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Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study.

ABSTRACT: BACKGROUND:The 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. METHODS:A 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. RESULTS:Of 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. CONCLUSIONS:In 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.

SUBMITTER: Zhang CY

PROVIDER: S-EPMC6337869 | biostudies-other | 2019 Jan

REPOSITORIES: biostudies-other

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Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study.

Zhang Can-You CY Zhao Fei F Xia Yin-Yin YY Yu Yan-Ling YL Shen Xin X Lu Wei W Wang Xiao-Meng XM Xing Jin J Ye Jian-Jun JJ Li Jian-Wei JW Liu Fei-Ying FY Wu Jian-Lin JL Xu Lin L Zhang Hui H Cheng Jun J Wang Li-Xia LX

Infectious diseases of poverty 20190118 1

<h4>Background</h4>The 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.<h4>Methods</h4>A 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 parti ...[more]

PMID: 30654836

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Project description:ObjectiveHypertension (HTN) is an important public health issue worldwide, associated with the rapid economic development and urbanisation over the last decades. This is especially the case in Shenzhen, which has benefited greatly from the reform and opening-up policies. However, there is limited information on the epidemiology of HTN in this region. This study was designed to investigate the prevalence, awareness, treatment and control of HTN and the associated factors among adult residents in Shenzhen, China.DesignPopulation-based, cross-sectional study.ParticipantsThrough the multistage stratified random sampling method, a representative sample of 10 043 urban population aged ≥18 years were selected. Three consecutive blood pressure (BP) readings were measured after resting for a 5 min seat by trained staff and HTN was defined as mean systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported current use of antihypertensive drugs. Participants were interviewed using a structured questionnaire. Anthropometric details, BP, blood and urine samples were also collected.Primary outcome measurePrevalence of HTN.ResultsOverall, the weighted prevalence of HTN among residents in Shenzhen was 19.2% (95% CI 18.5 to 20.0). Among patients with HTN, 55.0% (95% CI 52.9 to 57.1) were aware of their condition and 44.9% (95% CI 42.8 to 47.1) were taking antihypertensive medications, but only 21.7% (95% CI 20.0 to 23.5) achieved BP control. Among those who knew their HTN, 81.7% (95% CI 79.3 to 83.8) were under treatment and 48.3% (95% CI 45.1 to 51.5) were controlled among those with treated HTN. Male, older age, lower educational level, overweight and obesity, family history of HTN, tobacco smoking, alcohol intake, diabetes mellitus, dyslipidaemia and high uric acid were associated with HTN.ConclusionsHTN is a major public health concern in Shenzhen, which has low awareness, treatment and control rates, and is associated with several risk factors. Effective multifaceted implementation strategies are highly needed to combat the emerging burden of HTN.

Project description:OBJECTIVES:As a vulnerable group, the elders' oral health gained less attention, particularly the relationship between socioeconomic status (SES) and dental caries. This study aimed to assess the associations and to explore the effects of confounders on the associations in elderly people. DESIGN:Cross-sectional study. SETTINGS:3 neighbourhood committees and 3 village committees in Sichuan Province, China. PARTICIPANTS:744 people (362 men and 382 women) aged 65-74 years were included. OUTCOME MEASURES:Oral health outcomes included the decayed, missing and filled teeth (DMFT) index and its components. SES was assigned by educational level, household income and type of household. The bivariate association between the participants' characteristics and DMFT was analysed using non-parametric tests. Four logistic regression models were used to analyse the associations between SES and dental caries by regulating confounders. RESULTS:Poor oral health was observed in these participants. Bivariate analysis showed a significant association between SES and DMFT (p?0.05). Only adjusting gender, high educational level (adjusted (AOR)=0.34, 95%?CI 0.17 to 0.66), high household income (AOR=0.47, 95%?CI 0.41 to 0.77) were protective factors against dental caries, and living in agricultural families (AOR=1.86, 95%?CI 1.32 to 2.63) was risk factor (p?0.05). After adjusting other confounders, SES was partly related to the dental caries. Moreover, an interaction existed among SES indicators. CONCLUSIONS:SES is associated with dental caries, and older people with low SES have poor oral health. The associations were explained partly by diet, behaviour and awareness. Our results provide effective evidence in targeted policy-making and intervention measures and implicate that pertinence measures, economic assistance and medical insurance funds should be provided to older people of low SES. Furthermore, a follow-up design should attempt to confirm the causal relationship between SES and dental caries and evaluate the effect of intervention.

Dataset Information

Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study.

Publications

Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study.

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