COPD and the Risk of Tuberculosis - A Population-Based Cohort Study

BACKGROUND: Both chronic obstructive pulmonary disease (COPD) and tuberculosis (TB) primarily affect the lungs and are major causes of morbidity and mortality worldwide. COPD and TB have common risk factors such as smoking, low socioeconomic status and dysregulation of host defence functions. COPD is a prevalent co-morbid condition, especially in elderly with TB but in contrast to other diseases known to increase the risk of TB, relatively little is known about the specific relationship and impact from COPD on TB-incidence and mortality. METHODS AND FINDINGS: All individuals > or = 40 years of age, discharged with a diagnosis of COPD from Swedish hospitals 1987-2003 were identified in the Swedish Inpatient Register (n = 115,867). Records were linked to the Swedish Tuberculosis Register 1989-2007 and the relative risk of active TB in patients with COPD compared to control subjects randomly selected from the general population (matched for sex, year of birth and county of residence) was estimated using Cox regression. The analyses were stratified by year of birth, sex and county of residence and adjusted for immigration status, socioeconomic status (SES) and inpatient co-morbidities previously known to increase the risk of TB. COPD patients had a three-fold increased hazard ratio (HR) of developing active TB (HR 3.0 (95% confidence interval 2.4 to 4.0)) that was mainly dependent on an increased risk of pulmonary TB. In addition, logistic regression estimates showed that COPD patients who developed active TB had a two-fold increased risk of death from all causes within first year after the TB diagnosis compared to the general population control subjects with TB (OR 2.2, 95% confidence interval 1.2 to 4.1). CONCLUSIONS: This population-based study comprised of a large number of COPD patients shows that these patients have an increased risk of developing active TB compared to the general population. The results raise concerns that the increasing global burden of COPD will increase the incidence of active TB. The underlying contributory factors need to be disentangled in further studies

Drug Resistant Mycobacterium tuberculosis of the Beijing Genotype Does Not Spread in Sweden

BACKGROUND: Drug resistant (DR) and multi-drug resistant (MDR) tuberculosis (TB) is increasing worldwide. In some parts of the world 10% or more of new TB cases are MDR. The Beijing genotype is a distinct genetic lineage of Mycobacterium tuberculosis, which is distributed worldwide, and has caused large outbreaks of MDR-TB. It has been proposed that certain lineages of M. tuberculosis, such as the Beijing lineage, may have specific adaptive advantages. We have investigated the presence and transmission of DR Beijing strains in the Swedish population. METHODOLOGY/PRINCIPAL FINDINGS: All DR M. tuberculosis complex isolates between 1994 and 2008 were studied. Isolates that were of Beijing genotype were investigated for specific resistance mutations and phylogenetic markers. Seventy (13%) of 536 DR strains were of Beijing genotype. The majority of the patients with Beijing strains were foreign born, and their country of origin reflects the countries where the Beijing genotype is most prevalent. Multidrug-resistance was significantly more common in Beijing strains than in non-Beijing strains. There was a correlation between the Beijing genotype and specific resistance mutations in the katG gene, the mabA-inhA-promotor and the rpoB gene. By a combined use of RD deletions, spoligotyping, IS1547, mutT gene polymorphism and Rv3135 gene analysis the Beijing strains could be divided into 11 genomic sublineages. Of the patients with Beijing strains 28 (41%) were found in altogether 10 clusters (2-5 per cluster), as defined by RFLP IS6110, while 52% of the patients with non-Beijing strains were in clusters. By 24 loci MIRU-VNTR 31 (45%) of the patients with Beijing strains were found in altogether 7 clusters (2-11 per cluster). Contact tracing established possible epidemiological linkage between only two patients with Beijing strains. CONCLUSIONS/SIGNIFICANCE: Although extensive outbreaks with non-Beijing TB strains have occurred in Sweden, Beijing strains have not taken hold, in spite of the proximity to high prevalence countries such as Russia and the Baltic countries. The Beijing sublineages so far introduced in Sweden may not be adapted to spread in the Scandinavian population

Economic development and trade outcomes in East African countries: prospects and constraints

This study employed a panel data analysis from selected East African countries, with the use of fixed and random effects model which was tested using Hausman specification test. The results from the study showed that; trade agreement and foreign direct investment (FDI) have a significant positive effect on East African economy, while trade openness exerts a negative effect as a result of low productivity. Therefore, the study recommended that the government of East African countries should embrace and develop policies in promoting the continental trade agreement and economic integration, in order to raise the level of productivity within the region and the sub-region for sustainable economic development

Cashless Policy Instruments and Financial Transactions in Lagos, Nigeria

Digital technologies have become significant as organisations, including financial institutions, attempt to adopt enhanced and more efficient approach for service provisions to customers. Despite the obvious shift to digitalised methods of service delivery, some financial institutions argued that though digitisation may increase financial efficiency and profitability, it also poses new risks and potential threats with significantly unanticipated side effects, especially, with respect to employment. Against this background, this study examined how the following cashless policy instruments: Mobile banking, Automated Teller Machine (ATM) and Point of Sale (POS) Terminal, influence financial transactions in Lagos, Nigeria; using Zenith Bank PLC as a case study. Structured Questionnaire was administered to 100 Zenith bank customers. The study applied the logit regression method and findings showed that 54% respondents use mobile banking daily, 39% respondents use ATM daily, 25% respondents use POS daily. On an overall scale, mobile banking is widely used and mostly preferred. Also, results showed that while POS has a significant relationship with financial transactions, Mobile banking, and ATM both have an insignificant relationship. Results from the study encourage the management of CBN to create more awareness of these instruments, and likely increase the number of these instruments

Financial development and income inequality in Africa

Abstract Across the globe, a rise in income inequality has been experienced for the last two decades, particularly in developing countries. This problem of income inequality poses a challenge to Africa’s ability to attain the United Nations (UN) Sustainment Development Goals (SDGs) of reduced inequalities (SDG-10). Against this backdrop, there is a need to harness the potential of financial development to reduce income inequality in Africa. Therefore, this study empirically examines how financial development affects income inequality in Africa. Financial development dimensions, access, depth, efficiency, and stability were considered to achieve the study’s objective. The study applied the system generalized method of moments (SGMM) to analyse data and the findings showed that each dimension of financial development had a varying impact on income inequality. Access, stability and efficiency components of financial development reduce income inequality, while the depth dimension of financial development exacerbates income inequality in Africa. Therefore, the study recommends that policymakers should not neglect other dimensions of finance in facilitating economic development

Mycobacterium avium Lymphadenopathy among Children, Sweden

We studied Mycobacterium avium lymphadenopathy in 183 Swedish children (<7 years of age) from 1998 through 2003. Seasonal variation in the frequency of the disease, with a peak in October and a low point in April, suggests cyclic environmental factors. We also found a higher incidence of the disease in children who live close to water

Agricultural Exports and Economic Growth in Nigeria: An Econometric Analysis

It has been observed that export promotion drive boosts economic growth of developing countries (Nigeria inclusive) through the multiplier effects that the income earned from exports has on the economy. Prior to the discovery of oil, agriculture has been the main contributor to the Nigerian external sector. It is in the light of this that this study sets out to examine the impact of agricultural export on Nigeria’s economic growth. This study used the Autoregressive Distribution Lag (ARDL) econometric technique to analyze the long run relationship and the impact of agricultural exports on Nigeria’s economic growth. Economic growth is the dependent variable, and is proxied by the real gross domestic product, the explanatory variables include: agricultural export, foreign direct investment, inflation rate and the labour force. The results from the ARDL technique revealed that agricultural exports significantly affect Nigeria’s economic growth; this suggests that, a 1percent increase in - agricultural export will boost economic growth in Nigeria by approximately 25percent.Therefore, from the results, the study recommended that agricultural export need to be promoted through the increase in agricultural production base