A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.

<h4>Background</h4>Aging increases the risk of tuberculosis (TB) and its adverse outcomes, but most studies are based on secondary analyses, and few are in Hispanics. Diabetes is a risk factor for TB in adults, but its contribution in the elderly is unknown. We aimed to identify the role...

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Autores principales:	Julia M Scordo, Génesis P Aguillón-Durán, Doris Ayala, Ana Paulina Quirino-Cerrillo, Eminé Rodríguez-Reyna, Francisco Mora-Guzmán, Jose A Caso, Eder Ledezma-Campos, Larry S Schlesinger, Jordi B Torrelles, Joanne Turner, Blanca I Restrepo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/03498bbd35c84731be4b317a9a08baf5
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spelling	oai:doaj.org-article:03498bbd35c84731be4b317a9a08baf52021-12-02T20:08:54ZA prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.1932-620310.1371/journal.pone.0255194https://doaj.org/article/03498bbd35c84731be4b317a9a08baf52021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255194https://doaj.org/toc/1932-6203<h4>Background</h4>Aging increases the risk of tuberculosis (TB) and its adverse outcomes, but most studies are based on secondary analyses, and few are in Hispanics. Diabetes is a risk factor for TB in adults, but its contribution in the elderly is unknown. We aimed to identify the role of diabetes and other risk factors for TB in elderly Hispanics.<h4>Methods</h4>Cross-sectional study among newly-diagnosed TB patients, recent contacts (ReC), or community controls (CoC) totaling 646 participants, including 183 elderly (>60 years; 43 TB, 80 ReC, 60 CoC) and 463 adults (18 to 50 years; 80 TB, 301 ReC and 82 CoC). Host characteristics associated with TB and latent Mycobacterium tuberculosis infection (LTBI) were identified in the elderly by univariable and confirmed by multivariable logistic regression.<h4>Results</h4>LTBI was more prevalent among the elderly CoC (55% vs. 23.2% in adults; p<0.001), but not in ReC (elderly 71.3% vs. adult 63.8%); p = 0.213). Risk factors for TB in the elderly included male sex (adj-OR 4.33, 95% CI 1.76, 10.65), smoking (adj-OR 2.55, 95% CI 1.01, 6.45) and low BMI (adj-OR 12.34, 95% CI 4.44, 34.33). Unexpectedly, type 2 diabetes was not associated with TB despite its high prevalence (adj-OR 0.38, 95% CI 0.06, 2.38), and BCG vaccination at birth was protective (adj-OR 0.16, 95% CI 0.06, 0.45).<h4>Conclusions</h4>We report novel distinctions in TB risk factors in the elderly vs. adults, notably in diabetes and BCG vaccination at birth. Further studies are warranted to address disparities in this vulnerable, understudied population.Julia M ScordoGénesis P Aguillón-DuránDoris AyalaAna Paulina Quirino-CerrilloEminé Rodríguez-ReynaFrancisco Mora-GuzmánJose A CasoEder Ledezma-CamposLarry S SchlesingerJordi B TorrellesJoanne TurnerBlanca I RestrepoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255194 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Julia M Scordo Génesis P Aguillón-Durán Doris Ayala Ana Paulina Quirino-Cerrillo Eminé Rodríguez-Reyna Francisco Mora-Guzmán Jose A Caso Eder Ledezma-Campos Larry S Schlesinger Jordi B Torrelles Joanne Turner Blanca I Restrepo A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
description	<h4>Background</h4>Aging increases the risk of tuberculosis (TB) and its adverse outcomes, but most studies are based on secondary analyses, and few are in Hispanics. Diabetes is a risk factor for TB in adults, but its contribution in the elderly is unknown. We aimed to identify the role of diabetes and other risk factors for TB in elderly Hispanics.<h4>Methods</h4>Cross-sectional study among newly-diagnosed TB patients, recent contacts (ReC), or community controls (CoC) totaling 646 participants, including 183 elderly (>60 years; 43 TB, 80 ReC, 60 CoC) and 463 adults (18 to 50 years; 80 TB, 301 ReC and 82 CoC). Host characteristics associated with TB and latent Mycobacterium tuberculosis infection (LTBI) were identified in the elderly by univariable and confirmed by multivariable logistic regression.<h4>Results</h4>LTBI was more prevalent among the elderly CoC (55% vs. 23.2% in adults; p<0.001), but not in ReC (elderly 71.3% vs. adult 63.8%); p = 0.213). Risk factors for TB in the elderly included male sex (adj-OR 4.33, 95% CI 1.76, 10.65), smoking (adj-OR 2.55, 95% CI 1.01, 6.45) and low BMI (adj-OR 12.34, 95% CI 4.44, 34.33). Unexpectedly, type 2 diabetes was not associated with TB despite its high prevalence (adj-OR 0.38, 95% CI 0.06, 2.38), and BCG vaccination at birth was protective (adj-OR 0.16, 95% CI 0.06, 0.45).<h4>Conclusions</h4>We report novel distinctions in TB risk factors in the elderly vs. adults, notably in diabetes and BCG vaccination at birth. Further studies are warranted to address disparities in this vulnerable, understudied population.
format	article
author	Julia M Scordo Génesis P Aguillón-Durán Doris Ayala Ana Paulina Quirino-Cerrillo Eminé Rodríguez-Reyna Francisco Mora-Guzmán Jose A Caso Eder Ledezma-Campos Larry S Schlesinger Jordi B Torrelles Joanne Turner Blanca I Restrepo
author_facet	Julia M Scordo Génesis P Aguillón-Durán Doris Ayala Ana Paulina Quirino-Cerrillo Eminé Rodríguez-Reyna Francisco Mora-Guzmán Jose A Caso Eder Ledezma-Campos Larry S Schlesinger Jordi B Torrelles Joanne Turner Blanca I Restrepo
author_sort	Julia M Scordo
title	A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
title_short	A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
title_full	A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
title_fullStr	A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
title_full_unstemmed	A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.
title_sort	prospective cross-sectional study of tuberculosis in elderly hispanics reveals that bcg vaccination at birth is protective whereas diabetes is not a risk factor.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/03498bbd35c84731be4b317a9a08baf5
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A prospective cross-sectional study of tuberculosis in elderly Hispanics reveals that BCG vaccination at birth is protective whereas diabetes is not a risk factor.

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