Abstract:

Objective: To analyze the treatment outcomes and risk factors among patients with rifampicin-sensitive tuberculosis-diabetes mellitus comorbidity (PTB-DM) patients in Yunnan Province, to provide evidence for improving the effect of anti-tuberculosis treatment for PTB-DM by. Methods: The medical data of PTB-DM patients registered in Yunnan Province from January 1, 2017 to December 31, 2021 were obtained through the “Monitoring Report Management System” of the “China Disease Prevention and Control Information System” subsystem, including sociodemographic information, tuberculosis diagnosis, anti-tuberculosis treatment and judgment of the treatment, 3984 cases were finally included. The effectiveness of anti-tuberculosis treatment in PTB-DM patients was analyzed, and the risk factors of the treatment outcome were analyzed using Cox regression model. Results: The success rate of anti-tuberculosis treatment in 3984 PTB-DM patients was 89.36% (3560/3984), the incidence of adverse treatment outcomes of 10.64% (424/3984), the mortality was 4.27% (170/3984), and 2.46% (98/3984) were lost during treatment, with failure of 2.31% (92/3984) and discontinuation of treatment due to adverse drug reactions of 1.61% (64/3984). Of adverse outcomes, 44.22% (179/424) occurred in the first 2 months of treatment. Cox regression model analysis showed that individuals aged ≥65 had a higher risk of adverse treatment outcomes compared to those who aged <35 (HR=2.612, 95%CI: 1.483-4.601); the risk of adverse treatment outcomes in retreated patients was 1.405 times higher than that in newly treated patients (95%CI: 1.072-1.843), and the risk of adverse treatment outcomes in pathogen positive patients was 1.473 times higher than that in other patients (95%CI: 1.183-1.834). Conclusion: The effectiveness of anti-tuberculosis treatment for PTB-DM patients in Yunnan Province is not satisfactory, and attention should be paid to PTB-DM patients, especially elderly people aged 65 and above, re-treated, and pathogen-positive patients. During the anti-tuberculosis treatment, monitoring of treatment effectiveness and health management should be carried out, and timely intervention should be given.

Key words: Tuberculosis, pulmonary, Diabetes mellitus, Comorbidity, Treatment outcome, Factor analysis, statistical