糖尿病与耐多药结核病之间的关联：一项系统评价与荟萃分析方案
Association between diabetes mellitus and multi-drug-resistant tuberculosis: a protocol for a systematic review and meta-analysis.
作者信息
Tegegne Balewgizie Sileshi, Habtewold Tesfa Dejenie, Mengesha Melkamu Merid, Burgerhof Johannes G M
机构信息
Department of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
出版信息
Syst Rev. 2017 Jan 14;6(1):6. doi: 10.1186/s13643-017-0407-9.
INTRODUCTION
Multi-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries. Diabetes mellitus (DM) is an increasingly recognized comorbidity that can both accelerate TB disease and complicate its treatment. The aim of this study is to summarize available evidence on the association of DM and MDR-TB among TB patients and to provide a pooled estimate of risks.
METHODS
All studies published in English before October 2016 will be searched using comprehensive search strings through PubMed, EMBASE, Web of Science, and WHO Global Health Library databases which have reported the association of DM and MDR-TB in adults with TB (age > =15). Two authors will independently collect detailed information using structured data abstraction form. The quality of studies will be checked using Newcastle-Ottawa Scale for cohort and case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. Heterogeneity between included studies will be assessed using the I statistic. We will check potential publication bias by visual inspection of the funnel plot and Egger's regression test statistic. We will use the random effects model to compute a pooled estimate.
DISCUSSION
Increases in the burden of non-communicable diseases and aging populations are changing the importance of different risk factors for TB, and the profile of comorbidities and clinical challenges for people with TB. Although classic risk factors and comorbidities such as overcrowding, under-nutrition, silicosis, and HIV infection are crucial to address, chronic conditions like diabetes are important factors that impair host defenses against TB. Thus, undertaking integrated multifaceted approach is remarkably necessary for reducing the burden of DM and successful TB treatment outcome.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016045692 .
引言
耐多药结核病（MDR-TB）已成为全球结核病控制的一项挑战，在许多国家仍然是一个主要的公共卫生问题。糖尿病（DM）是一种日益被认识到的合并症，它既能加速结核病的发展，又会使其治疗复杂化。本研究的目的是总结结核病患者中糖尿病与耐多药结核病关联的现有证据，并提供风险的汇总估计。
方法
通过全面的检索词，在PubMed、EMBASE、科学网和世界卫生组织全球卫生图书馆数据库中检索2016年10月之前发表的所有英文研究，这些研究报告了成人结核病患者（年龄≥15岁）中糖尿病与耐多药结核病的关联。两位作者将使用结构化数据提取表独立收集详细信息。使用纽卡斯尔-渥太华量表对队列研究和病例对照研究进行质量检查，使用医疗保健研究与质量机构工具对横断面研究进行质量检查。使用I统计量评估纳入研究之间的异质性。我们将通过漏斗图的视觉检查和Egger回归检验统计量检查潜在的发表偏倚。我们将使用随机效应模型计算汇总估计值。
讨论
非传染性疾病负担的增加和人口老龄化正在改变结核病不同危险因素的重要性，以及结核病患者的合并症情况和临床挑战。尽管诸如过度拥挤、营养不良、矽肺病和艾滋病毒感染等经典危险因素和合并症对于应对至关重要，但糖尿病等慢性病是损害宿主抗结核防御能力的重要因素。因此，采取综合多方面的方法对于减轻糖尿病负担和成功治疗结核病结果非常必要。
系统评价注册
PROSPERO CRD42016045692
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