Incidence and outcome of newly-diagnosed tuberculosis in schizophrenics: a 12-year, nationwide, retrospective longitudinal study

BMC Infectious Diseases

Chang-Phone Fung²  Ih-Jen Su⁸  Tzeng-Ji Chen¹  Chia-Jen Liu⁶  Te-Li Chen²  Albert C Yang⁵  Yi-Tzu Lee⁴  Szu-Yuan Li³  Yung-Tai Chen⁷  Shu-Chen Kuo⁸ 

[1] Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Infectious Diseases, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan;Division of Nephrology, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Medicine, Chutung Veterans Hospital, Chutung, Taiwan;Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan;Institute of Public Health & School of Medicine, National Yang-Ming University, Taipei, Taiwan;Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan;National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan

关键词: Outcome;    Incidence;    Tuberculosis;    Schizophrenia;   

Others  :  1146633
DOI  :  10.1186/1471-2334-13-351

 received in 2012-08-28, accepted in 2013-07-27,  发布年份 2013

【 摘 要 】

Background

To control tuberculosis (TB), it is critical to identify at risk populations. Schizophrenia is recognized as an important risk factor for TB. However, previous studies have been confounded by comorbidities, and reports of TB infection outcomes are rare. Therefore, the current nation-wide study aimed to compare the adjusted incidence and outcome of TB diseases in schizophrenics and the general population.

Method

Using the National Health Insurance Research Database from 1998 to 2009, this retrospective longitudinal study included 60,409 schizophrenics and general population matched for age, Charlson’s score, and comorbidities. Diagnosis of TB was based on the international classification of disease, ninth revision and use of anti-TB drugs. Unfavorable outcome for TB was defined as death, loss to follow-up, or use of anti-TB treatment for more than 9 months.

Results

The adjusted incidence of TB in schizophrenics was significantly higher than in the general population [hazard ratio, 1.52; 95% confidence interval (CI), 1.29-1.79; p < 0.001; Kaplan-Meier log-rank test, p < 0.001]. Cox regression revealed age and male gender as risk factors for newly-diagnosed TB. The outcome of TB was comparable in schizophrenics and the general population [odds ratio (OR), 0.78; 95% CI, 0.55-1.09; p =0.144]. Logistic regression revealed a statistical trend for diabetes mellitus to predict poor outcome in schizophrenics with TB (OR, 2.30; 95% CI, 0.96-5.74; p = 0.062).

Conclusions

Schizophrenics are at increased risk for TB, and screening may be warranted for those living in areas with high prevalence of TB.

【 授权许可】

   
2013 Kuo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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