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Zhang P, Zheng J, Han T, Ma J, Gnanashanmugam D, Li M, Tang YW, Deng G. A blood-based 3-gene signature score for therapeutic monitoring in patients with pulmonary tuberculosis. Tuberculosis (Edinb) 2024; 147:102521. [PMID: 38801793 DOI: 10.1016/j.tube.2024.102521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/12/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To assess the validity of Xpert Tuberculosis Fingerstick score for monitoring treatment response and analyze factors influencing its performance. METHODS 122 adults with pulmonary tuberculosis were recruited and stratified into three cohorts: Diabetic-drug-susceptible-TB (DM-TB), Non-diabetic-drug-susceptible-TB (NDM-TB) and Non-diabetic Multidrug-resistant TB (MDR-TB). Fingerstick blood specimens were tested at treatment initiation (M0) and the end of the first (M1), second (M2), and sixth month (M6) to generate a TB-score. RESULTS The TB-score in all participants yielded an AUC of 0.707 (95% CI: 0.579-0.834) at M2 when its performance was evaluated against sputum culture conversion. In all non-diabetes patients, the AUC reached 0.88 (95% CI: 0.756-1.000) with an optimal cut-off value of 1.95 at which sensitivity was 90.0% (95% CI: 59.6-98.2%) and specificity was 81.3% (95% CI: 70.0-88.9%). The mean TB score was higher in patients with low bacterial loads (n = 31) than those with high bacterial loads (n = 91) at M0, M1, M2, and M6, and was higher in non-cavitary patients (n = 71) than those with cavitary lesions (n = 51) at M0, M1, and M2. CONCLUSION Xpert TB-score shows promising predictive value for culture conversion in non-diabetic TB patients. Sputum bacterial load and lung cavitation status have an influence on the value of TB score.
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Affiliation(s)
- Peize Zhang
- Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen, China.
| | - Junfeng Zheng
- Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen, China.
| | - Tingting Han
- Guangdong Medical University, The First Clinical Medical College, Zhanjiang, Guangdong, China.
| | - Jian Ma
- Medical Affairs, Danaher Corporation/Cepheid (China), Shanghai, China.
| | | | - Mengran Li
- Department of Biostatistics & Data Management, Beckman Coulter, Shanghai, China.
| | - Yi-Wei Tang
- Medical Affairs, Danaher Corporation/Cepheid (China), Shanghai, China.
| | - Guofang Deng
- Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen, China.
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Cabral BVB, Monte GLA, Vasconcelos MN, Maranhão TA, Sousa GJB, Pereira MLD. Spatial patterns and factors associated with the incidenceof tuberculosis-diabetes in Brazil. Public Health 2024; 233:149-156. [PMID: 38897067 DOI: 10.1016/j.puhe.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019. STUDY DESIGN Ecological study. METHODS Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted. RESULTS In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0-2.0/100,000 inhabitants. The regression showed that the Gini index (β = 0.85) and family health strategy coverage (β = -0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil. CONCLUSIONS This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB.
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Affiliation(s)
- B V B Cabral
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil.
| | - G L A Monte
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
| | - M N Vasconcelos
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
| | - T A Maranhão
- State University of Piauí, Teresina, Piauí, Brazil
| | | | - M L D Pereira
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
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Yu G, Xu X, Shen Y, Fang B. Diagnostic accuracy of nanopore sequencing for the rapid diagnosis of pulmonary tuberculosis: A protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0304162. [PMID: 38843269 PMCID: PMC11156269 DOI: 10.1371/journal.pone.0304162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is the most common type of tuberculosis (TB). Rapid diagnosis of PTB can help in TB control. Although the use of molecular tests (such as the GeneXpert MTB/RIF) has improved the ability to rapidly diagnose PTB, there is still room for improvement. Nanopore sequencing is a novel means of rapid TB detection. The purpose of this study was to establish a systematic review and meta-analysis protocol for evaluating the accuracy of nanopore sequencing for the rapid diagnosis of PTB. METHODS We completed this protocol according to the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement and registered on the PROSPERO platform. We will screen studies related to nanopore sequencing for diagnosis of PTB by searching through PubMed, EMBASE, the Cochrane Library using English, and Wanfang database, CNKI (China National Knowledge Infrastructure) using Chinese. Eligible studies will be screened according to the inclusion and exclusion criteria established in the study protocol. We will evaluate the methodological quality of the individual included studies using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We will use Stata (version 15.0) with the midas command and RevMan (version 5.3) for meta-analysis and forest plots and SROC curves generation. A p < 0.05 was treated as a statistically significant difference. When significant heterogeneity exists between studies, we will explore sources of heterogeneity through meta-regression analysis and subgroup analysis. CONCLUSION To the best of our knowledge, this will be the first systematic review and meta-analysis of nanopore sequencing for the diagnosis of PTB. We hope that this study will find a new and effective tool for the early diagnosis of PTB. PROSPERO REGISTRATION NUMBER CRD42023495593.
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Affiliation(s)
- Guocan Yu
- Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Xudong Xu
- Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Yanqin Shen
- Department of Nursing, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Bifei Fang
- Department of Nursing, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
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Li J, Zhao Y, Jiang Y, Zhang Y, Zhang P, Shen L, Chen Z. Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities. Diabetes Metab Syndr Obes 2024; 17:1105-1114. [PMID: 38450415 PMCID: PMC10916512 DOI: 10.2147/dmso.s450507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
Background Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities. Methods A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities. Results Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05-10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01-1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28-20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38-1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03-0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes. Conclusion Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB-DM comorbidity.
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Affiliation(s)
- Jing Li
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Yanhong Zhao
- Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China
| | - Youli Jiang
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Ying Zhang
- Department of Endocrinology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Peize Zhang
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Lingjun Shen
- Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China
| | - Zijiao Chen
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
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Wang BY, Song K, Wang HT, Wang SS, Wang WJ, Li ZW, Du WY, Xue FZ, Zhao L, Cao WC. Comorbidity increases the risk of pulmonary tuberculosis: a nested case-control study using multi-source big data. BMC Pulm Med 2024; 24:29. [PMID: 38212743 PMCID: PMC10782630 DOI: 10.1186/s12890-023-02817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Some medical conditions may increase the risk of developing pulmonary tuberculosis (PTB); however, no systematic study on PTB-associated comorbidities and comorbidity clusters has been undertaken. METHODS A nested case-control study was conducted from 2013 to 2017 using multi-source big data. We defined cases as patients with incident PTB, and we matched each case with four event-free controls using propensity score matching (PSM). Comorbidities diagnosed prior to PTB were defined with the International Classification of Diseases-10 (ICD-10). The longitudinal relationships between multimorbidity burden and PTB were analyzed using a generalized estimating equation. The associations between PTB and 30 comorbidities were examined using conditional logistic regression, and the comorbidity clusters were identified using network analysis. RESULTS A total of 4265 cases and 17,060 controls were enrolled during the study period. A total of 849 (19.91%) cases and 1141 (6.69%) controls were multimorbid before the index date. Having 1, 2, and ≥ 3 comorbidities was associated with an increased risk of PTB (aOR 2.85-5.16). Fourteen out of thirty comorbidities were significantly associated with PTB (aOR 1.28-7.27), and the associations differed by sex and age. Network analysis identified three major clusters, mainly in the respiratory, circulatory, and endocrine/metabolic systems, in PTB cases. CONCLUSIONS Certain comorbidities involving multiple systems may significantly increase the risk of PTB. Enhanced awareness and surveillance of comorbidity are warranted to ensure early prevention and timely control of PTB.
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Affiliation(s)
- Bao-Yu Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Ke Song
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Hai-Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Shan-Shan Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Wen-Jing Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Zhen-Wei Li
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Wan-Yu Du
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Fu-Zhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 250012, Jinan, China
- Institute for Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250002, China
| | - Lin Zhao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
| | - Wu-Chun Cao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dongda Street, Fengtai District, Beijing, 100071, China.
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Zhao L, Fan K, Sun X, Li W, Qin F, Shi L, Gao F, Zheng C. Host-directed therapy against mycobacterium tuberculosis infections with diabetes mellitus. Front Immunol 2024; 14:1305325. [PMID: 38259491 PMCID: PMC10800548 DOI: 10.3389/fimmu.2023.1305325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Tuberculosis (TB) is caused by the bacterial pathogen Mycobacterium tuberculosis (MTB) and is one of the principal reasons for mortality and morbidity worldwide. Currently, recommended anti-tuberculosis drugs include isoniazid, rifampicin, ethambutol, and pyrazinamide. TB treatment is lengthy and inflicted with severe side-effects, including reduced patient compliance with treatment and promotion of drug-resistant strains. TB is also prone to other concomitant diseases such as diabetes and HIV. These drug-resistant and complex co-morbid characteristics increase the complexity of treating MTB. Host-directed therapy (HDT), which effectively eliminates MTB and minimizes inflammatory tissue damage, primarily by targeting the immune system, is currently an attractive complementary approach. The drugs used for HDT are repositioned drugs in actual clinical practice with relative safety and efficacy assurance. HDT is a potentially effective therapeutic intervention for the treatment of MTB and diabetic MTB, and can compensate for the shortcomings of current TB therapies, including the reduction of drug resistance and modulation of immune response. Here, we summarize the state-of-the-art roles and mechanisms of HDT in immune modulation and treatment of MTB, with a special focus on the role of HDT in diabetic MTB, to emphasize the potential of HDT in controlling MTB infection.
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Affiliation(s)
- Li Zhao
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Ke Fan
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Xuezhi Sun
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Wei Li
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Fenfen Qin
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Liwen Shi
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
| | - Feng Gao
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunlan Zheng
- Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China
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Ling Y, Chen X, Zhou M, Zhang M, Luo D, Wang W, Chen B, Jiang J. The effect of diabetes mellitus on tuberculosis in eastern China: A decision-tree analysis based on a real-world study. J Diabetes 2023; 15:920-930. [PMID: 37434342 PMCID: PMC10667642 DOI: 10.1111/1753-0407.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES The public health system faces major challenges due to the double burden of diabetes mellitus (DM) and tuberculosis (TB) in China. We aimed to investigate the prevalence and impact of diabetes on patients with TB. METHODS Stratified cluster sampling was used to select 13 counties as study sites in the Zhejiang province. Patients who visited designated TB hospitals in these areas participated in this study between 1 January 2017 and 28 February 2019. Multiple logistic regression models were performed to investigate the association between DM and bacteriological and imaging results. A decision tree was used to predict the bacteriology and imaging results under the influence of DM. RESULTS Of 5920 patients with newly diagnosed pulmonary tuberculosis, 643 (12.16%) had DM. Patients with pulmonary TB and DM were more likely to have pulmonary cavities (adjusted odds ratio [aOR], 2.81; 95% confidence intervals [95% CI]: 2.35-3.37) and higher rates of positive bacteriological tests (aOR, 2.32; 95% CI:1.87-2.87). Decision-tree analysis showed similar results. CONCLUSIONS Concurrence of DM and pulmonary TB makes patients more likely to have positive bacteriological results and pulmonary cavities. Therefore, appropriate measures are necessary to promptly identify and manage patients with TB and DM.
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Affiliation(s)
- Yuxiao Ling
- School of Public Health, Health Science CenterNingbo UniversityNingboChina
| | - Xinyi Chen
- Department of Tuberculosis Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Meng Zhou
- Zhejiang University School of Public HealthHangzhouChina
| | - Mengdie Zhang
- Zhejiang University School of Public HealthHangzhouChina
| | - Dan Luo
- Department of Public HealthHangzhou Medical CollegeHangzhouChina
| | - Wei Wang
- Department of Tuberculosis Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Bin Chen
- Department of Tuberculosis Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jianmin Jiang
- Department of Tuberculosis Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
- Key Laboratory of VaccinePrevention and Control of Infectious Disease of Zhejiang ProvinceHangzhouChina
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Wang CA, Chen CH, Hsieh WC, Hsu TJ, Hsu CY, Cheng YC, Hsu CY. Risk of Herpes Zoster in Patients with Pulmonary Tuberculosis-A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2656. [PMID: 36768020 PMCID: PMC9916360 DOI: 10.3390/ijerph20032656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Pulmonary tuberculosis (TB), a global health problem, is typically caused by the bacterium Mycobacterium tuberculosis. Herpes zoster (HZ) is caused by the reactivation of the varicella-zoster virus (VZV). The reactivation of VZV can be caused by stress. We investigated whether pulmonary TB increases the risk of HZ development. METHODS This study used data that sampled a population of 2 million people in 2000 from the National Health Insurance Research Database. This cohort study observed Taiwanese patients aged 20-100 years with pulmonary TB from 2000 to 2017 (tracked to 2018). Pulmonary TB was defined as having two or more outpatient diagnoses or at least one admission record. To address potential bias caused by confounding factors, the control cohort and pulmonary TB cohort were matched 1:1 by age, gender, index year, and comorbidities. Patients with HZ before the index date were excluded. RESULTS A total of 30,805 patients were in the pulmonary TB and control cohorts. The incidence rate of HZ in pulmonary TB and control cohorts were 12.00 and 9.66 per 1000 person-years, respectively. The risk of HZ in the pulmonary TB cohort (adjusted hazard ratios = 1.23; 95% confidence interval = 1.16-1.30) was significantly higher than that of in control cohort. Among patients without comorbidities, the patients with TB were 1.28-fold more likely to have HZ than those without TB. CONCLUSION Patients with TB should be well treated to avoid the potential risk of HZ occurrence. Although we identified the association between pulmonary TB and HZ, further studies are needed to confirm the result.
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Affiliation(s)
- Chih-An Wang
- Division of Respiratory Therapy, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Chia-Hung Chen
- Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
- Department of Medical Imaging, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Wen-Che Hsieh
- Department of Chinese Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Tzu-Ju Hsu
- Management Office for Health Data, Clinical Trial Research Center, China Medical University Hospital, Taichung 404, Taiwan
| | - Chung-Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
| | - Yung-Chi Cheng
- Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
- Department of Rehabilitation, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
| | - Chao-Yu Hsu
- Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan
- Department of Artificial Intelligence and Healthcare Management, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
- Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
- Center for General Education, National Taichung University of Science and Technology, Taichung 404, Taiwan
- Department of General Education, National Chin-Yi University of Technology, Taichung 411, Taiwan
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Chavarría-Guzmán KL, Saldaña-Medina CD, Leyva-López AG, Ostos-Ortíz OL. Evaluación de una estrategia educativa sobre tuberculosis y diabetes mellitus para personal de salud de atención primaria en México. NOVA 2022. [DOI: 10.22490/24629448.6586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Antecedentes. En la literatura se ha identificado una asociación fuerte entre la tuberculosis y la diabetes mellitus, asimismo, algunos estudios han reportado un nivel bajo de conocimiento de esta relación por parte del personal de salud. Objetivos. Explorar el cambio en los conocimientos y actitudes del personal de salud de atención primaria sobre epidemiología y políticas públicas de la asociación de Tuberculosis (TB) y Diabetes (DM) después de una sesión de entrenamiento. Material y Métodos. Diseño de medición pre-post intervención de un solo grupo de 31 participantes, mediante un cuestionario estructurado autodiligenciado construido ad hoc. Se utilizaron las pruebas de rangos signados de Wilcoxon para estimar diferencias entre las evaluaciones pre y post, análisis de correlaciones y la prueba Chi cuadrada. Se consideró un conocimiento adecuado a puntajes mayores a 70%. Resultados.El 12,9% de los participantes tuvieron conocimientos adecuados en la evaluación previa, mientras que el 16,1% en la evaluación post. Hubo un aumento porcentual en el nivel de conocimientos (pre= 53,43% versus post= 58,27%) y actitudes (pre=89,56% versus post=96,29%); sin embargo, fue estadísticamente significativo sólo para las actitudes (p= 0.000). Conclusión. La evaluación inicial (pre) muestra la importancia y necesidad de entrenar al personal de salud para lograr el abordaje integral de un paciente con la asociación TB-DM.
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Luo M, Wang YT, Wang XK, Hou WH, Huang RL, Liu Y, Wang JQ. A multi-granularity convolutional neural network model with temporal information and attention mechanism for efficient diabetes medical cost prediction. Comput Biol Med 2022; 151:106246. [PMID: 36343403 DOI: 10.1016/j.compbiomed.2022.106246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/30/2022] [Accepted: 10/22/2022] [Indexed: 12/27/2022]
Abstract
As the cost of diabetes treatment continues to grow, it is critical to accurately predict the medical costs of diabetes. Most medical cost studies based on convolutional neural networks (CNNs) ignore the importance of multi-granularity information of medical concepts and time interval characteristics of patients' multiple visit sequences, which reflect the frequency of patient visits and the severity of the disease. Therefore, this paper proposes a new end-to-end deep neural network structure, MST-CNN, for medical cost prediction. The MST-CNN model improves the representation quality of medical concepts by constructing a multi-granularity embedding model of medical concepts and incorporates a time interval vector to accurately measure the frequency of patient visits and form an accurate representation of medical events. Moreover, the MST-CNN model integrates a channel attention mechanism to adaptively adjust the channel weights to focus on significant medical features. The MST-CNN model systematically addresses the problem of deep learning models for temporal data representation. A case study and three comparative experiments are conducted using data collected from Pingjiang County. Through experiments, the methods used in the proposed model are analyzed, and the super contribution of the model performance is demonstrated.
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Affiliation(s)
- Min Luo
- School of Business, Central South University, Changsha, 410083, PR China
| | - Yi-Ting Wang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Xiao-Kang Wang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Wen-Hui Hou
- School of Business, Central South University, Changsha, 410083, PR China
| | - Rui-Lu Huang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Ye Liu
- School of Business, Central South University, Changsha, 410083, PR China
| | - Jian-Qiang Wang
- School of Business, Central South University, Changsha, 410083, PR China.
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