Stephen E
spellingShingle Pasipanodya Jotam G
Vecino Edgar
Miller Thaddeus L
Munguia Guadalupe
Drewyer Gerry
Fernandez Michel
Slocum Philip
Weis Stephen E
Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
BMC Public Health
author_facet Pasipanodya Jotam G
Vecino Edgar
Miller Thaddeus L
Munguia Guadalupe
Drewyer Gerry
Fernandez Michel
Slocum Philip
Weis Stephen E
author_sort Pasipanodya Jotam G
title Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
title_short Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
title_full Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
title_fullStr Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
title_full_unstemmed Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
title_sort non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2012-02-01
description <p>Abstract</p> <p>Background</p> <p>Disparities in outcomes associated with race and ethnicity are well documented for many diseases and patient populations. Tuberculosis (TB) disproportionately affects economically disadvantaged, racial and ethnic minority populations. Pulmonary impairment after tuberculosis (PIAT) contributes heavily to the societal burden of TB. Individual impacts associated with PIAT may vary by race/ethnicity or socioeconomic status.</p> <p>Methods</p> <p>We analyzed the pulmonary function of 320 prospectively identified patients with pulmonary tuberculosis who had completed at least 20 weeks standard anti-TB regimes by directly observed therapy. We compared frequency and severity of spirometry-defined PIAT in groups stratified by demographics, pulmonary risk factors, and race/ethnicity, and examined clinical correlates to pulmonary function deficits.</p> <p>Results</p> <p>Pulmonary impairment after tuberculosis was identified in 71% of non-Hispanic Whites, 58% of non-Hispanic Blacks, 49% of Asians and 32% of Hispanics (<it>p </it>< 0.001). Predictors for PIAT varied between race/ethnicity. PIAT was evenly distributed across all levels of socioeconomic status suggesting that PIAT and socioeconomic status are not related. PIAT and its severity were significantly associated with abnormal chest x-ray, <it>p </it>< 0.0001. There was no association between race/ethnicity and time to beginning TB treatment, <it>p </it>= 0.978.</p> <p>Conclusions</p> <p>Despite controlling for cigarette smoking, socioeconomic status and time to beginning TB treatment, non-Hispanic White race/ethnicity remained an independent predictor for disproportionately frequent and severe pulmonary impairment after tuberculosis relative to other race/ethnic groups. Since race/ethnicity was self reported and that race is not a biological construct: these findings must be interpreted with caution. However, because race/ethnicity is a proxy for several other unmeasured host, pathogen or environment factors that may contribute to disparate health outcomes, these results are meant to suggest hypotheses for further research.</p>
url http://www.biomedcentral.com/1471-2458/12/119
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