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Cannabis use and the risk of tuberculosis: a systematic review

BACKGROUND: Cannabis has been identified as a possible risk factor in some tuberculosis (TB) outbreaks. As the most widely used (largely) illegal substance in Western countries this may be an important public health concern. We aim to systematically review the evidence on the association between can...

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Autores principales: French, Clare E., Coope, Caroline M., McGuinness, Luke A., Beck, Charles R., Newitt, Sophie, Ahyow, Lauren, Hickman, Matt, Oliver, Isabel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660970/
https://www.ncbi.nlm.nih.gov/pubmed/31351454
http://dx.doi.org/10.1186/s12889-019-7127-0
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author French, Clare E.
Coope, Caroline M.
McGuinness, Luke A.
Beck, Charles R.
Newitt, Sophie
Ahyow, Lauren
Hickman, Matt
Oliver, Isabel
author_facet French, Clare E.
Coope, Caroline M.
McGuinness, Luke A.
Beck, Charles R.
Newitt, Sophie
Ahyow, Lauren
Hickman, Matt
Oliver, Isabel
author_sort French, Clare E.
collection PubMed
description BACKGROUND: Cannabis has been identified as a possible risk factor in some tuberculosis (TB) outbreaks. As the most widely used (largely) illegal substance in Western countries this may be an important public health concern. We aim to systematically review the evidence on the association between cannabis use and TB (latent infection and active disease) to inform ongoing and future TB prevention and control strategies. METHODS: We conducted a systematic review. We searched Ovid Medline, Embase and PsycInfo, together with the World Health Organization website and Google Scholar, for all years to January 2018. Reference lists and conference abstracts were hand-searched, a forward citation search was conducted on the Web of Science, and experts were contacted. Two authors independently screened studies for inclusion, extracted data and assessed risk of bias using an adapted version of ROBINS-I (“Risk of Bias in Non-randomised Studies – of Interventions”). Data were narratively synthesised. RESULTS: Of 377 records identified, 11 studies were eligible. Study designs were heterogeneous. Six studies utilised a relevant comparator group. Four of these investigated the association between cannabis use and latent TB infection; all provided some evidence of an association, although only two of these had adjusted for confounders. The remaining two comparator studies investigated the association between cannabis use and active TB disease; neither found evidence of an association after adjusting for confounding. All six studies were at “Serious” risk of bias. The five studies which did not utilise a relevant comparator group were all indicative of TB outbreaks occurring among cannabis users, but the quality of the evidence was very weak. CONCLUSIONS: Evidence for an association between cannabis use and TB acquisition is weak. The topic warrants further robust primary research including the collection of consistent and accurate exposure information, including cannabis use practices, dose and frequency, and adjustment for confounders. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-019-7127-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-66609702019-08-01 Cannabis use and the risk of tuberculosis: a systematic review French, Clare E. Coope, Caroline M. McGuinness, Luke A. Beck, Charles R. Newitt, Sophie Ahyow, Lauren Hickman, Matt Oliver, Isabel BMC Public Health Research Article BACKGROUND: Cannabis has been identified as a possible risk factor in some tuberculosis (TB) outbreaks. As the most widely used (largely) illegal substance in Western countries this may be an important public health concern. We aim to systematically review the evidence on the association between cannabis use and TB (latent infection and active disease) to inform ongoing and future TB prevention and control strategies. METHODS: We conducted a systematic review. We searched Ovid Medline, Embase and PsycInfo, together with the World Health Organization website and Google Scholar, for all years to January 2018. Reference lists and conference abstracts were hand-searched, a forward citation search was conducted on the Web of Science, and experts were contacted. Two authors independently screened studies for inclusion, extracted data and assessed risk of bias using an adapted version of ROBINS-I (“Risk of Bias in Non-randomised Studies – of Interventions”). Data were narratively synthesised. RESULTS: Of 377 records identified, 11 studies were eligible. Study designs were heterogeneous. Six studies utilised a relevant comparator group. Four of these investigated the association between cannabis use and latent TB infection; all provided some evidence of an association, although only two of these had adjusted for confounders. The remaining two comparator studies investigated the association between cannabis use and active TB disease; neither found evidence of an association after adjusting for confounding. All six studies were at “Serious” risk of bias. The five studies which did not utilise a relevant comparator group were all indicative of TB outbreaks occurring among cannabis users, but the quality of the evidence was very weak. CONCLUSIONS: Evidence for an association between cannabis use and TB acquisition is weak. The topic warrants further robust primary research including the collection of consistent and accurate exposure information, including cannabis use practices, dose and frequency, and adjustment for confounders. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-019-7127-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-27 /pmc/articles/PMC6660970/ /pubmed/31351454 http://dx.doi.org/10.1186/s12889-019-7127-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
French, Clare E.
Coope, Caroline M.
McGuinness, Luke A.
Beck, Charles R.
Newitt, Sophie
Ahyow, Lauren
Hickman, Matt
Oliver, Isabel
Cannabis use and the risk of tuberculosis: a systematic review
title Cannabis use and the risk of tuberculosis: a systematic review
title_full Cannabis use and the risk of tuberculosis: a systematic review
title_fullStr Cannabis use and the risk of tuberculosis: a systematic review
title_full_unstemmed Cannabis use and the risk of tuberculosis: a systematic review
title_short Cannabis use and the risk of tuberculosis: a systematic review
title_sort cannabis use and the risk of tuberculosis: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660970/
https://www.ncbi.nlm.nih.gov/pubmed/31351454
http://dx.doi.org/10.1186/s12889-019-7127-0
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