Is cannabis use a risk factor for tuberculosis acquisition? A systematic review
PHE ePoster Library. French C. Apr 9, 2019; 257476; 15308
Dr. Clare French
Dr. Clare French
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Abstract Background:
Cannabis has been identified as a possible risk factor for TB in an ongoing outbreak in England. Since cannabis is the most widely used (largely) illegal substance in Western countries this may be an important public health concern. We aimed to review the evidence on the possible association between cannabis use and TB acquisition.
We searched Ovid Medline, Embase, PsycInfo, World Health Organization website and Google Scholar, all years up to January 2018. Reference lists and conference abstracts were hand-searched. 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..
Of 377 records identified, 11 studies were eligible. Seven utilised a comparator group. Five of these provided weak evidence of an association between cannabis use and TB acquisition (only two of which adjusted for confounding); the remaining two studies provided no evidence of an association after adjusting for confounding. Risk of bias was “Serious” in all seven studies. The four studies which did not utilise a relevant comparator group provided very weak evidence of a link between cannabis use and TB. ConclusionsThe evidence-base on the association between cannabis use and TB acquisition needs to be strengthened in order to better inform TB prevention and control strategies. The introduction of universal minimum standards for the reporting of infectious disease outbreaks could help improve the utility of outbreak reports. It is vital that future studies on the topic address, where possible, key sources of bias such as confounding. Funding The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol in partnership with Public Health England (PHE).
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