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

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. Methods: 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 | Pasipanodya et al. BMC Public Health 2012 12 119 http 1471-2458 12 119 BMC Public Health RESEARCH ARTICLE Open Access Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis 1 1 1 f ĩ 4 Jotam G Pasipanodya Edgar Vecino Thaddeus L Miller Guadalupe Munguia Gerry Drewyer Michel Fernandez1 4 Philip Slocum3 and Stephen E Weis1 4 Abstract Background 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. Methods 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. Results Pulmonary impairment after tuberculosis was identified in 71 of non-Hispanic Whites 58 of nonHispanic Blacks 49 of Asians and 32 of Hispanics p . 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 p . There was no association between race ethnicity and time to beginning TB treatment p . Conclusions 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

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