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结核病与糖尿病:与社会人口学特征以及结核病诊断和治疗的关联。巴西,2007年至2011年。

Tuberculosis and diabetes: association with sociodemographic characteristics and diagnosis and treatment of tuberculosis. Brazil, 2007-2011.

作者信息

Abreu Ricardo Gadelha de, Rolim Lúcia Santana, Sousa Artur Iuri Alves de, Oliveira Maria Regina Fernandes de

机构信息

Ministério da Saúde, Secretaria de Atenção Primária à Saúde - Brasília (DF), Brasil.

Ministério da Saúde, Secretaria de Vigilância Sanitária - Brasília (DF), Brasil.

出版信息

Rev Bras Epidemiol. 2020 Feb 21;23:e200009. doi: 10.1590/1980-549720200009. eCollection 2020.

Abstract

INTRODUCTION

Tuberculosis and diabetes comorbidity remains a challenge for global public health.

OBJECTIVE

To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil.

METHODS

This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals.

RESULTS

We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87).

CONCLUSION

The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.

摘要

引言

结核病与糖尿病合并存在仍是全球公共卫生面临的一项挑战。

目的

分析巴西患结核病且合并糖尿病与未合并糖尿病病例的社会人口学特征以及诊断和治疗特点。

方法

这是一项横断面研究,数据来源于2007年至2011年的法定传染病信息系统以及高血压和糖尿病初级保健临床管理系统。我们采用了具有稳健方差的泊松回归模型来估计患病率比(PR)及其各自的置信区间。

结果

我们在7.2%的病例中发现了所研究的合并症。分层模型显示女性中的患病率比更高(PR = 1.31;95%置信区间 - 95%CI 1.27 - 1.35);在40 - 59岁和≥60岁年龄组中关联更强(PR = 11.70;95%CI 10.21 - 13.39,以及PR = 17.49;95%CI 15.26 - 20.05),且在痰涂片显微镜检查结果为阳性的首个样本中也是如此(PR = 1.40;95%CI 1.35 - 1.47)。治疗中断后返回以及治疗中断与合并症呈负相关(PR = 0.66;95%CI 0.57 - 0.76和PR = 0.79;95%CI 0.72 - 0.87)。

结论

这些发现,例如合并症患者组中与结核病治疗中断的负相关关系,强化了卫生服务中综合行动对于改变这种具有挑战性的合并症情况的重要性。

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