| Summary: | 碩士 === 長榮大學 === 職業安全與衛生學系碩士在職專班 === 105 === 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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