{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:03:28Z","timestamp":1791263008899,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Introduction: There are several risk factors attributed to tuberculosis (TB) mortality and morbidity. There are few studies and systematic reviews showing the association of silicosis and tuberculosis at a country level. Very limited studies have been conducted using multi-country data in studying the association of incidence of silicosis with TB mortality and morbidity. Hence, the aim of this research was to explore the association of incidence of silicosis and other important risk factors with TB mortality and morbidity using multi-country data. Methods: Data from 217 WHO region countries were utilized, sourcing TB-related statistics from the Institute of Health Metrics and Evaluation and additional risk factors from the Demographic and Health Survey, Global Burden of Disease, and World Bank for 2019. Regression analysis was conducted to examine the association between silicosis incidence and TB outcomes. Results: The study found an average silicosis incidence of 121.92 per 100,000 population. Additionally, 62.69% of the sample population are exposed to air pollution from solid fuel cooking. Sanitation access stands at an average of 59.67%. Regression outcomes indicate that while alcohol consumption\u2019s influence on TB is not statistically significant, a unit increase in silicosis incidence significantly elevates TB deaths (235.9, p = 0.005), YLL (9399.3, p = 0.011), and YLD (910.8, p = 0.002). Conclusion: The burden of silicosis is found to be one of the important determinants of deaths, YLL, and YLD due to tuberculosis. Country-specific strategies to prevent and control silicosis is a need of the hour.<\/jats:p>","DOI":"10.3390\/medsci11040063","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:28:08Z","timestamp":1696220888000},"page":"63","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exploring the Impact of Silicosis Incidence on Tuberculosis Mortality and Morbidity: A Multi-Country Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7486-1677","authenticated-orcid":false,"given":"Muayad","family":"Albadrani","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Taibah University, Al-Madinah al-Munawwarah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2019). Global Tuberculosis Report 2019, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/329368\/9789241565714-eng.pdf."},{"key":"ref_2","unstructured":"World Health Organization (2021). Global Tuberculosis Report 2021, World Health Organization."},{"key":"ref_3","unstructured":"GBD 2017 DALYs and HALE Collaborators (2018). Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1859\u20131922."},{"key":"ref_4","unstructured":"GBD Tuberculosis Collaborators (2018). Global, regional, and national burden of tuberculosis, 1990\u20132016: Results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect. Dis., 18, 1329\u20131349."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e1679","DOI":"10.1016\/S2214-109X(21)00367-3","article-title":"Lifetime burden of disease due to incident tuberculosis: A global reappraisal including post-tuberculosis sequelae","volume":"9","author":"Menzies","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Alene, K.A., Wangdi, K., and Clements, A.C. (2020). Impact of the COVID-19 pandemic on tuberculosis control: An overview. Trop. Med. Infect. Dis., 5.","DOI":"10.3390\/tropicalmed5030123"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2001718","DOI":"10.1183\/13993003.01718-2020","article-title":"The potential impact of COVID-19-related disruption on tuberculosis burden","volume":"56","author":"McQuaid","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1177\/15648265100314S404","article-title":"Addressing tuberculosis in the context of malnutrition and HIV coinfection","volume":"31","author":"Semba","year":"2010","journal-title":"Food Nutr. Bull."},{"key":"ref_9","first-page":"377","article-title":"Clinical profile of HIV in India","volume":"121","author":"Kumarasamy","year":"2005","journal-title":"Indian J. Med Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"828939","DOI":"10.1155\/2013\/828939","article-title":"Risk factors for tuberculosis","volume":"2013","author":"Narasimhan","year":"2013","journal-title":"Pulm. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dhanaraj, B., Papanna, M.K., Adinarayanan, S., Vedachalam, C., Sundaram, V., Shanmugam, S., Sekar, G., Menon, P.A., Wares, F., and Swaminathan, S. (2015). Prevalence and risk factors for adult pulmonary tuberculosis in a metropolitan city of south India. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0124260"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.ijtb.2016.08.007","article-title":"Tuberculosis prevalence and socio-economic differentials in the slums of four metropolitan cities of India","volume":"63","author":"Marimuthu","year":"2016","journal-title":"Indian J. Tuberc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1093\/trstmh\/try052","article-title":"A comparative study of the socioeconomic risk factors for pulmonary tuberculosis in the Saharia tribe of Madhya Pradesh, India","volume":"112","author":"Rao","year":"2018","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_14","unstructured":"(2007). WHO and the Global Occupational Health Network. Elimin. Silicosis, 12, 1\u201318. Available online: https:\/\/www.who.int\/occupational_health\/publications\/newsletter\/gohnet12e.pdf?ua=1."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1093\/aje\/kwr159","article-title":"Silicosis Mortality with Respiratory Tuberculosis in the United States, 1968\u20132006","volume":"174","author":"Nasrullah","year":"2011","journal-title":"Am. J. Epidemiol."},{"key":"ref_16","unstructured":"World Health Organization (2021, December 16). The Top 10 Causes of Death 2020. Available online: https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/the-top-10-causes-of-death."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ehrlich, R., Akugizibwe, P., Siegfried, N., and Rees, D. (2021). The association between silica exposure, silicosis and tuberculosis: A systematic review and meta-analysis. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10711-1"},{"key":"ref_18","unstructured":"(2000). Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Morb. Mortal. Wkly. Rep., 49, 1\u201351."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1136\/oem.60.2.122","article-title":"Occupational silica exposure and risk of various diseases: An analysis using death certificates from 27 states of the United States","volume":"60","author":"Calvert","year":"2003","journal-title":"Occup. Environ. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1179\/oeh.1997.3.3.163","article-title":"Tuberculosis mortality and silica exposure: A case\u2013control study based on a national mortality database for the years 1983\u20131992","volume":"3","author":"Chen","year":"1997","journal-title":"Int. J. Occup. Environ. Health"},{"key":"ref_21","unstructured":"World Health Organization (2021, December 17). Household Air Pollution and Health. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/household-air-pollution-and-health."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Singh, S.K., Kashyap, G.C., and Puri, P. (2018). Potential effect of household environment on prevalence of tuberculosis in India: Evidence from the recent round of a cross-sectional survey. BMC Pulm. Med., 18.","DOI":"10.1186\/s12890-018-0627-3"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Feleke, B.E., Feleke, T.E., and Biadglegne, F. (2019). Nutritional status of tuberculosis patients, a comparative cross-sectional study. BMC Pulm. Med., 19.","DOI":"10.1186\/s12890-019-0953-0"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pathak, D., Vasishtha, G., and Mohanty, S.K. (2021). Association of multidimensional poverty and tuberculosis in India. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-12149-x"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"281","DOI":"10.15585\/mmwr.mm6911a2","article-title":"Global Epidemiology of Tuberculosis and Progress Toward Meeting Global Targets\u2014Worldwide, 2018","volume":"69","author":"MacNeil","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_26","unstructured":"World Health Organization (2021, December 16). Available online: https:\/\/www.who.int\/news\/item\/14-10-2021-tuberculosis-deaths-rise-for-the-first-time-in-more-than-a-decade-due-to-the-covid-19-pandemic."},{"key":"ref_27","unstructured":"International Diabetes Federation (2021, December 17). IDF Atlas 10th Edition 2021. Available online: https:\/\/diabetesatlas.org\/idfawp\/resource-files\/2021\/07\/IDF_Atlas_10th_Edition_2021.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1038\/s41598-021-81057-2","article-title":"Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: A systematic review and meta-analysis","volume":"11","author":"Gautam","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.ejcdt.2016.05.009","article-title":"Study of risk factors for pulmonary tuberculosis among diabetes mellitus patients","volume":"65","author":"Khalil","year":"2016","journal-title":"Egypt. J. Chest Dis. Tuberc."},{"key":"ref_30","unstructured":"(2021, December 16). Global Tuberculosis Report. Available online: https:\/\/www.who.int\/tb\/publications\/global_report\/gtbr2017_main_text.pdf."},{"key":"ref_31","unstructured":"World Health Organization (2021, December 16). A Conceptual Framework for Action on the Social Determinants of Health. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/44489."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e4748","DOI":"10.1097\/MD.0000000000004748","article-title":"Prognostic effect of tuberculosis on patients with occupational lung diseases: A 13-year observational study in a nationwide cohort","volume":"95","author":"Hung","year":"2016","journal-title":"Medicine"},{"key":"ref_33","unstructured":"(2021, December 18). Report of the Joint TB Monitoring Mission, India. Available online: http:\/\/www.tbonline.info\/media\/uploads\/documents\/jmmdraft2015.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.ajic.2006.03.013","article-title":"Burden of tuberculosis in Serbia","volume":"34","author":"Vlajinac","year":"2006","journal-title":"Am. J. Infect. Control."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.ijid.2021.07.067","article-title":"Long-term Survival of Treated Tuberculosis Patients in Comparison to a General Population in South India: A Matched Cohort Study","volume":"110","author":"Selvaraju","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"374","DOI":"10.5152\/balkanmedj.2021.21208","article-title":"Premature Deaths Due to Silicosis in Turkey, 2006-2017: A Twelve-Year Longitudinal Study","volume":"38","year":"2021","journal-title":"Balk. Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Pasipanodya, J.G., McNabb, S.J., Hilsenrath, P., Bae, S., Lykens, K., Vecino, E., Munguia, G., Miller, T.L., Drewyer, G., and Weis, S.E. (2010). Pulmonary impairment after tuberculosis and its contribution to TB burden. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-259"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Alene, K.A., Wangdi, K., Colquhoun, S., Chani, K., Islam, T., Rahevar, K., Morishita, F., Byrne, A., Clark, J., and Viney, K. (2021). Tuberculosis related disability: A systematic review and meta-analysis. BMC Med., 19.","DOI":"10.1186\/s12916-021-02063-9"},{"key":"ref_39","unstructured":"Ehrlich, R.I., Montgomery, A., Akugizibwe, P., and Gonsalves, G. (2017). Health implications of changing trends in the origins and characteristics of mineworkers in South Africa, 1973\u20132012. BMC Public Health, 8."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3389\/fpubh.2020.00107","article-title":"Can the South African milestones for reducing exposure to respirable crystalline silica and silicosis be achieved and reliably monitored?","volume":"8","author":"Brouwer","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Newman Taylor, A., Cullinan, P., Blanc, P., and Pickering, A. (2016). Parkes\u2019 Occupational Lung Disorders, CRC Press. [4th ed.]. Chapter 18.","DOI":"10.1201\/9781315381848"}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/11\/4\/63\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:03:53Z","timestamp":1760130233000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/11\/4\/63"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,1]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["medsci11040063"],"URL":"https:\/\/doi.org\/10.3390\/medsci11040063","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,1]]}}}