Characteristics, incidence trends, and treatment outcomes of tuberculosis patients with diabetes in Chongqing city from 2016 to 2022: an analysis of registration data

Abstract

ObjectiveTo understand the epidemiologic trends and factors influencing the prevention and control of pulmonary tuberculosis with diabetes mellitus (PTB-DM) in Chongqing city, and to provide a basis for reducing the risk of comorbidities and improving patient outcomes in the region. MethodsData on PTB-DM patients registered in Chongqing city from 2016 to 2022 were extracted from the National Tuberculosis Information Management System. Descriptive analysis was used to analyze disease trends and demographic characteristics. Chi-square test was used to compare between groups. Multivariate unconditional logistic regression was used to analyze factors influencing patient outcomes. Joinpoint regression model was used to analyze disease trends. ResultsFrom 2016 to 2022, the average registration rate of PTB patients in Chongqing city was 49.38/100 000, with a decreasing trend (average annual percentage change [AAPC]= −10.70%, 95% confidence interval [95%CI]: 16.16%–5.63%). The average registration rate of PTB-DM patients was 2.9/100 000, with an increasing trend (AAPC=14.38%, 95%CI: 7.08%–23.73%). Enrolled PTB-DM were predominantly male, older, referred, had delayed medical visits, and had positive pathogen detection results. Among the outcomes of PTB-DM patients, successful treatment accounted for 80.85% and adverse outcomes accounted for 19.15%. The average annual treatment success rate was 82.01%. Joinpoint regression analysis showed a decreasing trend in the patients′ treatment success rate. Multivariate unconditional logistic regression analysis showed that ethnic minorities (odds ratio [OR]=0.744, 95%CI: 0.633–0.874), 0–24 years old (OR=0.217, 95%CI: 0.051–0.922), 25–39 years old (OR=0.540, 95%CI: 0.398–0.734), 40–54 years old (OR=0.488, 95%CI: 0.416–0.572), 55–64 years old (OR=0.709, 95%CI: 0.607–0.828), initial treatment (OR=0.648, 95%CI: 0.531–0.791), and with negative pathogen detection results (OR=0.576, 95%CI: 0.489–0.677) were protective factors against adverse outcomes in PTB-DM patients. Living in southeast Chongqing (OR=1.560, 95%CI: 1.218–1.999) and being referred for treatment (OR=1.289, 95%CI: 1.080–1.539) were risk factors for adverse outcomes in PTB-DM patients. ConclusionsThe co-morbidity trend of PTB-DM in Chongqing city is obvious. Treatment and management factors, such as diagnostic route, delayed medical visits and management methods, have an impact on the treatment outcomes of PTB-DM patients.

Keywords

• tuberculosis
• diabetes
• comorbidity
• epidemiological trend
• treatment outcome
• chongqing city