Bardenheier Barbara H, Pavkov Meda E, Winston Carla A, Klosovsky Alex, Yen Catherine, Benoit Stephen, Gravenstein Stefan, Posey Drew L, Phares Christina R
Centers for Disease Control and Prevention, 1600 Clifton Rd, NE MS E-03, 30333, Atlanta, GA, Georgia.
International Organization for Migration, Washington, USA.
J Immigr Minor Health. 2019 Dec;21(6):1275-1281. doi: 10.1007/s10903-018-00852-8.
The association between chronic kidney disease (CKD) and tuberculosis disease (TB) has been recognized for decades. Recently CKD prevalence is increasing in low- to middle-income countries with high TB burden. Using data from the required overseas medical exam and the recommended US follow-up exam for 444,356 US-bound refugees aged ≥ 18 during 2009-2017, we ran Poisson regression to assess the prevalence of TB among refugees with and without CKD, controlling for sex, age, diabetes, tobacco use, body mass index ( kg/m), prior residence in camp or non-camp setting, and region of birth country. Of the 1117 (0.3%) with CKD, 21 (1.9%) had TB disease; of the 443,239 who did not have CKD, 3380 (0.8%) had TB. In adjusted analyses, TB was significantly higher among those with than without CKD (prevalence ratio 1.93, 95% CI: 1.26, 2.98, p < 0.01). Healthcare providers attending to refugees need to be aware of this association.
慢性肾脏病（CKD）与结核病（TB）之间的关联已被认识数十年。最近，在结核病负担较高的低收入和中等收入国家，CKD的患病率正在上升。利用2009年至2017年期间444356名年龄≥18岁的赴美难民所需的海外体检数据和建议的美国后续体检数据，我们进行了泊松回归分析，以评估患有和未患有CKD的难民中的结核病患病率，并对性别、年龄、糖尿病、吸烟情况、体重指数（kg/m）、之前在难民营或非难民营居住情况以及出生国地区进行了控制。在1117名（0.3%）患有CKD的人中，21名（1.9%）患有结核病；在443239名未患有CKD的人中，3380名（0.8%）患有结核病。在调整分析中，患有CKD的难民中的结核病患病率显著高于未患有CKD的难民（患病率比值为1.93，95%置信区间：1.26，2.98，p<0.01）。为难民提供医疗服务的医护人员需要了解这种关联。
