Abstract:

Objective: To describe the epidemiological characteristics of pulmonary tuberculosis patients comorbid with diabetes mellitus and hypertension in Daxing from 2022 to 2024, and analyze the influencing factors of treatment outcomes, and provide a basis for the prevention and treatment of PTB and chronic disease comorbidity. Methods: Information on PTB patients notified in Daxing from 2022 to 2024 was extracted from the National Tuberculosis Management Information System. The data on diabetes mellitus and hypertension were investigated through the basic public health service information system, Hospital Information System, residents’ electronic health records, and questionnaires. Results: A total of 992 pulmonary tuberculosis patients were included in the analysis. Among them, 12.10% (120/992) had comorbid diabetes, 17.14% (170/992) had comorbid with hypertension, 16.73% (166/992) had both diabetes and hypertension. Higher proportions of comorbid with diabetes, hypertension, and both diabetes mellitus and hypertension were observed among males (14.63% (90/615), 19.03% (117/615), 18.37% (113/615)), farmers (15.26% (18/118), 32.20% (38/118), 25.42% (30/118)), local residents (12.36% (91/736), 20.25% (149/736), 19.97% (147/736)), and pathogen-positive (14.87% (88/592), 18.24% (108/592), 20.27% (120/592)) patients. The proportion of PTB patients with diabetes (15.50% (42/271)) was higher in the group aged 45-64, while the proportions of PTB patients with comorbid hypertension (36.30% (102/281)) and with diabetes mellitus and hypertension (30.25% (85/281)) were higher in the group aged ≥65. The re-treated patients had a higher proportion of comorbid diabetes (27.59% (16/58)), while new patients had higher proportions of hypertension (17.67% (165/934)), and with both diabetes mellitus and hypertension (17.24% (161/934)). The treatment course was the longest for patients combined diabetes (371.00 (274.25, 398.00) days), and shortest for those comorbid with hypertension (234.00 (192.00, 321.75) days)(Z=48.189, P<0.001). Multivariate logistic regression analysis showed that patients in the ≥65-years group (OR=3.105, 95%CI: 1.378-7.113), retreated patients (OR=6.372, 95%CI: 2.074-19.663), and those with comorbid diabetes (OR=4.717, 95%CI: 1.529-14.078) had a higher risk of adverse outcomes, while a longer treatment course (OR=0.980, 95%CI: 0.976-0.984) was associated with a lower risk of adverse outcomes. Conclusion: Pulmonary tuberculosis patients with diabetes and hypertension in Daxing District are predominantly male, older, farmer, local residents, and pathogen-positive. Patients with diabetes are more likely to be retreated and have longer treatment course, while patients with hypertension are more likely to be new treated and have shorter treatment course. Elder, retreatment, combined diabetes, and short treatment course are associated with higher risk of adverse outcomes.

Key words: Tuberculosis, pulmonary, Diabetes, Hypertension, Comorbidity, Treatment outcome