Epidemiological characteristics and temporal trends of pulmonary tuberculosis complicated diabetes in Nanjing,2015-2022
Objective To analyze the epidemiological characteristics and temporal trends of tuberculosis complicated with diabetes in Nanjing,Jiangsu Province,to provide scientific basis for the treatment of pulmonary tuberculosis complicated with diabetes.Methods The Tuberculosis Information Management System was used to derive cases of tuberculosis patients from 2015-2022 according to their current residential address,and the temporal trends in the incidence of pulmonary tuberculosis complicated diabetes were analyzed using the Join-point 4.9.0.0 software.According to whether tuberculosis patients had diabetes,SPSS 22.0 software was used to analyze the differences in population,regional,and diagnostic characteristics between the two groups.Results From 2015 to 2022,a total of 566 patients with pulmonary tuberculosis complicated diabetes were registered in Nanjing.The average annual reported incidence rate over 8 years was 0.82 per 100 000,rising from 0.21 per 100 000 in 2015 to 2.40 per 100 000 in 2022.The annual reported incidence rate showed an overall upward trend,with a statistically significant difference(APC=50.0%,95%CI:37.4%-63.8%,t=11.3,P<0.001).In terms of gender,the sex ratio of those with diabetes was 4.60∶1,which was higher than that of those without diabetes(2.12∶1),with a statistically significant difference(χ2=50.63,P<0.001);in terms of age,the highest number of patients with pulmonary tuberculosis complicated diabetes was in the 65-75 years age group,accounting for 28.45%(161/566),while the highest number of patients with pulmonary tuberculosis without diabetes was in the 25-35 years age group,accounting for 19.59%(3 620/18 477);regionally,the proportion of rural areas for those with diabetes was 73.85%(418/566),and the proportion of rural areas for those without diabetes was 58.22%(10 758/18 477),which showed that rural areas were higher than urban areas(χ2=54.68,P<0.001).In terms of the characteristics of diagnosis and treatment,the patients with diabetes had a higher proportion of positive pathology,a lower proportion of successful treatment,a higher proportion of multi-drug resistance,and a higher proportion of extra-pulmonary tuberculosis,with the proportions of 75.80%vs 51.45%,67.67%vs 89.43%,2.65%vs 1.85%,and 13.60%vs 6.28%,respectively.All these differences were statistically significant(P<0.001).Conclusions The overall annual reported incidence of pulmonary tuberculosis complicated diabetes in Nanjing from 2015 to 2022 showed an overall upward trend over time.Hence,more efforts should be made in the prevention and control of such patients.