Hyperglycemia is associated with increased risk of patient delay in pulmonary tuberculosis in rural areas1: 高血糖与农村地区肺结核患者延误就诊风险增加相关. (20th September 2016)

• Record Type: Journal Article
• Authors: Wang, Qiuzhen; Ma, Aiguo; Han, Xiuxia; Zhao, Shanliang; Cai, Jing; Kok, Frans J.; Schouten, Evert G.
• Is Part Of: Journal of diabetes. Volume 9:Number 7(2017)
• Page Start: 648
• Page End: 655
• Publication Date: 2016-09-20
• Subjects: community -- determining factor -- diabetes mellitus -- infectious disease -- odds ratio; 社区 -- 决定因素 -- 糖尿病 -- 传染病 -- 优势比; Diabetes -- Periodicals; 618.3646005
• DOI: 10.1111/1753-0407.12459
• Languages: English
• ISSNs: 1753-0393

Abstract

Abstract: Background: Excessive time between the first presentation of symptoms of pulmonary tuberculosis (PTB) and diagnosis contributes to ongoing transmission and increased risk of infection in the community, as well as to increased disease severity and higher mortality. People with type 2 diabetes mellitus (T2DM) have a higher risk of developing PTB. However, the effect of T2DM on delayed diagnosis of PTB is not fully understood. This study investigated the effects of hyperglycemia (diabetes and prediabetes) and other factors on PTB patient delay in a rural area of China. Methods: In the present community‐based investigation, PTB patients aged ≥16 years newly diagnosed at county tuberculosis dispensaries were recruited consecutively between September 2011 and December 2013. Fasting blood glucose was determined in all subjects, and a structured questionnaire was used to collect basic information. Results: Of the 2280 patients, 605 (26.5 %) had hyperglycemia. The median (interquartile range) time to seeking health care was 44 (59) days. Health care seeking was delayed in 1754 subjects, and hyperglycemia was independently associated with an increased probability (odds ratio 2.10; 95 % confidence interval 1.49–2.97) of patient delay in subjects aged ≥30 years. Other factors associated with patient delay were cough, night sweats, and lack of knowledge regarding typical tuberculosis symptoms. The onset of hemoptysis was negatively correlated with patient delay. Conclusions: Patient delay appears to be a serious problem in this rural area with a high prevalence of tuberculosis. Hyperglycemia is independently associated with an increased probability of patient delay, which, in turn, may result in more serious clinical manifestations. Abstract : Logistic regression analysis for hyperglycemia stratified by age and the probability of patient delay Highlights Hyperglycemia, including diabetes and prediabetes, was found to be associated with a two fold higher possibility of patient delay in tuberculosis in rural areas. The existence of patient delay in tuberculosis was still high in this rural area of China. In addition to known factors contributing to patient delay in tuberculosis, including cough, old age, and lack of knowledge of typical TB symptoms, hyperglycemia is closely related to patient delay in tuberculosis.