Urban-rural difference in adverse outcomes of pulmonary tuberculosis in patients with pulmonary tuberculosis-diabetes mellitus comorbidity
10.19485/j.cnki.issn2096-5087.2025.01.002
- Author:
FANG Zijian
;
LI Qingchun
;
XIE Li
;
SONG Xu
;
DAI Ruoqi
;
WU Yifei
;
JIA Qingjun
;
CHENG Qinglin
- Publication Type:Journal Article
- Keywords:
pulmonary tuberculosis;
diabetes mellitus;
comorbidity;
adverse outcome;
urban-rural difference
- From:
Journal of Preventive Medicine
2025;37(1):7-11
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the urban and rural differences in adverse outcomes of pulmonary tuberculosis (PTB) in patients with pulmonary tuberculosis-diabetes mellitus comorbidity (PTB-DM), so as to provide insights into improving the prevention and treatment measures for PTB-DM.
Methods:Patients with PTB-DM who were admitted and discharged from 14 designated tuberculosis hospitals in Hangzhou City from 2018 to 2022 were selected. Basic information, and history of diagnosis and treatment were collected through hospital information systems. The adverse outcomes of PTB were defined as endpoints, and the proportions of adverse outcomes of PTB in urban and rural patients with PTB-DM were analyzed. Factors affecting the adverse outcomes of PTB were identified using a multivariable Cox proportional hazards regression model.
Results:A total of 823 patients with PTB-DM were enrolled, including 354 (43.01%) urban and 469 (56.99%) rural patients. There were 112 (13.61%) patients with adverse outcomes of PTB. The proportions of adverse outcomes of PTB in urban and rural patients were 14.41% and 13.01%, respectively, with no statistically significant difference (P>0.05). Multivariable Cox proportional hazards regression analysis identified first diagnosed in county-level hospitals or above (HR=2.107, 95%CI: 1.181-3.758) and drug resistance (HR=3.303, 95%CI: 1.653-6.600) as the risk factors for adverse outcomes of PTB in urban patients with PTB-DM, while the treatment/observed management throughout the process (HR=0.470, 95%CI: 0.274-0.803) and fixed-dose combinations throughout the process (HR=0.331, 95%CI: 0.151-0.729) as the protective factors for adverse outcomes in rural patients with PTB-DM.
Conclusions:There are differences in influencing factors for adverse outcomes of PTB in urban and rural patients with PTB-DM. The adverse outcomes of PTB are associated with first diagnosed hospitals and drug resistance in urban patients, and are associated with the treatment/observed management and fixed-dose combinations throughout the process in rural patients.
- Full text:2025011713560311588肺结核与糖尿病共病患者肺结核不良转归的城乡差异.pdf
