Epidemiological and clinical outcomes of tuberculosis with its co-morbidities in general population and in prisons in Malaysia

dc.contributor.author	Hayat Khan, Amer
dc.date.accessioned	2015-05-25T06:47:47Z
dc.date.available	2015-05-25T06:47:47Z
dc.date.issued	2011
dc.description.abstract	The threat of tuberculosis (TB) seemed to have become increasingly looming with the fatal combination of co-morbid conditions like human immunodeficiency virus (HIV)-acquired immune deficiency syndrome (AIDS), diabetes mellitus (DM) and hepatitis. Globally, prison population is at a higher risk to acquire these diseases as compared to general population. However, there is no substantial data concerning the different types of TB and its co-morbidities in Malaysia. The aim of the present study was to obtain a comprehensive data pertaining to the epidemiology and clinical evaluation of TB alone and with co-morbidities in the hospitals and prisons of the four states of Malaysia i.e. Penang, Sabat..., Sarawak and Selangor. A retrospective study was performed by collecting data of 9337 patients, from the patient records available at the hospitals and prisons and a prospective study was also conducted through direct question-answer session from January 2006 to December 2008. Out of the total selected 9337 patients, 405 were from the prisons and the remaining were from the general population. Data obtained was a..i.alyzed with Statistical Package for the Social Sciences (SPSS) software. The highest number of patients was from Sabah state. Among the total selected patients, majority of them (7781) had pulmonary tuberculosis (PTB). Out of the total number of 1222 patients with confirmed extrapulmonary tuberculosis (EPTB), majority were suffering from lymphadenitis TB [325 (26.6%)]. Among the total number of cases, 8159 (87.4%) were newly registered and 675 (7.2%) were relapsed cases. Of the total number of patients 6650 (71.2%) were found to be sputum smear positive. When socio-demographic factors were related to the prevalence of the three types of TB the occurrence was higher among the male population, unmarried, Malay race and the age group 31 - 50 yr. Furthermore, the occurrence of PTB, EPTB along with co-morbidity were significantly higher in urban population. Alcohol consumption was identified as a risk factor for PTB with EPTB combination. The prevalence of TB-Hepatitis and TB-HIV was higher in unmarried and unemployed male smokers of Malay race, whereas tuberculosis-Diabetes Mellitus (TB-DM) was predominantly seen in Chinese race. The older age group (56- 65 yr) was highly affected with TB-DM, whereas TB-HIV and TB-Hepatitis was more in the sexually active age group. Patients with DM had a higher incidence of PTB (87.5%) and patients with HIV/AIDS had a higher incidence of EPTB (26.1%) and PTB \\Olth EPTB (6.1 %). The incidence rate of TB in the prison was 440/100,000 populations. The higher incidence rate (7551100,000 population) was seen in Selangor prisons. Majority of the patients (78.9%) in the study complained of cough as the symptom experienced. Culture sensitivity test was the most reliable laboratory test for diagnosis, as 70.6% of the patients responded positively. Of the 9337 patients in the present study, 7241 (77.6%) patients were successfully treated. The Odd Ratio (OR) of patients treated successfully in the hospital compared to those in the prison was 6.696. The treatment success rate was highest in PTB group patients (79.5%). When TB-DM, TB- HIV/AIDS and TB-Hepatitis cases were assessed, 73.3%, 68.6% and 75.4% of patients were successfully treated respectively. The mortality rate was higher (23 .8%) in the TB-DM-HIV group of patients. The risk factors identified for higher mortality rate in this group of patients were increased age, alcohol consumption and Chinese race.	en_US
dc.identifier.uri	http://hdl.handle.net/123456789/711
dc.language.iso	en	en_US
dc.title	Epidemiological and clinical outcomes of tuberculosis with its co-morbidities in general population and in prisons in Malaysia	en_US
dc.type	Thesis	en_US