[Review on risk factors associated with tuberculosis death].

Tuberculosis is a major public health problem threatening human health and life. Although the level of diagnosis and treatment of tuberculosis has greatly improved in recent years, it is still one of the major infectious diseases causing human death. Tuberculosis has the characteristics of both chronic and infectious diseases, and is affected by many factors. Identification of the risk factors associated with tuberculosis death has certain guiding value for the prevention and control of tuberculosis. This articled reviewed recent studies on risk factors associated with tuberculosis death both in China and abroad. Male, old age, smoking, drinking, low socioeconomic level, malnutrition, drug resistance, AIDS and diabetes mellitus were found to increase the risk of tuberculosis mortality. It is expected that these findings could provide useful information to clinicians for taking necessary interventions to reduce tuberculosis mortality.

[Questionnaire survey analysis on the screening of tuberculosis among diabetic patients in general hospitals of Hunan Province].

Objective: To investigate the development of tuberculosis screening-related tests in general public hospitals(GPHs) of different levels in Hunan Province and the"awareness and practice of screening tuberculosis in diabetic patients"by doctors directly involved in diabetes diagnosis and treatment in the hospitals, aiming to provide reference for the formulation of the tuberculosis-diabetes joint prevention and control activity plan based on our national conditions. Methods: Stratified sampling was used to select 43 GPHs at three different levels in Hunan province: 14 tertiary GPHs, 13 secondary GPHs, and 16 primary GPHs. 284 endocrinologists working in enrolled hospitals were invited to participate in the on-site questionnaire-survey and 277 qualified. The study used SPSS 22.0 statistical software to analyze the data. The prevalence rate of tuberculosis screening test among hospitals at all levels was compared by chi-square test, and logistic regression was used to analyze the related factors affecting doctors' screening awareness. P≤0.05 was considered statistically significant. Results: The allocation of digital X-ray cameras, tuberculin skin tests, sputum acid-fast bacillus smears, sputum cultures for Mycobacterium tuberculosis, and interferon-gamma release assays in the 43 GPHs were 90.7% (39/43), 72.1% (31/43), 55.8% (24/43), 34.9% (15/43), 27.9% (12/43) with significant differences between the different hospital levels(P<0.05). 173 endocrinologists considered it necessary to proactively initiate tuberculosis screening for patients at first diagnosis. When admitting patients, 197 endocrinologists chose tuberculosis screening only for diabetes mellitus patients with suspected tuberculosis symptoms. The most possible reasons why diabetes mellitus patients wouldn't undergo tuberculosis screening were"patients refused(76.5%, 212/277)","patients didn't complain of the symptom(46.9%, 130/277)", and"tuberculosis screening-related tests haven't been conducted in the hospital(35.7%, 99/277)". Conclusions: Although endocrinologists displayed some tuberculosis-related knowledge and awareness of the need for proactive tuberculosis screening, the actual screening rate in the clinical setting was low. This may be related to multiple factors, including those of patients, doctors, and medical institutions.