Institute of Public Health and Social Sciences, KMU Peshawar-Pakistan.
Institute of Public Health and Social Sciences, KMU Peshawar-Pakistan Department of Health Sciences, University of York, York-United Kingdom.
J Ayub Med Coll Abbottabad. 2024 Apr-Jun;36(2):316-322. doi: 10.55519/JAMC-02-12677.
With the rise of non-communicable diseases (NCDs) in a country that is already facing high tuberculosis (TB) burden, TB multi-morbidity is likely to pose a significant public health challenge in Pakistan. Data were analysed to determine the prevalence of TB and explore the distribution and determinants of multi-morbidity associated with TB in the population of Khyber Pakhtunkhwa -a province of Pakistan.
This is a secondary analysis of data gathered as part of the KPIPHS survey conducted in 2016-17 in both the rural and urban areas of Khyber Pakhtunkhwa, Pakistan. An interviewer-administered questionnaire was used to collect data, from adults, on demographics, education and socioeconomic status, physical and mental health, reproductive health, child health, health-related quality of life, and self-reported cardiometabolic diseases including Diabetes, hypertension, renal disorders, cardiac failure, angina, and stroke.
A total of 20,715 participants were recruited in the survey including 52.8% (n=10,943) males and 47.2% (n=9,772) females with a mean age of 41 (13.1) years. Data on TB status was available for a total of 14452 participants. The prevalence of TB in Khyber Pakhtunkhwa was found to be 0.49% (n=72) including an almost equal number of males and females [48% (n=34) vs 51% (n=36)], respectively. The mean age of the patients with TB was 47.5 (11.6) years. A higher proportion of people with TB had cardiometabolic diseases compared to people without TB (45.9% vs. 30.9%). Amongst the cardiometabolic disorders, self-reported hypertension (OR: 1.81, 95% CI 1.08-3.02, p=0.02), Diabetes (OR: 3.99, 95% CI 1.95-8.18, p=<0.002), and angina (OR: 3.88 95% CI 1.20-12.49, p=0.02) were positively associated with the occurrence of TB. In the adjusted analysis, only self-reported Diabetes was positively associated with the occurrence of TB (OR: 3.33, 95% CI 1.61-6.88, p=0.001).
There is a higher burden of self-reported cardiometabolic diseases among people with TB, suggesting that this high-risk group should be screened for cardiometabolic diseases, especially Diabetes.
随着非传染性疾病（NCDs）在一个已经面临高结核病（TB）负担的国家的上升，TB 合并症很可能在巴基斯坦构成重大公共卫生挑战。对数据进行了分析，以确定结核病的流行情况，并探讨与该地区人口相关的结核病合并症的分布和决定因素。
这是对 2016-17 年在巴基斯坦开伯尔-普赫图赫瓦省（巴基斯坦的一个省）城乡地区进行的 KPIPHS 调查中收集的数据进行的二次分析。使用访谈者管理的问卷从成年人那里收集了有关人口统计学、教育和社会经济地位、身心健康、生殖健康、儿童健康、与健康相关的生活质量以及自我报告的心血管代谢疾病的数据，包括糖尿病、高血压、肾脏疾病、心力衰竭、心绞痛和中风。
调查共招募了 20715 名参与者，其中包括 52.8%（n=10943）男性和 47.2%（n=9772）女性，平均年龄为 41（13.1）岁。共有 14452 名参与者提供了结核病状况数据。在开伯尔-普赫图赫瓦发现结核病的患病率为 0.49%（n=72），其中男性和女性的比例几乎相等[48%（n=34）与 51%（n=36）]。结核病患者的平均年龄为 47.5（11.6）岁。与没有结核病的人相比，患有结核病的人患心血管代谢疾病的比例更高（45.9% 与 30.9%）。在心血管代谢疾病中，自我报告的高血压（OR：1.81，95%CI 1.08-3.02，p=0.02）、糖尿病（OR：3.99，95%CI 1.95-8.18，p<0.002）和心绞痛（OR：3.88 95%CI 1.20-12.49，p=0.02）与结核病的发生呈正相关。在调整分析中，只有自我报告的糖尿病与结核病的发生呈正相关（OR：3.33，95%CI 1.61-6.88，p=0.001）。
患有结核病的人中有更高比例的自我报告心血管代谢疾病，这表明该高危人群应进行心血管代谢疾病筛查，尤其是糖尿病。
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