{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T07:44:55Z","timestamp":1696232695904},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,8,24]],"date-time":"2016-08-24T00:00:00Z","timestamp":1471996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Globally, tuberculosis prevalence has declined, but its risk factors have varied across place and time \u2013 low body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) has persisted while diabetes has increased. Using India's National Family Health Survey (<jats:styled-content style=\"fixed-case\">NFHS<\/jats:styled-content>), wave 3 and World Health Survey (<jats:styled-content style=\"fixed-case\">WHS<\/jats:styled-content>) data, we examined their relationships to support projection of future trends and targeted control efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multivariate logistic regressions at the individual level with and without diabetes\/<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> interactions assessed the relationship between tuberculosis, diabetes and low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and the importance of risk factor co\u2010occurrence. Population\u2010level analyses examined how tuberculosis incidence and prevalence varied with diabetes\/low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> co\u2010occurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">NFHS<\/jats:styled-content>, diabetic individuals had higher predicted tuberculosis risks (diabetic <jats:italic>vs<\/jats:italic>. non\u2010diabetic: 2.50% <jats:italic>vs<\/jats:italic>. 0.63% at low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>; 0.81% <jats:italic>vs<\/jats:italic>. 0.20% at normal <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>; 0.37% <jats:italic>vs<\/jats:italic>. 0.09% at high <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), which were not significantly different when modelled independently or allowing for risk modification with diabetes\/low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> co\u2010occurrence. <jats:styled-content style=\"fixed-case\">WHS<\/jats:styled-content> findings were generally consistent. Population\u2010level analysis found that diabetes\/low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> co\u2010occurrence may be associated with elevated tuberculosis risk, although its predicted effect on tuberculosis incidence\/prevalence was generally \u22640.2 percentage points and not robustly statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Concerns about the additional elevation of tuberculosis risk from diabetes\/low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> co\u2010occurrence and hence the need to coordinate tuberculosis control efforts around the nexus of co\u2010occurring diabetes and low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> may be premature. However, study findings robustly support the importance of individually targeting low <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and diabetes as part of ongoing tuberculosis control efforts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12763","type":"journal-article","created":{"date-parts":[[2016,8,6]],"date-time":"2016-08-06T09:06:23Z","timestamp":1470474383000},"page":"1272-1281","source":"Crossref","is-referenced-by-count":2,"title":["Risk of self\u2010reported symptoms or diagnosis of active tuberculosis in relationship to low body mass index, diabetes and their co\u2010occurrence"],"prefix":"10.1111","volume":"21","author":[{"given":"L.","family":"Prince","sequence":"first","affiliation":[{"name":"Stanford Health Policy Centers for Health Policy and Primary Care and Outcomes Research Stanford University Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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