Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China.
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SUBMITTER: Liu X
PROVIDER: S-EPMC8654396 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe problem of population aging is a critical public health concern in modern China, and more tuberculosis (TB) control efforts are needed to reach elderly people at high priority. In this study, we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.MethodsA multistage cluster-sampled cross-sectional survey was conducted in 2013, and 27 clusters were selected from 10 counties of 10 provinces in China. All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray (CXR) and a symptom questionnaire. Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive. Prevalence was calculated, a multiple logistic regression model was performed to confirm the risk factors, and population attributable fraction (PAF) of each risk factor was calculated to indicate the public health significance.ResultsOf 38 888 eligible people from 27 clusters, 34 269 participants finished both questionnaire and physical examination. There were 193 active pulmonary TB cases, 62 of which were bacteriologically confirmed. The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100 000 (95% CI: 483.73-642.65) and 180.92 per 100 000 (95% CI: 135.89-225.96), respectively. Male sex, older age, living in rural areas, underweight, diabetes, close contact of pulmonary TB (PTB) and previous TB history are all risk factors for TB. The risk of TB increased with increasing age and decreasing body mass index (BMI) after adjusting for other factors, and there is a positive dose-response relationship.ConclusionsIn China, active case finding (ACF) could be implemented among elderly people aged 65 and above with underweight, diabetes, close contact history and previous TB history as a priority, which will get significant yields and be cost-effective.
| S-EPMC6337869 | biostudies-literature
Project description:BackgroundIn geriatric and long-term care settings, intertrigo seems to be common, but generalizable epidemiological estimates are lacking. Aim of this study was to measure the prevalence of intertrigo in aged nursing home residents and to identify possible relationships with demographic and health characteristics.MethodsA cross-sectional prevalence study was conducted between September 2014 and May 2015 in a random sample of ten institutional long-term care facilities in Berlin, Germany. In total 223, aged long-term care residents were included. Mean age was 83.6 (SD 8.0) years and mean Barthel score was 45.1 (SD 23.8). Board certified dermatologists and study assistants performed skin assessments and measurements according to standard operating procedures. Mean differences and odds ratios between residents with and without intertrigo were calculated.ResultsThe prevalence of intertrigo was 16.1% (95% CI 11.6 to 21.2%). The submammary fold was most often affected (9.9%), followed by the inguinal region (9.4%), axilla (0.5%) and abdominal region (0.5%). Increased age was statistically significantly associated with the presence of intertrigo (OR 1.05; 95% CI 1.00 to 1.10). Care dependency in bathing activities was associated with intertrigo. Obesity, sex and skin functional parameters were not associated with intertrigo.ConclusionsEvery sixth nursing home resident was affected by intertrigo indicating the high load of this skin condition in this population. Older age seems to be associated with intertrigo. Care dependency in bathing activities was likely to be associated with intertrigo. Structured skin care regimens are needed to prevent and treat intertrigo in this population.Trial registrationThis study is registered at https://clinicaltrials.gov/ct2/show/NCT02216526 . Registration date: 8th November 2014.
| S-EPMC6466768 | biostudies-literature
Project description:IntroductionComplementary and alternative medicine (CAM) is frequently used by patients with rheumatic diseases (RD) to improve their symptoms; however, its diversity and availability have increased notably while scientific support for its effectiveness and adverse effects is still scarce.ObjectiveTo describe the prevalence and diversity of CAM in patients with RD in Chihuahua, Mexico.MethodsA cross-sectional study was conducted in 500 patients with RD who were interviewed about the use of CAM to treat their disease. The interview included sociodemographic aspects, characteristics of the disease, as well as a description of CAM use, including type, frequency of use, perception of the benefit, communication with the rheumatologist, among others.ResultsThe prevalence of CAM use was reported by 59.2% of patients, which informed a total of 155 different therapies. The herbal CAM group was the most used (31.4%) and included more than 50 different therapies. The use of menthol-based and arnica ointments was highly prevalent (35%). Most patients (62.3%) reported very little or no improvement in their symptoms. Only a fourth of the patients informed the rheumatologist of the use of CAM. The use of CAM was influenced by female sex, university degree, diagnosis delay, lack adherence to the rheumatologist's treatment, family history of RD, and orthopedic devices.ConclusionThe use of CAM in our population is highly prevalent and similar to reports in different populations suggesting a widespread use in many different societies. We found high use of herbal remedies; however, there were many different types suggesting a lack of significant effect. Patients continue using CAM despite a perception of no-effectiveness. Recurrent use of CAM is explained by factors other than its efficacy.
| S-EPMC8478211 | biostudies-literature
Project description:Rheumatic diseases (RD) are chronic diseases that significantly affect the lives of patients. Assessing health outcomes through a patient-reported outcome measurement information system (PROMIS) is essential for RD management. Moreover, these tend to be less favorable among individuals than among the rest of the population. This study aimed to compare PROMIS between RD patients and other patients. This cross sectional study was conducted in the year 2021. Information about patients with RD was obtained from the RD registry at King Saud University Medical City. Patients without RD were recruited from family medicine clinics. Patients were contacted electronically through WhatsApp© to complete the PROMIS surveys. We compared the individual PROMIS scores between the 2 groups using linear regression, adjusting for sex, nationality, marital status, education level, employment, family history of RD, income, and chronic comorbidities. There were 1024 individuals (512 with RD and 512 without RD). The most common RD was systemic lupus erythematosus (51.6%), followed by rheumatoid arthritis (44.3%). Individuals with RD reported significantly higher PROMIS T-scores for pain [β = 6.2; 95% confidence interval (CI) = 4.76, 7.71] and fatigue (β = 2.9; 95% CI = 1.37, 4.38) compared to those without RD. Moreover, RD individuals reported lower physical functioning (β = -5.4; 95% CI = -6.50, -4.24) and social interaction (β = -4.5; 95% CI = -5.73, -3.20). Patients with RD in Saudi Arabia, particularly those with systemic lupus erythematosus and rheumatoid arthritis, have significantly greater impairment in physical functioning and social interaction and report higher levels of fatigue and pain. Addressing and ameliorating these negative outcomes is necessary to improve quality of life.
| S-EPMC9981388 | biostudies-literature
Project description:BackgroundLittle is known about the prevalence of latent tuberculosis infection (LTBI) among coal workers' pneumoconiosis (CWP) patients. To estimate the prevalence of LTBI and identify its associated risk factors among CWP patients.MethodsA cross-sectional study was conducted to assess the prevalence of LTBI. Participants were screened for active TB or a history of TB by X-ray and those that underwent QuantiFERON-TB Gold In-Tube (QFT) test. A standardized questionnaire was completed and risk factors were assessed for acquiring TB. Log-binomial regression was used to estimate the LTBI prevalence ratio (PR) in relation to risk factors.ResultsOf 244 individuals with CWP (median age 67 years; all male), 162 (66.4%) were QFT positive. In Multivariate analysis, poor workplace ventilation (adjusted prevalence ratio [APR] = 1.26) and intake of fruits regularly (≥4 days of every week) (APR = 0.81) (all p < 0.05) were associated with a decreased risk of QFT.ConclusionsThis study showed a high prevalence of LTBI among individuals with CWP in China. Poor workplace ventilation may be an important contributing factor for LTBI. Regular monitoring and dust control measures need to be improved in workplaces to ensure the safety of workers. Moreover, intake of fruits regularly may be a protective factor for LTBI. However, the effect of fruits should be further studied.
| S-EPMC5896101 | biostudies-literature
Project description:BackgroundUnderstanding the most common and costly conditions treated by inpatient general medical services is important for implementing quality improvement, developing health policy, conducting research, and designing medical education.ObjectiveTo determine the prevalence and cost of conditions treated on general internal medicine (GIM) inpatient services.DesignRetrospective cross-sectional study involving 7 hospital sites in Toronto, Canada.ParticipantsAll patients discharged between April 1, 2010 and March 31, 2015 who were admitted to or discharged from an inpatient GIM service.Main measuresHospital administrative data were used to identify diagnoses and costs associated with admissions. The primary discharge diagnosis was identified for each admission and categorized into clinically relevant and mutually exclusive categories using the Clinical Classifications Software (CCS) tool.Key resultsAmong 148,442 admissions, the most common primary discharge diagnoses were heart failure (5.1%), pneumonia (5.0%), urinary tract infection (4.6%), chronic obstructive pulmonary disease (4.5%), and stroke (4.4%). The prevalence of the 20 most common conditions was significantly correlated across hospitals (correlation coefficients ranging from 0.55 to 0.95, p???0.01 for all comparisons). No single condition represented more than 5.1% of all admissions or more than 7.9% of admissions at any hospital site. The costliest conditions were stroke (median cost $7122, interquartile range 5587-12,354, total cost $94,199,422, representing 6.0% of all costs) and the group of delirium, dementia, and cognitive disorders (median cost $12,831, IQR 9539-17,509, total cost $77,372,541, representing 4.9% of all costs). The 10 most common conditions accounted for only 36.2% of hospitalizations and 36.8% of total costs. The remaining hospitalizations included 223 different CCS conditions.ConclusionsGIM services care for a markedly heterogeneous population but the most common conditions were similar across 7 hospitals. The diversity of conditions cared for in GIM may be challenging for healthcare delivery and quality improvement. Initiatives that cut across individual diseases to address processes of care, patient experience, and functional outcomes may be more relevant to a greater proportion of the GIM population than disease-specific efforts.
| S-EPMC6206337 | biostudies-literature
Project description:BackgroundMaturity-onset diabetes of the young (MODY) is the most common monogenic diabetes. The aim of this study was to assess the prevalence of MODY in phenotypic type 2 diabetes (T2DM) among Chinese young adults.MethodsFrom April 2015 to October 2017, this cross-sectional study involved 2429 consecutive patients from 46 hospitals in China, newly diagnosed between 15 years and 45 years, with T2DM phenotype and negative for standardized glutamic acid decarboxylase antibody at the core laboratory. Sequencing using a custom monogenic diabetes gene panel was performed, and variants of 14 MODY genes were interpreted as per current guidelines.ResultsThe survey determined 18 patients having genetic variants causing MODY (6 HNF1A , 5 GCK , 3 HNF4A , 2 INS , 1 PDX1 , and 1 PAX4 ). The prevalence of MODY was 0.74% (95% confidence interval [CI]: 0.40-1.08%). The clinical characteristics of MODY patients were not specific, 72.2% (13/18) of them were diagnosed after 35 years, 47.1% (8/17) had metabolic syndrome, and only 38.9% (7/18) had a family history of diabetes. No significant difference in manifestations except for hemoglobin A1c levels was found between MODY and non-MODY patients.ConclusionThe prevalence of MODY in young adults with phenotypic T2DM was 0.74%, among which HNF1A -, GCK -, and HNF4A -MODY were the most common subtypes. Clinical features played a limited role in the recognition of MODY.
| S-EPMC10106210 | biostudies-literature
Project description:BackgroundPsychological distress, a major comorbidities of tuberculosis (TB) patients, has posed a serious threat to the progress being made in global TB programs by affecting treatment adherence and health outcomes. However, the magnitude and associated factors of psychological distress have not been fully studied in China. The aim of the current study was to assess the prevalence of psychological distress in TB patients and to further determine the effects of socio-demographic characteristics, health-related variables, substance use status, social support, and experienced stigma on psychological distress.MethodsA cross-sectional survey was conducted among TB patients attending three medical institutions in Dalian, Liaoning Province, Northeast China from November 2020 to March 2021. A structured questionnaire was developed to collect data on patients' socio-demographic characteristics, health-related information, substance use status, psychological distress, family function, doctor-patient relationship, policy support, experienced stigma and so on. The binary logistics regression model was used to determine the associated factors of psychological distress.ResultsA total of 473 TB patients were enrolled in this study, and the prevalence of psychological distress was 64.1%. Binary logistic regression analysis revealed that patients with a middle school education level or above (OR: 0.521, 95%CI: 0.279-0.974), no adverse drug reactions (OR: 0.476, 95%CI: 0.268-0.846), and regular physical exercise (OR: 0.528, 95%CI: 0.281-0.993) were more likely to stay away from psychological distress. However, patients who had a high economic burden (OR: 1.697, 95%CI: 1.014-2.840), diabetes (OR: 2.165, 95%CI: 1.025-4.573), self-rated illness severe (OR: 3.169, 95%CI: 1.081-9.285), perceived poor resistance (OR: 2.065, 95%CI: 1.118-3.815), severe family dysfunction (OR: 4.001, 95%CI: 1.158-13.823), perceived need for strengthen psychological counseling (OR: 4.837, 95%CI: 2.833-8.258), and a high experienced stigma (OR: 3.253, 95%CI: 1.966-5.384) tended to have a psychological distress.ConclusionsThe study found that the proportion of psychological distress among TB patients was high in Northeast China, and it was influenced by a variety of factors. Effective interventions to reduce psychological distress in TB patients urgently need to be developed, and greater attention should be given to patients with risk factors.
| S-EPMC8196916 | biostudies-literature
Project description:ObjectivesTo evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine acceptance among patients with rheumatic diseases (RMD).MethodsAll rheumatology patients attending a large suburban health network were invited to participate in an anonymized online survey. The primary outcome of interest was SARS-COV-2 vaccine acceptance.ResultsThe mean (SD) age of respondents (n = 641) was 52.7 (15.1) years and 74.4% (n = 474) were female. Sixty-five percent were willing to have a SARS-COV-2 vaccine, while 34.4% were vaccine-hesitant (unwilling or undecided). On multivariate analysis, vaccine acceptance was associated with smoking (OR: 2.25 [95% CI: 1.22-4.15; p = .009]), history of malignancy (OR: 2.51 [95% CI: 1.19-5.26; p = .015]), influenza or pneumococcal vaccination in the preceding year (OR: 2.69 [95% CI: 1.78-4.05; p < .001]) and number of COVID-Safe measures practiced (OR: 1.54 [95% CI: 1.05-2.26; p = .027]). Vaccine acceptance correlated with positive beliefs regarding vaccine efficacy (r = 0.40; p < .001) and safety (r = 0.36; p < .001). Vaccine acceptance correlated negatively with concerns regarding side-effects (r = -0.30; p < .001) and vaccine-associated RMD flare (r = -0.21; p < .001). In vaccine-hesitant respondents, 39.2% were more likely to accept vaccination if given a choice of which vaccine they receive and 54.5% if their rheumatologist recommended it. Twenty-seven percent of patients on immunomodulators were willing to withhold medications while 42.1% were willing if advised by their rheumatologist.ConclusionSARS-COV-2 vaccine hesitancy is prevalent amongst RMD patients and associated with concerns regarding vaccine safety, efficacy, side effects and RMD flare. Clinician recommendation, vaccine choice and communications targeting patient concerns could facilitate vaccine acceptance.Significance and Innovations Vaccine hesitancy is prevalent in RMD patientsVaccine acceptance is associated with beliefs regarding vaccine safety and efficacy and concerns regarding RMD flare and vaccine-associated side effectsVaccine choice and clinician recommendation have the potential to improve vaccine acceptance in patients who are hesitant.
| S-EPMC8828082 | biostudies-literature
Project description:BackgroundStudies exploring influencing factors of emotional engagement among medical students are scarce. Thus, we aimed to identify influencing factors of medical students' emotional engagement.MethodsWe carried out a multi-center cross-sectional study among 10,901 medical students from 11 universities in China. The Chinese version of Utrecht Work Engagement Scale-Student version (UWES-S) was used to evaluate emotional engagement level of medical students. The predictors related to engagement level were determined by the logistic regression analysis. Furthermore, we constructed a nomogram to predict emotional engagement level of medical students.ResultsA total of 10,576 sample were included in this study. The mean emotional engagement score was 74.61(± 16.21). In the multivariate logistic regression model, we found that males showed higher engagement level compared with females [odds ratio (OR) (95% confidence interval (CI)): 1.263 (1.147, 1.392), P < 0.001]. Medical students from the second batches of medical universities had higher engagement level and from "Project 985" universities had lower engagement level compared with 211 project universities [OR (95%CI): 1.376 (1.093, 1.733), P = 0.007; OR (95%CI): 0.682 (0.535, 0.868), P = 0.002]. Medical students in grade 4 and grade 2 presented lower engagement level compared with in grade 1 [OR (95%CI): 0.860 (0.752, 0.983), P = 0.027; OR (95%CI): 0.861 (0.757, 0.980), P = 0.023]. Medical students lived in provincial capital cities had higher engagement level compared with in country [OR (95%CI): 1.176 (1.022, 1.354), P = 0.024]. Compared with eight-year emotional duration, medical students in other emotional duration (three-year and four-year) had lower engagement level [OR (95%CI): 0.762 (0.628, 0.924), P = 0.006]. Medical students' engagement level increased with increases of grade point average and interest in studying medicine. Medical students learned by converging style showed lower engagement level [OR (95%CI): 0.827 (0.722, 0.946), P = 0.006] compared with accommodating style. The model showed good discriminative ability (area under curve = 0.778), calibrating ability and clinical utility.ConclusionsWe identified influencing factors of medical students' emotional engagement and developed a nomogram to predict medical students' emotional engagement level, providing reference and convenience for educators to assess and improve emotional engagement level of medical students. It is crucial for educators to pay more attention to emotional engagement of medical students and adopt effective strategies to improve their engagement level.
| S-EPMC10631166 | biostudies-literature