南市某醫學中心結核病之趨勢研究：2015-2016

盧中蘭

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南市某醫學中心結核病之趨勢研究：2015-2016

Trend of Tuberculosis in a Medical Center in Tainan City: 2015-2016

盧中蘭 , Masters　　Advisor：張振平;吳佩芝　　

繁體中文

結核病；共生疾病；死亡率；年齡；發生率； tuberculosis ； comorbidities ； mortality ； age ； incidence rate

Abstract │ Reference (20) │ Altmetrics

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Background and Objectives: This study evaluated the incidence trends of tuberculosis (TB) and the analysis of related comorbidities in a Tainan City’s medical center. Methods: We collected data obtained the reporting cases of the TB in the medical center from the nationwide TB database of Taiwan Center for Disease Control (CDC) on 2015 and 2016. All TB patients were analyzed with related comorbidities, incidence and mortality risk, and evaluated the epidemiology by characteristics of pulmonary TB and extra-pulmonary TB. Conclusion and suggestion: The study showed the increase of the incidence of TB on older age, significantly on more than aged 65. Out of the total of 408 TB patients, 96 (23.5%) had diabetes mellitus (DM), 80 (19.6%) had end-stage renal disease (ESRD), 65 (15.9%) had cancer, 15 (3.6%) had liver cirrhosis and 6 (1.47%) had HIV. The statistics showed patients more than age 65 with comorbid DM, ESRD and cancer were more sensitive to TB. Additionally, 63 out of 408 patients could not finish the procedure of treatment due to death. We conducted logistic regression analyses by using R statistics and evaluated the association between TB deaths and different comorbidities through the calculation of odds ratio (RR) and its 95% confidence interval (95%CI) for each comorbidity.  The results revealed that the OR of liver cirrhosis was 1.94 (95%CI 2.11~24.60), head and neck cancer was 1.69 (95%CI 2.75~10.97), end-stage renal disease was 0.85 (95%CI 1.19~4.59) and age over 65 was 2.14 (95%CI 1.47~172.72). All of these results showed significantly positive correlations between TB deaths and comorbidities (OR>1 or 95%CI not containing 1).  Especially, the OR of mortality for the TB patients with age over 65 was 8.57 times more than that for those who were age under 40. We demonstrated that the age of patients would influence the mortality of TB. Therefore, we suggested routine diabetes screening, cancer screening and blood tests would be required for TB patients. Due to the lack of comorbid statistical data in the existing national surveillance network of communicable diseases of CDC, the nationwide TB database still supplies incomplete information yet. We hope to build a TB database linking to immuno-deficient patients and to provide a better environment to guide the future prevention and new strategies.

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1. 王培東 (2007) 北台灣結核病發生率性別差異之研究．北市醫學雜誌，4(4)，18-25。
連結：
2. 王培東 (2005) 台北市肺外結核之趨勢：1998至2002．北市醫學雜誌，2(12)，1125-1136。
連結：
3. 王培東 (2005) 台北市結核病流行趨勢與防治成效之研究．內科學誌，16(1)，26-32。
連結：
4. 王培東、李燕鳴 (2005) 台北市登錄之結核病發生率及其共生疾病分析．北市醫學雜誌，2(9)，37-46。
連結：
5. 李品慧、王貴鳳、詹珮君、陳昶勳( 2012) 2007~2011台灣結核病群聚事件分析．疫情報導，28(17)，279-284。
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