Association between smoking and paracoccidioidomycosis: a case-control study in the State of Espírito Santo, Brazil

Abstract

Paracoccidioidomycosis, the main systemic mycosis in Brazil, requires long-term, high-cost treatment and leaves serious sequelae in the lungs, the organ most frequently affected and further subject to aggressive external risk factors like smoking. The influence of tobacco and alcohol consumption on chronic paracoccidioidomycosis was investigated using a case-control study. Data on occupation, place of residence, and living habits were obtained from 70 cases and 180 controls residing in the same geographic areas. The risk of becoming ill was 14 times greater among smokers and 3.6 times greater among individuals with an alcohol intake of more than 50 g/day. Logistic regression showed as significant variables: tobacco consumption for more than 20 years (OR = 10.1), smoking manufactured (not hand-rolled) cigarettes (OR = 4.8), and alcohol intake > 50 g/day (OR = 2.9). Cases who smoked 20 or more cigarettes/day became ill on average eight years before others (p = 0.002). Alcohol intake > 50 g/day had no statistically significant impact on age at onset of illness (p = 0.78). The study concludes that smoking stands as an important risk factor for the development of chronic paracoccidioidomycosis. As for alcoholism, there is evidence that it acts as a co-factor, together with smoking.