Micronutrient Biomarkers of Nutrition Status Influence the Risk of TB in US Men and Women: NHANES I Epidemiologic Follow-up Study 公开
Srichandra, Farah (2011)
Published
Abstract
Abstract
Micronutrient biomarkers of Nutrition Status Influence the Risk of
TB in US Men
and Women: NHANES I Epidemiologic Follow-up Study
By Farah Srichandra
Background: One third of the world's population is thought
to be infected with
tuberculosis (TB), and new infections occur at a rate of about one
per second. The
proportion of people who become sick with TB each year is stable or
falling in different
regions of the world, but, because of population growth, the
absolute number of new
cases is still increasing. Undernutrition is an important risk
factor for TB, but, primarily,
studies have been conducted on anthropometric measures for
nutritional status and few
studies have used biomarkers for nutritional status.
Objective: This research analyzes the risk of developing TB
in relation to micronutrient
biomarkers of nutritional status. Our specific interest is whether
micronutrient biomarkers
of nutritional status at baseline are related to the incidence of
TB during the follow-up of
10 to 20 years.
Methods: In the NHANES-1 epidemiological follow-up study,a
nationally representative
data set of 14,407 adults who were followed up on 3 to 4 occasions
over a period of 10 to
20 years. Secondary data analysis was carried out using SAS
statistical software, to
examine the relationship between deficiencies in hemoglobin,
albumin, vitamins A,
iron and the incidence of TB. The primary dependent variable is
incidence of TB during the follow - up period.
Results: Anemia and low serum albumin are independent risk
factors for physician
diagnosed TB, and it's magnitude of effect is 3.02 (1.44, 6.34) 95%
CI.As a result, the chances of
developing TB increase by 3-fold for persons who are anemic.
Vitamin A was not associated with physician diagnosed TB.
Discussion: The longitudinal cohort study provides data on a
large national sample, it presents a unique opportunity for health
researchers to study changes in health status and the factors that
contribute to good health as well as illness. This study provides
implications to address the importance of micronutrient biomarkers
as a way to combat TB globally.
Table of Contents
Table of Contents
I. Introduction
...............................................................................................................................
1
Title
.............................................................................................................................................
1
II. Specific Aims
............................................................................................................................
3
III.Literature Review
....................................................................................................................
3
A. Epidemiology of Tuberculosis
...................................................................................................
3
B. Recent Studies on TB
.................................................................................................................
5
IV. Subjects and Methods
............................................................................................................
6
A.The first National Health and Nutrition Examination Survey
(NHANES-1) ............................. 6
B. The NHANES-1 Epidemiological Follow-up Study (NHEFS)
................................................. 7
C. The present analytic data set
......................................................................................................
8
1. Inclusion/exclusion criteria
.....................................................................................................
8
2. Exposure Variables
.................................................................................................................
9
3. Outcome Variable
...................................................................................................................
9
4. Follow-up time
......................................................................................................................
11
5. Covariates
.............................................................................................................................
12
D. Analysis
....................................................................................................................................
12
V. Results
.....................................................................................................................................
15
A. Description of the Study Sample
.............................................................................................
15
B. Bivariate Analysis
....................................................................................................................
16
C. Logistic Regression and Modeling
...........................................................................................
17
VI. Discussion
..............................................................................................................................
17
A. Limitations
...............................................................................................................................
18
B. Strengths
...................................................................................................................................
19
C. Future Research
........................................................................................................................
20
D. Importance for Public Health
...................................................................................................
21
VII. Literature Cited
..................................................................................................................
22
Appendix A - Tables
...................................................................................................................
24
About this Master's Thesis
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