Auguste Milhenka, McGuire-Wolfe Christine, Alonso Alina, Okobi Okelue E
Family Medicine, Lakeside Medical Center, Belle Glade, USA.
Infectious Disease, Florida Department of Health in Palm Beach County, Palm Beach, USA.
Cureus. 2021 Nov 24;13(11):e19852. doi: 10.7759/cureus.19852. eCollection 2021 Nov.
Background With tuberculosis (TB) being among the top 13 leading cause of death and second leading infectious disease killer next to COVID-19 globally, there is a need for continued study and a better understanding of the risk factors and management approaches. One in five tuberculosis (TB) deaths occurs in individuals who have contracted human immunodeficiency virus (HIV). However, other risk factors play a role in its morbidity pattern. Therefore, descriptions of these comorbidities between TB, HIV, and other risk factors such as diabetes are needed. Method A retrospective, descriptive study was conducted to evaluate the prevalence of TB and its relationship with some risk factors (HIV, diabetes, race, ethnicity, end-stage renal disease, post-organ transplant, recent contact with active TB, and other non-HIV immunosuppressive conditions) using data from three South Florida counties (Dade, Broward, and Palm Beach) from 2010 to 2019 retrieved from the CDC's (RVCT). Results A total of 2437 cases of TB were reported between 2010 and 2019. There was approximately a 14% positive rate among the three counties for HIV. In contrast, 47% of the individuals with active TB in all three counties were also diagnosed with diabetes mellitus. An average of 25% of the active TB cases in these counties had a concurrent immunosuppressive condition other than HIV. Known contact with another active TB case was an identified risk factor in 18%, 17%, and 29% of reported TB cases in Dade, Broward, and Palm Beach counties, respectively. Discussion The HIV status of patients with TB in these three counties was predominantly negative, in contrast to initial theories. The presence of diabetes mellitus was associated with a diagnosis of TB or latent tuberculosis infection (LTBI) within the studied population. Conclusion Screening for latent tuberculosis infection (LTBI), compliance, and promotion of LTBI management in newly diagnosed and uncontrolled diabetics may be a successful prevention strategy for this high-risk group
背景 结核病是全球13大主要死因之一，是仅次于新型冠状病毒肺炎的第二大传染病杀手，因此需要持续开展研究并更好地了解其风险因素和管理方法。五分之一的结核病死亡发生在感染了人类免疫缺陷病毒（HIV）的个体中。然而，其他风险因素也在其发病模式中起作用。因此，需要描述结核病、HIV和其他风险因素（如糖尿病）之间的这些合并症。方法 进行了一项回顾性描述性研究，利用从疾病控制与预防中心的回顾性虚拟队列研究（RVCT）中获取的2010年至2019年南佛罗里达三个县（戴德、布劳沃德和棕榈滩）的数据，评估结核病的患病率及其与一些风险因素（HIV、糖尿病、种族、民族、终末期肾病、器官移植后、近期接触活动性结核病以及其他非HIV免疫抑制状况）的关系。结果 2010年至2019年期间共报告了2437例结核病病例。这三个县的HIV阳性率约为14%。相比之下，所有三个县中47%的活动性结核病患者也被诊断患有糖尿病。这些县中平均25%的活动性结核病病例同时患有除HIV以外的免疫抑制状况。在戴德、布劳沃德和棕榈滩县，分别有18%、17%和29%的报告结核病病例中，已知与另一名活动性结核病病例有接触是一个确定的风险因素。讨论 与最初的理论相反，这三个县结核病患者的HIV状况主要为阴性。在所研究的人群中，糖尿病的存在与结核病或潜伏性结核感染（LTBI）的诊断相关。结论 对新诊断和未得到控制的糖尿病患者进行潜伏性结核感染（LTBI）筛查、依从性监测以及促进LTBI管理，可能是针对这一高危人群的成功预防策略
