The prevalence and risks of major comorbidities among inpatients with pulmonary tuberculosis in China from a gender and age perspective: a large-scale multicenter observational study

Kang, Wanli; Du, Juan; Yang, Song I; Yu, Jiajia; Chen, Hongyan; Liu, Jianxiong; Ma, Jun; Li, Mingwu; Qin, Jianjie; Shu, Wei; Zong, Peilan; Zhang, Yi; Dong, Yongkang; Yang, Zhiyi; Mei, Zaoxian; Deng, Qunyi; Wang, Pu; Han, Wenge; M, Wu; Chen, Ling; Zhao, Xinguo; Tan, Lei; Li, Fujian; Zheng, Chao; Liu, Hongwei; Li, Xinjie; Ertai, A; Du, Yingrong; Liu, Fenglin; Wenyu, Cui; Wang, Quanhong; Chen, Xiaohong; Han, Junfeng; Xie, Qingyao; Feng, Yanghe; Liu, Wenyu; Tang, Peijun; Zhang, Jianyong; Zheng, Jian; Chen, Fan; Yao, Xiangyang; Ren, Tong; Yang, Li; Li, Yuanyuan; Wu, Lei; Song, Qiang; Yang, Mei; Zhang, Jian; Liu, Yuanyuan; Guo, Shuliang; Yan, Kun; Shen, Xinghua; Lei, Dan; Zhang, Yanli; Yan, Xiaofeng; Li, Liang; Tang, Shenjie

doi:10.1007/s10096-020-04077-2

Cited by 17 publications

(19 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Testosterone plays an immunosuppressive and harmful role in the pathogenesis of TB. Adult males are more likely to develop active disease due to smoking, biological or comorbidities [ 33 ], leading to higher mortality [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020

Dong

Wang

et al. 2022

Infect Dis Poverty

View full text Add to dashboard Cite

Background Tuberculosis (TB) poses a severe public health challenge in China and worldwide. This study evaluated the effects of age, period, and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups. Methods Aggregate data that reported pulmonary tuberculosis (PTB) cases from China Tuberculosis Management Information System (TBIMS) from 2006 to 2020 were used to analyze effect coefficients through the age–period–cohort (APC) model based on intrinsic estimator (IE) method, and converted them into relative risk (RR) to estimate trends. Results A total of 14.82 million cases of PTB were reported in China from 2006 to 2020, showing a continuous downward trend. The reporting rate increased with age by age group, with 70–74 years old being 2–3 times higher than that in 20–24 years old. APC analysis model showed that age effects were bimodal in 20–24 years old [RR = 2.29, 95% confidence interval (CI): 1.73–3.03] and 70–74 years old (RR = 1.95, 95% CI: 1.67–2.27), and lower than the overall average in the groups under 15 years old. Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40. The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old. The risk for 15–34 years old was significantly higher in the east than in other regions. The period effects showed a decreasing trend, and the risk was higher in rural in recent years. Except for cohorts born in 1961–1965 and 2001–2005, where the RR increased, the later the cohort was born, the lower the risk. The cohort 1926–1930 in eastern had the highest risk (RR = 3.49, 95% CI: 2.44–4.98). Conclusions The reported incidence of PTB continued to decline in China from 2006 to 2020. The young (20–24 years old) and the elderly (70–74 years old) were equally at high risk. There were differences in the age, period and cohort effects on PTB incidence among gender, urban–rural and regions. Our findings better reflected the characteristics of high-risk populations, thus contributing to the development of timely and effective intervention strategies, and providing clues for etiological research. Graphical abstract

show abstract

Section: Discussionmentioning

confidence: 99%

Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020

Dong

Wang

et al. 2022

Infect Dis Poverty

View full text Add to dashboard Cite

show abstract

“…Another strength of this study is the use of LCA in providing information regarding clinically meaningful subgroups (19). More simplistic methods employed a fixed list of chronic conditions in defining chronic condition groups, our datadriven approach allowed inclusion of all observed diagnoses to identify distinct subgroups (20)(21)(22). This approach takes account for potentially joint comorbidity patterns between more severe chronic conditions such as heart failure and common illnesses like hypertension and gout, our study is capable of elucidating more detailed condition combinations.…”

Section: Discussionmentioning

confidence: 99%

Impact of Multimorbidity Subgroups on the Health Care Use and Clinical Outcomes of Patients With Tuberculosis: A Population-Based Cohort Analysis

Chen

Xiao

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Background: Multimorbidity is defined as the existence of two or more chronic health conditions in the same individual. While patients with tuberculosis commonly have multiple conditions at diagnosis, such as HIV, diabetes, and depression, to the authors' knowledge, there is limited information on the patterns of multimorbidity, and how the types and combinations of conditions could impact the healthcare utilization, expenditure, and TB outcomes.Methods: An observational cohort study of adult patients diagnosed with tuberculosis was conducted using the Chinese Center for Disease Control and Prevention (CDC)'s National TB Information System (NTBIS) linked to the Ningbo Regional Health Care Database (NRHCD) (2015–2020). Latent class analysis was used to identify comorbidity groups among the subset with ≥2 conditions including TB. Group-level health care use, expenditure, and treatment outcomes were compared with patients without chronic conditions using multivariate regression models.Results: A total of 9,651 patients with TB were identified, of whom approximately 61.4% had no chronic conditions, 17.4% had 1 chronic condition, and 21.3% had ≥2 chronic conditions. Among those with ≥1 chronic condition other than TB, 4 groups emerged: (1) general morbidity (54.4%); (2) cardiovascular morbidity without complications (34.7%); (3) cardiovascular morbidity with complications (5.0%); (4) respiratory morbidity (5.9%). The respiratory morbidity group experienced the highest expenditures, at 16,360 CNY more overall (95% CI, CNY 12,615–21,215) after adjustment compared with TB patients without chronic conditions. The respiratory morbidity and cardiovascular morbidity with complications group also had the lowest odds of favorable TB outcomes [adjusted odds ratio (aOR), 0.68; 95% CI, 0.49–0.93] and (aOR 0.59, 95% CI 0.42–0.83), respectively. The cardiovascular morbidity without complications group had the highest odds of successful TB treatment (aOR, 1.40; 95% CI, 1.15–1.71).Conclusions: Multimorbidity is common among patients with TB. The current study identified four distinct comorbidity subgroups, all of which experienced high, yet differential, rates of health care use. These findings highlight the need for urgent reforms to transform current fragmented TB care delivery and improve access to other specialists and financial assistance.

show abstract

“…Previous studies revealed that age is a vital factor of TB incidence, and ageing may lead to a continuous increase in the risk of TB [ 15 ]. Gender is considered to be another factor implicated in TB incidence, and TB is more common in males than females [ 16 ]. In order to clarify the impact of genetic factors on TB risk in different age and gender groups, the present study performed an analysis of the stratification to provide more clues for further study.…”

Section: Introductionmentioning

confidence: 99%

Associations of genetic variants at TAP1 and TAP2 with pulmonary tuberculosis risk among the Chinese population

et al. 2021

View full text Add to dashboard Cite

Tuberculosis (TB) is a common infectious disease, and the present study aims to explore the associations of single nucleotide polymorphisms (SNPs) at rs1135216 and rs1057141 of transporter-associated antigen processing (TAP1) and rs2228396 of TAP2 with pulmonary tuberculosis (PTB) risk. A case–control study including 168 smear-positive PTB cases and 251 controls was conducted. Genotyping of the SNPs at rs1135216, rs1057141 and rs2228396 was performed, and their associations with PTB risk were analysed with SPSS software version 19.0. After conducting stratification for age, a significant association was detected for rs1057141 with increased PTB risk (OR = 0.17, 95% CI 0.04–0.79) among those aged ≥60 years. For those aged <60 years, a marginally significant association was detected between rs1135216 TC/CC and PTB risk (OR = 1.97, 95% CI 0.93–4.19). Haplotype analysis revealed that the haplotype AT at rs1135216 and rs2228396, as well as AAT at rs1057141, rs1135216 and rs2228396, was associated with increased PTB risk, and the ORs were 2.83 (95% CI 1.30–6.14) and 2.89 (95% CI 1.34–6.27), respectively. Rs1057141 is a genetic predictor of reduced PTB risk for those aged ≥60 years, while rs1135216 might be a potential genetic predictor for those aged <60 years. Haplotype AT at rs1135216 and rs2228396, as well as AAT at rs1057141, rs1135216 and rs2228396, is a genetic marker that may predict PTB risk.

show abstract

The prevalence and risks of major comorbidities among inpatients with pulmonary tuberculosis in China from a gender and age perspective: a large-scale multicenter observational study

Cited by 17 publications

References 34 publications

Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020

Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020

Impact of Multimorbidity Subgroups on the Health Care Use and Clinical Outcomes of Patients With Tuberculosis: A Population-Based Cohort Analysis

Associations of genetic variants at TAP1 and TAP2 with pulmonary tuberculosis risk among the Chinese population

Contact Info

Product

Resources

About