| Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants. | |
| | |
MedLine Citation:
|
PMID: 21252210 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: A growing body of evidence supports the role of type 2 diabetes as an individual-level risk factor for tuberculosis (TB), though evidence from developing countries with the highest TB burdens is lacking. In developing countries, TB is most common among the poor, in whom diabetes may be less common. We assessed the relationship between individual-level risk, social determinants and population health in these settings. METHODS: We performed individual-level analyses using the World Health Survey (n = 124 607; 46 countries). We estimated the relationship between TB and diabetes, adjusting for gender, age, body mass index, education, housing quality, crowding and health insurance. We also performed a longitudinal country-level analysis using data on per-capita gross domestic product and TB prevalence and incidence and diabetes prevalence for 1990-95 and 2003-04 (163 countries) to estimate the relationship between increasing diabetes prevalence and TB, identifying countries at risk for disease interactions. RESULTS: In lower income countries, individuals with diabetes are more likely than non-diabetics to have TB [univariable odds ratio (OR): 2.39; 95% confidence interval (CI): 1.84-3.10; multivariable OR: 1.81; 95% CI: 1.37-2.39]. Increases in TB prevalence and incidence over time were more likely to occur when diabetes prevalence also increased (OR: 4.7; 95% CI: 1.0-22.5; OR: 8.6; 95% CI: 1.9-40.4). Large populations, prevalent TB and projected increases in diabetes make countries like India, Peru and the Russia Federation areas of particular concern. CONCLUSIONS: Given the association between diabetes and TB and projected increases in diabetes worldwide, multi-disease health policies should be considered. |
| | |
Authors:
|
Jeremy D Goldhaber-Fiebert; Christie Y Jeon; Ted Cohen; Megan B Murray |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-1-20 |
Journal Detail:
|
Title: International journal of epidemiology Volume: - ISSN: 1464-3685 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2011-1-21 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7802871 Medline TA: Int J Epidemiol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Medicine, Stanford Health Policy, CHP/PCOR, Stanford University School of Medicine, Stanford, CA, USA, Center for Infectious Disease Epidemiologic Research, Mailman School of Public Health, Columbia University, New York, NY, USA, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA and Infectious Disease Unit, Massachusetts General Hospital, Boston, MA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Reoperation for ascending aorta false aneurysm using deep hypothermia and circulatory arrest.
Next Document: Modifying effects of wealth on the response to nutrient supplementation in pregnancy on birth weight...