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

BMC Infectious Diseases

Research Article

Tzeng-Ji Chen¹  Albert C Yang²  Yung-Tai Chen³  Te-Li Chen⁴  Chang-Phone Fung⁴  Yi-Tzu Lee⁵  Shu-Chen Kuo⁶  Szu-Yuan Li⁷  Chia-Jen Liu⁸  Ih-Jen Su⁹ 

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

关键词: Schizophrenia;    Tuberculosis;    Incidence;    Outcome;   

DOI  :  10.1186/1471-2334-13-351

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

来源: Springer

【 摘 要 】

BackgroundTo 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.MethodUsing 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.ResultsThe 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).ConclusionsSchizophrenics 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】

Unknown   
© Kuo et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.