Abstract
BACKGROUND: Tuberculosis infection being one of the major risk factor for morbidity and mortality in developing countries according to WHO and CDC. The risk of developing TB increases significantly with the drop of immunity.Using steroid (prednisolone or its equivalent) at a dose of more than 15 mg/day more than 4 weeks is associated with significant drop in immunity, hence increasing the risks of being infected with TB to eight folds AIM OF THE STUDY: To assess the risk of developing TB infection in asthmatic patients that use steroid in their asthma treatment regime.MATERIALS & METHODS: A prospective study designed to include patients complaining from Asthma who have visited Baghdad teaching hospital in the period from (June 2016 to June 2017) that included in-patients and out-patients.A questionnaire prepared to document the related information of most concern to the researcher and for the sake of study. RESULTS: In this study, we managed to enroll 60 patients. Male to female ratio was 7:23. 80% of the study cohort lived in urban residence and 20 % in suburban neighborhood. 33.3% of the patients had diabetes as comorbidity. 21.7 % of the patients used inhaled steroid as a modality of management of asthma, while 45% used systemic steroids, and 33.3 % used combined modality. Of the study cohort, 18.3 % used steroid for no more than 4 weeks, and the rest used it for more than 4 weeks. Regarding tuberculin test results, 11.7 % test positive.A significant correlations were found between the tuberculin test and the increasing age of the patient p=0.01, and the duration of use of steroids p=0.001, also, between TST and previous history of TB p=0.04.CONCLUSION: There is no relationship between the type of steroid and the risk of getting TB infection.The risk of steroid on immune system and the raise of risk increase with increasing subject age. The extended period of exposure to steroid will definitely increase the risk of TB infection.
Highlights
Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role, including mast cells, eosinophil's, T lymphocytes macrophages, neutrophils, and epithelial cells
A significant correlations were found between the tuberculin test and the increasing age of the patient p=0.01, and the duration of use of steroids p=0.001, between test with tuberculin-PPD (TST) and previous history of Tuberculosis Bacillus infection (TB) p=0.04
There is no relationship between the type of steroid and the risk of getting TB infection
Summary
Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role, including mast cells, eosinophil's, T lymphocytes macrophages, neutrophils, and epithelial cells. 1.1 Role and Types of Steroids in the Management of Asthma. With recognition of the central role of inflammation in the pathophysiology of asthma, contemporary treatment gjhs.ccsenet.org. Airway inflammatory cell influx and markers of airway inflammation in asthma are reduced by corticosteroid administration (Van Rensen, 1999; Olivieri, 1997). Systemic corticosteroids have been used in the treatment of asthma since the 1940s and continue to be a cornerstone of the management of acute exacerbations. The use of ICSs improves all aspects of asthma control; ICSs reduce asthmatic symptoms, improve lung function decrease airway inflammation, and control AHR (Juniper, 1990; The Childhood Asthma Management Program, 2000). Using steroid (prednisolone or its equivalent) at a dose of more than 15 mg/day more than 4 weeks is associated with significant drop in immunity, increasing the risks of being infected with TB to eight folds
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