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Co-existence of diabetes and TB among adults in India: a study based on National Family Health Survey data
Journal of Biosocial Science ( IF 1.5 ) Pub Date : 2020-09-22 , DOI: 10.1017/s0021932020000516
Apyayee Sil 1 , Dinabandhu Patra 1 , Preeti Dhillon 1 , Padmanesan Narasimhan 2
Affiliation  

Multiple studies suggest that diabetes mellitus (DM) is a potential risk factor for tuberculosis (TB) development and treatment, especially in low- and middle-income countries. The study aimed to test concomitancy between DM and TB among adults in India. Data were from the 2015–16 National Family Health Survey (NFHS-4). The study sample comprised 107,575 men aged 15–54 and 677,292 women aged 15–49 for which data on DM status were available in the survey. The association between state-level prevalence of TB and DM was examined and robust Poisson regression analysis applied to examine the effect of DM on TB. A high prevalence of TB was observed among individuals with diabetes in India in 2015–16. A total of 866 per 100,000 men and 405 per 100,000 women who self-reported having diabetes also had TB; among those who self-reported not having diabetes the ratios were 407 per 100,000 men and 241 per 100,000 women. The risk of having TB among those who self-reported having DM was higher for both men (2.03, 95% CI: 1.26, 3.28) and women (1.79, 95% CI: 1.48, 2.49) than for those who did not self-report having DM. Adults who were diagnosed with diabetes (including pre-diabetes) also had a higher rate of TB (477 per 100,000 men and 331 per 100,000 women) than those who were not diagnosed (410 per 100,000 men and 239 per 100,000 women). Adults from poor families, with lower BMIs, lower levels of literacy and who were not working had a higher risk of TB–DM co-morbidity. The state-level pattern of co-morbidity, the under-reporting of DM (undiagnosed) and TB stigmatization are discussed. The study confirms that diabetes is an important co-morbid feature with TB in India, and reinforces the need to raise awareness on screening for the co-existence of DM and TB with integrated health programmes for the two conditions.

中文翻译:

印度成年人糖尿病和结核病的共存:一项基于全国家庭健康调查数据的研究

多项研究表明,糖尿病 (DM) 是结核病 (TB) 发展和治疗的潜在危险因素,尤其是在低收入和中等收入国家。该研究旨在测试印度成年人中 DM 和 TB 之间的伴随情况。数据来自 2015-16 年全国家庭健康调查 (NFHS-4)。研究样本包括 107,575 名 15-54 岁的男性和 677,292 名 15-49 岁的女性,调查中提供了 DM 状态数据。检验了州级结核病和糖尿病患病率之间的关联,并应用稳健的泊松回归分析来检验糖尿病对结核病的影响。2015-16 年,印度糖尿病患者的结核病患病率很高。每 100,000 名男性中有 866 名自称患有糖尿病,每 100,000 名女性中有 405 名患有结核病;在那些自我报告没有患糖尿病的人中,这一比例为每 100,000 名男性中有 407 人,每 100,000 名女性中有 241 人。男性 (2.03, 95% CI: 1.26, 3.28) 和女性 (1.79, 95% CI: 1.48, 2.49) 在自我报告患有 DM 的人中患 TB 的风险均高于未自我报告的人。报告有 DM。被诊断患有糖尿病(包括糖尿病前期)的成年人的结核病发病率(每 100,000 名男性 477 人,每 100,000 名女性 331 人)也高于未确诊的成年人(每 100,000 名男性 410 人,每 100,000 名女性 239 人)。来自贫困家庭、BMI 较低、识字水平较低且不工作的成年人患 TB-DM 合并症的风险较高。讨论了合并症的州级模式、DM(未诊断)的漏报和结核病的污名化。
更新日期:2020-09-22
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