The effect of diabetes mellitus on tuberculosis in eastern China: A decision‐tree analysis based on a real‐world study

Ling, Yuxiao; Chen, Xinyi; Zhou, Meng; Zhang, Mengdie; Luo, Dan; Wang, Wei; Chen, Bin; Jiang, Jianmin

doi:10.1111/1753-0407.13444

Cited by 3 publications

(1 citation statement)

References 51 publications

(84 reference statements)

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“…Our study identifies prevalent comorbidities such as diabetes, HIV/AIDS, and pneumoconiosis, which significantly impact treatment outcomes. Extensive research underscores the deleterious effect of diabetes on TB treatment outcomes [46][47][48], while the influence of HIV/AIDS on TB is widely acknowledged [49,50]. Additionally, studies elucidate the intricate interaction between pneumoconiosis and PTB treatment [51,52].…”

Section: Discussionmentioning

confidence: 99%

Multivariate regression analysis affecting successful treatment of pulmonary tuberculosis patients in western China: a retrospective study in a high-incidence area

Zhou,

Li,

et al. 2024

Preprint

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Background Guizhou, situated in western China, exhibits a high incidence of pulmonary tuberculosis (PTB) alongside comparatively challenging medical and economic conditions. Our objective was to investigate the determinants influencing successful PTB treatment and their scope, aiming to provide a scientific foundation for targeted interventions and enhancing treatment efficacy. Methods Data encompassing all PTB cases registered in Guizhou's China Disease Prevention and Control Information System from 2017 to 2022 were analyzed. Using the successful treatment rate as the dependent variable, initial univariate analysis of independent variables was conducted, followed by multilevel binary logistic regression analysis to assess variables demonstrating statistically significant disparities. Results A total of 139,414 patients, with an average age of 44 years, were included in the study, comprising 89,802 males (64.41%) and 49,612 females (35.59%). Among them, 66,316 (47.57%) were etiologically positive, and 22,795 (16.35%) had comorbidities. The successful treatment rate stood at 95.77%, with a cure rate of 42.54%. 9 factors were identified to influence the successful treatment rate. These included a higher proportion of females compared to males (OR = 1.178, 95%CI = 1.111–1.249), a higher ratio of students versus farmers (OR = 1.960, 95%CI = 1.649–2.330), and a greater proportion of etiologically negative cases compared to etiologically positive (OR = 1.831, 95%CI = 1.725–1.942). Additionally, initial treatment showed higher success rates than retreatment (OR = 3.046, 95%CI = 2.836–3.272), and PTB patients without comorbidities fared better than those with comorbidities (OR = 1.303, 95% CI = 1.217–1.394). The use of fixed-dose combination (FDC) therapy yielded higher success rates than non-FDC treatment (OR = 1.296, 95%CI = 1.206–1.393). Furthermore, successful treatment rates were lower among the Miao ethnic group (OR = 0.874, 95%CI = 0.809–0.945) and higher among the Buyi (OR = 1.270, 95%CI = 1.137–1.419) compared to the Han. Age also played a significant role, with lower success rates observed in the 41–60 age group (OR = 0.731, 95%CI = 0.638–0.838) and the lowest rates among those aged 61 years and older (OR = 0.604, 95%CI = 0.527–0.693). Conclusions Western China faces ongoing challenges in enhancing its PTB treatment capacity and should prioritize the promotion of FDC therapy. Risk factors that influence treatment outcomes for PTB include male gender, advanced age, belonging to the Miao ethnic group, occupation as a farmer, etiological positivity, retreatment status, and comorbidities such as diabetes and HIV/AIDS. Further investigation is warranted to explore the disparities in successful treatment rates among different ethnicities.

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Section: Discussionmentioning

confidence: 99%

Multivariate regression analysis affecting successful treatment of pulmonary tuberculosis patients in western China: a retrospective study in a high-incidence area

Zhou,

Li,

et al. 2024

Preprint

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Molecular Indicator for Distinguishing Multi-drug-Resistant Tuberculosis from Drug Sensitivity Tuberculosis and Potential Medications for Treatment

Song,

Gan,

et al. 2024

Mol Biotechnol

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Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study

Kong,

Xia,

Wang

et al. 2024

Front. Public Health

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BackgroundThe global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid pulmonary tuberculosis and diabetes mellitus (PTB-DM) presents challenges to PTB control. We conducted this study given that current research on PTB-DM has primarily focused on clinical medicine and immunology, with limited reports on the true prevalence of population-wide PTB-DM in specific regions, as well as the heightened risk of PTB-DM co-prevalence due to aging and the high prevalence of DM in Chongqing, Southwest China.MethodsThis retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The medical records of 112,592 PTB patients registered in Chongqing from 2016 to 2022 were extracted. After excluding patients with incomplete records, those not residing in Chongqing, and individuals still undergoing treatment, a total of 108,003 PTB patients were included in the study. The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Chi-squared test and Fisher’s exact tests was used to compare groups, and multivariable logistic regression model with stepwise backward elimination based on the Wald test was used to examine risk factors for adverse treatment outcomes.ResultsFrom 2016 to 2022, the incidence rate of PTB in southwest China showed a decreasing trend (AAPC = -10.22, 95% CI: −11.49% ~ −8.94%), while the incidence rate of PTB-DM increased rapidly (AAPC = 14.25, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased from 2.96 to 12.28%. PTB-DM patients were characterized by a higher proportion of males and older adult individuals, the age range of the patients was 11 ~ 100 years, with a mean age of 58.21 ± 12.02 years, with multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85%, while unsuccessful outcomes accounted for 19.15%. Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC = 12.22, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC = 14.18, 95% CI: 6.53% ~ 27.67%). Older age, retreatment, referral, and multiple positive aetiological results were risk factors for adverse treatment outcomes among PTB-DM patients.ConclusionThe study presents the true prevalence of PTB-DM comorbidity in the general population of Southwest China, revealing a significant upward trend in its prevalence and a higher risk of adverse outcomes among PTB-DM patients. Future efforts should focus on the prevention and control of PTB-DM comorbidity, with early screening and standardized treatment for high-risk groups such as the older adult, as well as implementing comprehensive and effective treatment and management measures for patients.

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The effect of diabetes mellitus on tuberculosis in eastern China: A decision‐tree analysis based on a real‐world study

Cited by 3 publications

References 51 publications

Multivariate regression analysis affecting successful treatment of pulmonary tuberculosis patients in western China: a retrospective study in a high-incidence area

Multivariate regression analysis affecting successful treatment of pulmonary tuberculosis patients in western China: a retrospective study in a high-incidence area

Molecular Indicator for Distinguishing Multi-drug-Resistant Tuberculosis from Drug Sensitivity Tuberculosis and Potential Medications for Treatment

Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study

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