Factors Associated with Participation in Pulmonary Tuberculosis Screening Using Chest X-Ray among Diabetes Mellitus Type II Patients in Denpasar, Bali, Indonesia

Abstract

Diabetes mellitus (DM) increases the risk of developing pulmonary tuberculosis (TB) disease. Therefore, pulmonary TB screening among DM patients is essential. This study aimed to identify factors associated with participation of DM type II patients in pulmonary TB screening using chest X-ray. This was a cross-sectional analytic study and was part of TB-DM screening study in Denpasar, Bali, Indonesia. The sample consisted of 365 DM type II patients selected by quota sampling among DM type II patients joining the screening program from January until March 2016 in 11 public health centres in Denpasar. Data were collected via structured interviews. The contributing factors were determined by modified Poisson regression test for cross-sectional data. From the findings, less than half (45.48%) of DM type II patients participated in chest X-ray examination for TB. Factors associated with participation in pulmonary TB screening were having a higher educational level [APR = 1.34, 95% CI (1.07–1.67)], having family member who developed pulmonary TB disease [APR = 1.47, 95% CI (1.12–1.93)], the travel time to referral hospital for screening being ≤ 15 minutes [APR = 1.6, 95% CI (1.26–2.03)], having health insurance [APR = 2.69, 95% CI (1.10–6.56)], and receiving good support from health provider [APR = 1.35, 95% CI (1.06–1.70)]. Therefore, training for health provider on providing counselling, involvement of family members in screening process, and improving the health insurance coverage and referral system are worth considering.

CT Image Features of the FBP Reconstruction Algorithm in the Evaluation of Fasting Blood Sugar Level of Diabetic Pulmonary Tuberculosis Patients and Early Diet Nursing

“…The examination methods of diabetes complicated with tuberculosis mainly include X-ray and CT, but the X-ray is inferior to CT in determining the activity of tuberculosis [ 11 ]. Multislice spiral CT overcomes the image overlap problem in traditional X-ray examinations thanks to its high density and spatial resolution and significantly increases the detection rate of lesions.…”

Relationship Between Clinical, Laboratory, and Radiological Symptoms with The Incidence of Active Pulmonary Tuberculosis in People with Type 2 Diabetes Mellitus

“…Research byWahiduddin et al, (2019) in Surabaya obtained an average age in DM-TB subjects of 51.91 7.93 and 55.78 7.36 in DM subjects without TB. The results of this study indicate that most of the subjects were aged 45 years in both DM-TB and DM without TB[12].Other research byPutra et al, (2018) in Bali, has the same age characteristics, namely out of 365 subjects of type 2 DM who screened as many as 335 aged> 45 years[13]. Research byDas et al, (2017) in Bhubaneswar, Odisha screened for type 2 DM in subjects with pulmonary TB, out of 350 samples as many as 236 were aged 45[14] .The results of statistical analysis that are not related between these two studies can be caused by first the number of age samples in DM-TB and DM subjects without TB is the same, second 45 years of age is one of the risk factors for type 2 DM, third 45 years of age is a productive age with high activity and mobility so that it has a high probability of contact with other people.…”

Shift in Tissue-Specific Immune Niches and CD137 Expression in Tuberculoma of Pembrolizumab-Treated Nasopharyngeal Carcinoma Patients

“…The balance of CD4+ Th cell subsets (Th1/Th2/Th17/Treg) is crucial in determining the outcome of MTB infections [24]. To understand this, we examined the expressions of transcription factors (T-bet, GATA3, RORγt and FOXP3) that regulate the development of these subsets [25].…”