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Xia L, Wei W, Zhou ZL, Zhang WQ, Luan RS. The environmental and socioeconomic effects of tuberculosis patients in the southwest of China: a population-based study. Public Health 2024; 227:131-140. [PMID: 38219290 DOI: 10.1016/j.puhe.2023.10.043] [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: 05/09/2023] [Revised: 09/14/2023] [Accepted: 10/26/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The objective of this study was to assess the incidence of tuberculosis (TB) and find the risk factors of TB patients with a high burden of TB in socioeconomic level, the high level of TB incidence and the great changes of economic and social factors, explore the possible factors, construct scientific and robust prediction model, and analyse whether the task of stopping TB can be accomplished by the expected global deadline. STUDY DESIGN This was an ecological study. METHODS Descriptive analysis, spatial and space-time scan, correlation analysis, and regression analysis were carried out, based on cases of TB in Sichuan Province and ecological data from 2006 to 2017, to explore the characters of TB and ecological factors, using the transfer function-noise model to forecast the trend of TB until 2035. RESULTS Factors affecting the incidence of TB, increasing per capita green area, reporting status of TB among Tibetans and Yi minorities, comprehensive treatment management, total cost of TB per capita for urban residents, proportion of males with high school education, 20 to 20 h of 24-h accumulated precipitation, reducing HIV at the same time as AIDS deaths, the increase in the proportion of males in junior high school education, and the increase in the number of registered TB cases can reduce the incidence of TB. CONCLUSIONS There was concentration mainly on enhanced control of the environment and society measures, helpful in guiding government planning to control TB. Reinforcement is required to reduce the TB of population aged 15-24 and aged 25-64 in socioeconomic level by 2035.
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Affiliation(s)
- L Xia
- Center for Disease Control and Prevention of Sichuan Province, China
| | - W Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China; Leshan Hospital, China
| | - Z L Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - W Q Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - R S Luan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
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Xia L, Zhu S, Chen C, Rao ZY, Xia Y, Wang DX, Zhang PR, He J, Zhang JY, Wu JL. Spatio-temporal analysis of socio-economic characteristics for pulmonary tuberculosis in Sichuan province of China, 2006-2015. BMC Infect Dis 2020; 20:433. [PMID: 32571231 PMCID: PMC7310234 DOI: 10.1186/s12879-020-05150-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 06/11/2020] [Indexed: 01/06/2023] Open
Abstract
Background The disease burden caused by pulmonary tuberculosis (TB) in Sichuan province still persisted at a high level, and large spatial variances were presented across regional distribution disparities. The socio-economic factors were suspected to affect the population of TB notification, we aimed to describe TB case notification rate (CNR) and identify which factors influence TB epidemic are necessary for the prevention and control of the disease in Sichuan province. Methods A retrospective cross-sectional study and an ecological spatial analysis was conducted to quantify the presence and location of spatial clusters of TB by the Moran’s I index and examined these patterns with socio-economic risk factors by hierarchical Bayesian spatio-temporal model. Results A total of 630,009 pulmonary TB cases were notified from 2006 to 2015 in 181 counties of Sichuan province. The CNR decreased year by year since 2007, from 88.70 to 61.37 per 100,000 persons. The spatial heterogeneities of CNR were observed during the study periods. Global Moran’s I index varied from 0.23 to 0.44 with all P-value < 0.001. The Bayesian spatio-temporal model with parametric spatio-temporal interactions was chosen as the best model according to the minimum of Deviance Information Criterion (DIC)(19,379.01), and in which the quadratic form of time was taken. The proportion of age group and education year were all associated with CNR after adjusting the spatial effect, temporal effect and spatio-temporal interactions. TB CNR increased by 10.2% [95% credible interval (CI): 6.7–13.7%] for every 1-standard-deviation increase in proportion of age group and decreased by 23% (95% CI: 13.7–32.7%) for every 1-standard-deviation increase in education year. Conclusions There were spatial clusters of TB notification rate in Sichuan province from 2006 to 2015, and heavy TB burden was mainly attributed to aging and low socioeconomic status including poor education. Thus, it is more important to pay more attention to the elderly population and improve socioeconomic status including promoting education level in Sichuan province to reduce the TB burden.
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Affiliation(s)
- Lan Xia
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Sui Zhu
- Department of Statistics, School of Basic Medical Sciences, Jinan University, No. 601, West of Huangpu Road, Guangzhou, 510632, Guangdong Province, China
| | - Chuang Chen
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Zheng-Yuan Rao
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Yong Xia
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Dan-Xia Wang
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Pei-Ru Zhang
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Jinge He
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China
| | - Ju-Ying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Sichuan University, No.17 Section 3, Renmin South Road, Chengdu, 610044, Sichuan Province, China.
| | - Jian-Lin Wu
- Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu, 610041, Sichuan Province, China.
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GADALLAH M, ABDELMONIEM W, FAWZY M, MOKHTAR A, MOHSEN A. Multicenter screening of diabetic patients for detecting new cases of tuberculosis: an approach to intensify the case detection rate of tuberculosis in developing countries with high prevalence of diabetes. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E343-E348. [PMID: 31967091 PMCID: PMC6953452 DOI: 10.15167/2421-4248/jpmh2019.60.4.883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 08/28/2019] [Indexed: 11/16/2022]
Abstract
Introduction Tuberculosis (TB) is a major public health problem in most of developing countries. Meanwhile, the prevalence of type 2 diabetes mellitus (DM) is also increasing rapidly. Objectives To describe the feasibility of implementing screening test for tuberculosis among diabetic patients and identifying factors associated with high detection rate. Methods Study Design: Multi-center cross-sectional study. This study was implemented in the governmental healthcare settings. To diagnose TB among diabetics, we used a symptom-based questionnaire that included the symptoms of suspected TB according to the guidelines of National Tuberculosis Program in Egypt. Results Among 4283 adult diabetics, 14 TB cases were diagnosed; 9 known TB cases and 5 newly detected cases. The number needed to detect one new case of TB was 855. Male diabetics and who those suffered from liver disease experienced a significantly higher prevalence of TB and a higher detection rate of new active cases. Conclusions Screening for TB among diabetics in routine governmental healthcare services was successfully implemented. Screening DM patients in countries with a high prevalence of DM will reveal a significant number of active TB cases, which will in turn improve the case detection rate of TB.
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Affiliation(s)
- M. GADALLAH
- Department of Community Medicine, Faculty of Medicine, Ain Shams University, Egypt
- Correspondence: Mohsen Gadallah, Department of Community Medicine, Faculty of Medicine, Ain Shams University, Ramsis Street, Abbassyia Square, Cairo-Egypt, 11566 - E-mail:
| | - W. ABDELMONIEM
- Ministry of Health and Population, Chest Directorate, National Tuberculosis Control Program, Cairo, Egypt
| | - M. FAWZY
- Ministry of Health and Population, Chest Directorate, National Tuberculosis Control Program, Cairo, Egypt
| | - A. MOKHTAR
- Ministry of Health and Population, Chest Directorate, National Tuberculosis Control Program, Cairo, Egypt
| | - A. MOHSEN
- Department of Community Medicine, National Research Centre, Cairo, Egypt
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Diarra B, Tolofoudie M, Sarro YS, Togo ACG, Bane S, Nientao I, Cisse AB, Kone M, Somboro A, Degoga B, Diallo F, Coulibaly G, Kodio O, Sanogo M, Kone B, Diabate S, Baya B, Kone A, Dabitao D, Maiga M, Belson M, Dao S, Maiga II, Murphy RL, Siddiqui S, Toloba Y, Konate B, Doumbia S, de Jong BC, Diallo S. Diabetes Mellitus among new tuberculosis patients in Bamako, Mali. J Clin Tuberc Other Mycobact Dis 2019; 17:100128. [PMID: 31788570 PMCID: PMC6879999 DOI: 10.1016/j.jctube.2019.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. Methods We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. Results Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47–6.02). Conclusion The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.
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Affiliation(s)
- B Diarra
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - M Tolofoudie
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Bane
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I Nientao
- Service de Médecine et d'Endocrinologie de l'hôpital du Mali, Bamako, Mali
| | - A B Cisse
- Laboratoire National de Référence des Mycobactéries (LNR), Institut National de Recherche en Santé publique (INRSP), Bamako, Mali
| | - M Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Somboro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Degoga
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - F Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - G Coulibaly
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O Kodio
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Sanogo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Baya
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Dabitao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Maiga
- Global Health, Northwestern University, Chicago, IL, United States
| | - M Belson
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - S Dao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I I Maiga
- Laboratoire d'analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - R L Murphy
- Global Health, Northwestern University, Chicago, IL, United States
| | - S Siddiqui
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - Y Toloba
- Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - B Konate
- Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et de l'hygiène publique, Bamako, Mali
| | - S Doumbia
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B C de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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Hu W, Zhang X, Yu J, Hu F, Zhang H, Wang Y. Vertebral column decancellation in Pott's deformity: use of Surgimap Spine for preoperative surgical planning, retrospective review of 18 patients. BMC Musculoskelet Disord 2018; 19:13. [PMID: 29334957 PMCID: PMC5769555 DOI: 10.1186/s12891-018-1929-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Background In the late stage of Spinal tuberculosis, the bony destruction and vertebral collapse often leads to significant kyphosis, presenting clinically as a painful gibbus deformity, with increased instability, vertebral body translations and increased risk of neurologic involvement. Vertebral column decancellation is thought to be suitable for most patients with severe rigid kyphosis. Surgimap Spine, could offer a pragmatic graphical method for the surgical planning of osteotomies. The aim of this study was to evaluate the efficacy of Vertebral column decancellation planned preoperatively with the computer software-assistance in the patients with Pott’s kyphosis. Methods Between May 2012 and May 2015, 18 patients with Pott’s kyphosis underwent the Vertebral column decancellation using Surgimap Spine for preoperative surgical planning. Preoperative and postoperative Konstam’s angle, sagittal vertical angle, lumbar lordosis, thoracic kyphosis, pelvic tilt and pelvic incidence were measured. Visual analog scale and American Spinal Injury Association were documented. Results The Konstam’s angles decreased from 88.1° (range, 70–105°) preoperatively to 18.5° (range, 7–31°) (P < 0.01). All patients reached the physiological limits at the final follow-up. The mean VAS score was reduced from preoperative 7.1 (range, 6–8) to 1.8 (range, 1–3, P < 0.01) and the ODI improved from 65.8% (range, 58–74%) to 20.2% (range, 12–38%, P < 0.01). At final follow-up, there was radiographic evidence of solid fusion at the osteotomy site and fixed segments in all patients. Neurological function improved from ASIA scale D to E in 5 patients. The patients were followed up for 30.4 months on average. Conclusion Vertebral column decancellation is an effective treatment option for severe Pott’s kyphosis. The surgical planning software Surgimap Spine can be a reliable and helpful tool that provides a simplified method to evaluate and analyze the spino-pelvic parameters and simulate the osteotomy procedure. According to individual character, the appropriate surgery strategy should be selected.
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Affiliation(s)
- Wenhao Hu
- The Department of Orthopedics, Chinese PLA General Hospital, Fuxing Rd. 28, Haidian District, Beijing, China
| | - Xuesong Zhang
- The Department of Orthopedics, Chinese PLA General Hospital, Fuxing Rd. 28, Haidian District, Beijing, China
| | - Jiayi Yu
- Department of Renal cancer and Melanoma, Peking University Cancer Hospital, Fucheng Rd. 28, Haidian District, Beijing, China
| | - Fanqi Hu
- The Department of Orthopedics, Chinese PLA General Hospital, Fuxing Rd. 28, Haidian District, Beijing, China
| | - Hao Zhang
- The Department of Orthopedics, Chinese PLA General Hospital, Fuxing Rd. 28, Haidian District, Beijing, China
| | - Yan Wang
- The Department of Orthopedics, Chinese PLA General Hospital, Fuxing Rd. 28, Haidian District, Beijing, China.
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Zhu S, Xia L, Yu S, Chen S, Zhang J. The burden and challenges of tuberculosis in China: findings from the Global Burden of Disease Study 2015. Sci Rep 2017; 7:14601. [PMID: 29097809 PMCID: PMC5668247 DOI: 10.1038/s41598-017-15024-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/20/2017] [Indexed: 01/28/2023] Open
Abstract
To achieve the End Tuberculosis (TB) Strategy, it is important to understand the characteristics of TB in China, which may provide the government with important clues for controlling TB by 2030. Data from the Global Burden of Disease Study 2015 (GBD 2015) and Institute for Health Metrics and Evaluation (IHME) were reviewed and analysed. The age-standardized death rate decreased by 83.79% [95% uncertainty interval (UI) 73.06–87.10] from 1990 to 2015. The age-standardized prevalence of TB in males decreased steadily by 33.88% (95% UI 29.35–37.67) but nearly increased by 6.24% (95% UI -2.02–15.07) in females from 1990 to 2015. Disability-adjusted life years (DALYs) were higher in males than in females, and the highest TB burden was found in the elderly (70+ years of age). Over the period 1990–2015, the attributable age-standardized DALY rates for smoking decreased by 12.98% (95% UI 2.40–24.27), but increased for alcohol use and high fasting plasma glucose (HFPG). Greater attention should be paid to females especially in the under 5 years of age group, and more latent reasons explaining TB DALYs should be explored in future studies.
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Affiliation(s)
- Sui Zhu
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, 610044, China
| | - Lan Xia
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, P.R. China
| | - Shicheng Yu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Saobing Chen
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, 610044, China
| | - Juying Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, 610044, China.
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Prevalence of pulmonary tuberculosis in western China in 2010-11: a population-based, cross-sectional survey. Lancet Glob Health 2016; 4:e485-94. [PMID: 27283762 DOI: 10.1016/s2214-109x(16)30074-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/08/2016] [Accepted: 04/26/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Progress in tuberculosis control in China has been the slowest in western areas, which have the highest prevalence. We assessed the prevalence of pulmonary tuberculosis in the Xinjiang province, China, 10 years after introduction of a control programme based on directly observed treatment, short course. METHODS In this population-based, cross-sectional survey, we used a multistage stratified random cluster sample design to estimate the prevalence of smear-positive and bacteriologically confirmed (either smear positive or culture positive, or both) pulmonary tuberculosis among adults (aged ≥15 years) in Xinjiang who had been resident in their household for the last 6 months. The screening strategy and diagnosis followed WHO guidelines. We estimated prevalence by combining inverse probability weighting and multiple imputation of missing data. We compared our prevalence survey estimates with the ones from the 2010 China national pulmonary tuberculosis survey and the ones from a provincial pulmonary survey done in Xinjiang in 2000. The new smear-positive pulmonary tuberculosis notification rate in 2011 in Xinjiang was obtained to allow the calculation of patient diagnosis rate (PDR). FINDINGS Between Sept 1, 2010, and July 31, 2011, 31 081 individuals were eligible, of whom 29 835 (96·0%) participated in the survey. We identified 50 (0·2%) smear-positive and 101 (0·3%) bacteriologically confirmed pulmonary tuberculosis cases. The weighted prevalence of smear-positive pulmonary tuberculosis was 170 (95% CI 103-233) per 100 000 people and of bacteriologically confirmed pulmonary tuberculosis was 430 (249-611) per 100 000 people. Compared with 2000 Xinjiang survey estimates, the prevalence of smear-positive pulmonary tuberculosis has decreased by 26·4% (from 231 [95% CI 148-314] per 100 000 people), whereas the prevalence of bacteriologically confirmed pulmonary tuberculosis has increased by 17·8% (from 365 [237-493] per 100 000 people). In each age group and sex, the pulmonary tuberculosis prevalence was higher in the 2010-11 Xinjiang survey than in the 2010 national survey. The PDR in 2011 was 0·34 (95% CI 0·25-0·44). INTERPRETATION Despite progress in other parts of China, the prevalence of pulmonary tuberculosis in Xinjiang remains high. The very low PDR suggests poor access to diagnosis and care. Further studies are needed to understand the barriers to diagnosis and care of this population, and efforts are urgently needed to enhance tuberculosis screening in this area. FUNDING Xinjiang Uyghur Autonomous Region Health Bureau.
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Workneh MH, Bjune GA, Yimer SA. Prevalence and Associated Factors of Diabetes Mellitus among Tuberculosis Patients in South-Eastern Amhara Region, Ethiopia: A Cross Sectional Study. PLoS One 2016; 11:e0147621. [PMID: 26808967 PMCID: PMC4726615 DOI: 10.1371/journal.pone.0147621] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/06/2016] [Indexed: 12/31/2022] Open
Abstract
Background The association between diabetes mellitus (DM) and tuberculosis (TB) is re-emerging worldwide. Recently, the prevalence of DM is increasing in resource poor countries where TB is of high burden. The objective of the current study was to determine the prevalence and analyze associated factors of TB and DM comorbidity in South-Eastern Amhara Region, Ethiopia. Methods This was a facility based cross-sectional study. All newly diagnosed TB patients attending selected health facilities in the study area were consecutively screened for DM. DM was diagnosed based on the World Health Organization diagnostic criteria. A pre-tested semi-structured questionnaire was used to collect socio-demographic, lifestyles and clinical data. Logistic regression analysis was performed to identify factors associated with TB and DM comorbidity. Result Among a total of 1314 patients who participated in the study, the prevalence of DM was estimated at 109 (8.3%). Being female [odds ratio (OR) 1.70; 95% confidence interval (CI) (1.10–2.62)], patients age [41–64 years (OR 3.35; 95% CI (2.01–5.57), 65–89 years (OR 3.18; 95% CI (1.52–6.64)], being a pulmonary TB case [(OR 1.69; 95% CI 1.09–2.63)] and having a family history of DM [(OR 4.54; 95% CI (2.36–8.73)] were associated factors identified with TB and DM comorbidity. Conclusion The prevalence of DM among TB patients in South-Eastern Amahra Region is high. Routine screening of TB patients for DM is recommended in the study area.
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Affiliation(s)
- Mahteme Haile Workneh
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Amhara Regional State Health Bureau, Bahir-Dar, Ethiopia
- * E-mail:
| | - Gunnar Aksel Bjune
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Solomon Abebe Yimer
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Amhara Regional State Health Bureau, Bahir-Dar, Ethiopia
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway
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Ade S, Affolabi D, Agodokpessi G, Wachinou P, Faïhun F, Toundoh N, Békou W, Makpenon A, Ade G, Anagonou S, Harries AD. Low prevalence of diabetes mellitus in patients with tuberculosis in Cotonou, Benin. Public Health Action 2015; 5:147-9. [PMID: 26400387 DOI: 10.5588/pha.14.0110] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
SETTING The three Basic Management Units (BMUs) of the National Tuberculosis Programme (NTP) in Cotonou, Benin. OBJECTIVE To determine the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients in Cotonou. DESIGN A cross-sectional study of consecutively registered TB patients treated for a minimum of 2 weeks between June and July 2014 in the three BMUs, with measurement of their fasting blood glucose (FBG). A patient was considered as having DM if venous FBG was ⩾7 mmol/l or if they reported a known history of DM. RESULT There were 159 patients assessed: 114 with new smear-positive pulmonary tuberculosis (PTB), 5 with new smear-negative PTB, 8 with extra-pulmonary TB, 21 retreatment patients with fully susceptible bacilli and 11 with multidrug-resistant TB. Of these, respectively 31 (19%), 18 (11%) and 10 (6%) were human immunodeficiency virus co-infected, smokers and hypertensive. Eight patients (5%) had impaired fasting glucose and three (1.9%) had DM (FBG ⩾ 7 mmol/l), of whom two were already known to have the disease and one was newly diagnosed. CONCLUSION DM may not be an important risk factor for TB in Cotonou. A larger study on TB and DM in the whole country is needed.
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Affiliation(s)
- S Ade
- National Tuberculosis Programme, Cotonou, Benin ; Service de Médecine Interne, Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, Benin ; International Union Against Tuberculosis and Lung Disease, Paris, France
| | - D Affolabi
- National Tuberculosis Programme, Cotonou, Benin
| | | | - P Wachinou
- National Tuberculosis Programme, Cotonou, Benin
| | - F Faïhun
- National Tuberculosis Programme, Cotonou, Benin
| | - N Toundoh
- National Tuberculosis Programme, Cotonou, Benin
| | - W Békou
- National Tuberculosis Programme, Cotonou, Benin
| | - A Makpenon
- National Tuberculosis Programme, Cotonou, Benin
| | - G Ade
- National Tuberculosis Programme, Cotonou, Benin ; Service de Médecine Interne, Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, Benin
| | - S Anagonou
- National Tuberculosis Programme, Cotonou, Benin
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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