{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:48:04Z","timestamp":1784065684278,"version":"3.55.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid pulmonary tuberculosis and diabetes mellitus (PTB-DM) presents challenges to PTB control. We conducted this study given that current research on PTB-DM has primarily focused on clinical medicine and immunology, with limited reports on the true prevalence of population-wide PTB-DM in specific regions, as well as the heightened risk of PTB-DM co-prevalence due to aging and the high prevalence of DM in Chongqing, Southwest China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The medical records of 112,592 PTB patients registered in Chongqing from 2016 to 2022 were extracted. After excluding patients with incomplete records, those not residing in Chongqing, and individuals still undergoing treatment, a total of 108,003 PTB patients were included in the study. The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Chi-squared test and Fisher\u2019s exact tests was used to compare groups, and multivariable logistic regression model with stepwise backward elimination based on the Wald test was used to examine risk factors for adverse treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2016 to 2022, the incidence rate of PTB in southwest China showed a decreasing trend (AAPC\u2009=\u2009-10.22, 95% CI: \u221211.49%\u2009~\u2009\u22128.94%), while the incidence rate of PTB-DM increased rapidly (AAPC\u2009=\u200914.25, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased from 2.96 to 12.28%. PTB-DM patients were characterized by a higher proportion of males and older adult individuals, the age range of the patients was 11\u2009~\u2009100\u2009years, with a mean age of 58.21\u2009\u00b1\u200912.02\u2009years, with multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85%, while unsuccessful outcomes accounted for 19.15%. Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC\u2009=\u200912.22, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC\u2009=\u200914.18, 95% CI: 6.53%\u2009~\u200927.67%). Older age, retreatment, referral, and multiple positive aetiological results were risk factors for adverse treatment outcomes among PTB-DM patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study presents the true prevalence of PTB-DM comorbidity in the general population of Southwest China, revealing a significant upward trend in its prevalence and a higher risk of adverse outcomes among PTB-DM patients. Future efforts should focus on the prevention and control of PTB-DM comorbidity, with early screening and standardized treatment for high-risk groups such as the older adult, as well as implementing comprehensive and effective treatment and management measures for patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1445857","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T14:14:27Z","timestamp":1732112067000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Deliang","family":"Kong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongping","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangliu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingtong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyuan","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengguo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Pu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"ref1","unstructured":""},{"key":"ref2","unstructured":"2023"},{"key":"ref3","unstructured":""},{"key":"ref4","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1016\/S0140-6736(15)60436-6","article-title":"Prevalence of tuberculosis in China","volume":"385","author":"Hill","year":"2015","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.2147\/IDR.S249698","article-title":"Epidemic trends of tuberculosis in China from 1990 to 2017: evidence from the global burden of disease study","volume":"13","author":"Ding","year":"2020","journal-title":"Infect Drug Resist"},{"key":"ref6","unstructured":""},{"key":"ref7","unstructured":""},{"key":"ref8","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s13690-021-00632-1","article-title":"Epidemiological factors for type 2 diabetes mellitus: evidence from the global burden of disease","volume":"79","author":"Kotwas","year":"2021","journal-title":"Arch Public Health"},{"key":"ref9","unstructured":""},{"key":"ref10","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/S2213-8587(14)70164-0","article-title":"The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets","volume":"2","author":"Odone","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/imm.12762","article-title":"Influence of diabetes mellitus on immunity to human tuberculosis","volume":"152","author":"Nathella","year":"2017","journal-title":"Immunology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"6837745","DOI":"10.1155\/2022\/6837745","article-title":"Cellular immunity of patients with tuberculosis combined with diabetes","volume":"2022","author":"Cheng","year":"2022","journal-title":"J Immunol Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1134036","DOI":"10.3389\/fcimb.2023.1134036","article-title":"The cause-effect relation of tuberculosis on incidence of diabetes mellitus","volume":"13","author":"Bisht","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"107140","DOI":"10.1016\/j.ijid.2024.107140","article-title":"Tuberculosis and diabetes mellitus: the complexity of the comorbid interactions","volume":"146","author":"Boadu","year":"2024","journal-title":"Int J Infect Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e001275","DOI":"10.1136\/bmjdrc-2020-001275","article-title":"Diabetes mellitus among adults with tuberculosis in the USA, 2010-2017","volume":"8","author":"Armstrong","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"43","DOI":"10.5588\/pha.13.0033","article-title":"Screening tuberculosis patients for diabetes in a tribal area in South India","volume":"3","author":"Achanta","year":"2013","journal-title":"Public Health Action"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"150","DOI":"10.5588\/pha.15.0006","article-title":"Screening patients with tuberculosis for diabetes mellitus in Ampara, Sri Lanka","volume":"5","author":"Rajapakshe","year":"2015","journal-title":"Public Health Action"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"145","DOI":"10.5588\/pha.12.0058","article-title":"Screening tuberculosis patients for diabetes mellitus in Fiji: notes from the field","volume":"2","author":"Gounder","year":"2012","journal-title":"Public Health Action"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"14","DOI":"10.5588\/pha.17.0098","article-title":"Did diabetes mellitus affect treatment outcome in drug-resistant tuberculosis patients in Pakistan from 2010 to 2014?","volume":"8","author":"Latif","year":"2018","journal-title":"Public Health Action"},{"key":"ref20","unstructured":""},{"key":"ref21","unstructured":"2022"},{"key":"ref22","unstructured":"2022"},{"key":"ref23","unstructured":""},{"key":"ref24","unstructured":""},{"key":"ref25","unstructured":""},{"key":"ref26","unstructured":""},{"key":"ref27","unstructured":""},{"key":"ref28","unstructured":""},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2057","DOI":"10.1016\/S0140-6736(13)62639-2","article-title":"Tuberculosis prevalence in China, 1990-2010;a longitudinal analysis of national survey data","volume":"383","author":"Wang","year":"2014","journal-title":"Lancet"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.jdiacomp.2015.11.014","article-title":"Diabetes mellitus in patients with pulmonary tuberculosis in an aging population in Shanghai, China: prevalence, clinical characteristics and outcomes","volume":"30","author":"Wu","year":"2016","journal-title":"J Diabetes Complicat"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s13098-021-00743-3","article-title":"Global, regional, and national prevalence of diabetesmellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis","volume":"13","author":"Li","year":"2021","journal-title":"Diabetol Metab Syndr"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.1038\/s41598-021-81057-2","article-title":"Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis","volume":"11","author":"Gautam","year":"2021","journal-title":"Sci Rep"},{"key":"ref33","unstructured":""},{"key":"ref34","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.ijid.2020.01.019","article-title":"Screening for pulmonary tuberculosis in high-risk groups of diabetic patients","volume":"93","author":"Ji","year":"2020","journal-title":"Int J Infect Dis"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1093\/cid\/ciz284","article-title":"Diabetes mellitus among pulmonary tuberculosis patients from 4 tuberculosis-endemic countries: the tandem study","volume":"70","author":"Ugarte-Gil","year":"2020","journal-title":"Clin Infect Dis"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1111\/1753-0407.13444","article-title":"The effect of diabetes mellitus on tuberculosis in eastern China: a decision-tree analysis based on a real-world study","volume":"15","author":"Ling","year":"2023","journal-title":"J Diabetes"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1186\/s12879-021-05929-8","article-title":"Delayed diagnosis of tuberculosis in patients with diabetes mellitus co-morbidity and its associated factors in Zhejiang Province, China","volume":"21","author":"Xiao","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1186\/s12889-019-6544-4","article-title":"Epidemiological characteristics of pulmonary tuberculosis in mainland China from 2004 to 2015: a model-based analysis","volume":"19","author":"Guo","year":"2019","journal-title":"BMC Public Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1186\/s12879-019-4539-5","article-title":"Diabetes mellitus among patients attending TB clinics in Dar Es Salaam: a descriptive cross-sectional study","volume":"19","author":"Munseri","year":"2019","journal-title":"BMC Infect Dis"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e24507","DOI":"10.1016\/j.heliyon.2024.e24507","article-title":"Prospective cohort study on tuberculosis incidence and risk factors in the elderly population of eastern China","volume":"10","author":"Jiang","year":"2024","journal-title":"Heliyon"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"973991","DOI":"10.3389\/fimmu.2022.973991","article-title":"The impact of pulmonary tuberculosis on immunological and metabolic features of diabetic patients","volume":"13","author":"Chen","year":"2022","journal-title":"Front Immunol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3390\/jcm10245888","article-title":"Tuberculosis in the elderly","author":"Caraux-Paz","year":"2021","journal-title":"J Clin Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e24830","DOI":"10.2196\/24830","article-title":"Assessment of strategies and epidemiological characteristics of tuberculosis in Henan Province, China: observational study","volume":"7","author":"Jiang","year":"2021","journal-title":"JMIR Public Health Surveill"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"557","DOI":"10.46234\/ccdcw2021.144","article-title":"The epidemiological characteristics of pulmonary tuberculosisKashgar prefecture, Xinjiang Uygur autonomous region, China, 2011-2020","volume":"3","author":"Tusun","year":"2021","journal-title":"China CDC Wkly"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S1473-3099(18)30022-7","article-title":"Incidence of active tuberculosis in rural China reply","volume":"18","author":"Gao","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1007\/s11684-013-0257-3","article-title":"Treatment outcomes of pulmonary tuberculosis in the past decade in the mainland of China: a meta-analysis","volume":"7","author":"Li","year":"2013","journal-title":"Front Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1186\/s12879-020-05249-3","article-title":"Spatial-temporal analysis of tuberculosis in Chongqing, China 2011-2018","volume":"20","author":"Yu","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"20","DOI":"10.2807\/1560-7917.ES.2015.20.49.30087","article-title":"Tuberculosis treatment outcome in the European Union and European economic area: an analysis of surveillance data from 2002-2011","volume":"20","author":"Karo","year":"2015","journal-title":"Euro Surveill"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"110242","DOI":"10.1016\/j.diabres.2023.110242","article-title":"Longitudinal trends in glycated hemoglobin during and after tuberculosis treatment","volume":"196","author":"Kornfeld","year":"2023","journal-title":"Diabetes Res Clin Pract"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/S2213-8587(14)70011-7","article-title":"Tandem: understanding diabetes and tuberculosis","volume":"2","author":"Van Crevel","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e185","DOI":"10.1097\/01.hjh.0000837296.95158.67","article-title":"The risk of combined pathology of diabetes mellitus and tuberculosis","volume":"40","author":"Semianiv","year":"2022","journal-title":"J Hypertens"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"3903","DOI":"10.2147\/IDR.S414918","article-title":"Assessment of effective anti-TB regimens and adverse outcomes related risk factors in the elderly and senile-aged TB patients","volume":"16","author":"Guo","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"ofab097","DOI":"10.1093\/ofid\/ofab097","article-title":"Diabetes mellitus and tuberculosis treatment outcomes in Pune, India","volume":"8","author":"Mave","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1007\/s13410-020-00834-3","article-title":"The risk factors for tuberculosis patients with diabetes mellitus living in Western China: a retrospective study conducted from 2014 to 2018","volume":"40","author":"He","year":"2020","journal-title":"Int J Diabetes Dev Ctries"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.puhe.2024.01.021","article-title":"Predictors, mortality, and health outcomes of intensive phase non-adherence to a regimen in patients with drug-susceptible tuberculosis: a nationwide linkage database","volume":"229","author":"Lee","year":"2024","journal-title":"Public Health"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"2300614","DOI":"10.2807\/1560-7917.ES.2024.29.12.2300614","article-title":"Cost-effectiveness of active tuberculosis screening among high-risk populations in low tuberculosis incidence countries: a systematic review, 2008 to 2023","volume":"29","author":"Gogichadze","year":"2024","journal-title":"Euro Surveill"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.4269\/ajtmh.16-0358","article-title":"Delays and pathways to final tuberculosis diagnosis in patients from a referral hospital in urban China","volume":"96","author":"Martinez","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e1003039","DOI":"10.1371\/journal.pmed.1003039","article-title":"Predicting the impact of patient and private provider behavior on diagnostic delay for pulmonary tuberculosis patients in India: a simulation modeling study","volume":"17","author":"Deo","year":"2020","journal-title":"PLoS Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1445857\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T14:14:31Z","timestamp":1732112071000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1445857\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,20]]},"references-count":58,"alternative-id":["10.3389\/fpubh.2024.1445857"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1445857","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,20]]},"article-number":"1445857"}}