electronic-Perak Medical Journal. August 2019; Volume 1, Special Issue 2
Journal homepage: http://gids.mohe.gov.my/index.php/pmj
18
CONFERENCE PROCEEDINGS
This abstract was submitted to Perak Research Conference 2019 20 August 2019
PRE-EXISTING CHRONIC MEDICAL ILLNESSES AND FOLLOW UP STATUS AMONG ACTIVE PULMONARY TUBERCULOSIS CASES IN A DISTRICT POPULATION
Thai Lun Tan1, Li Yuan Lee1, Kig Tsuew Yong1, Muhammad Afiq Rohimi1, Shoen Chuen Chiew2, Sing Hoon Cheng1, Hafizah Mohamed Haniba1, Min Tat Ding1
1Internal Medicine Department, Seri Manjung Hospital, Ministry of Health MALAYSIA
2Clinical Research Centre, Seri Manjung Hospital, Ministry of Health MALAYSIA
ABSTRACT
INTRODUCTION AND OBJECTIVES
Tuberculosis (TB) is a major health concern globally and Malaysia has an intermediate burden of TB that is increasing in trend. A timely evaluation of the current TB related comorbidity prevalence rate among pulmonary tuberculosis (PTB) patients and their clinical characteristics would provide information in guiding future tuberculosis programme planning.
The objectives of the study were to examine (1) the prevalence of pre-existing chronic medical illnesses, (2) the follow up status of known pre-existing comorbidities and (3) to distinguish between diagnosed and undiagnosed pre-existing tuberculosis-related chronic medical illnesses among active PTB subjects.
METHODOLOGY
This was a cross-sectional study involving retrospective review of all active pulmonary tuberculosis cases which were diagnosed and registered in Manjung District from January 2015 till June 2017. The study was conducted in all the health facilities that were located in Manjung District, which had provided tuberculosis treatment and treatment for pre-existing chronic medical illness. Trained investigators reviewed all the tuberculosis records in the respective health facilities that provided TB treatment. Demographic data, clinical data and centres of follow up for pre-existing chronic medical diseases were collected. Subsequently, trained investigator visited health care facilities within Manjung district which provided treatment for the pre-existing chronic medical illnesses to determine the follow up status within the last 6 months prior to PTB diagnosis. The data was analysed using SPSS 20.0.
RESULTS
Among 302 TB clinical notes reviewed, 253 patients were included. The median age of the population studied was 44 years (IQR: 31, 59) with 64.4% (163 cases) of them being male. Majority of them were Malay which composed of 60.9 % (154 cases), followed by Chinese and Indian ethnics which represented 27.7% (70 cases) of the population. The remaining 11.4%
(29 cases) comprised of minor ethnic groups and foreigners. The commonest comorbidity was diabetes mellitus (DM) with 30.5% (77 cases) of the PTB patients having diagnosed or undiagnosed DM prior to PTB diagnosis, followed by Human Immunodeficiency Virus (HIV) and Hepatitis C infection which accounted for 12.0% (30 cases) of the study populations.
Importantly, almost 90.0% (68 cases) of the diabetic subjects had pre-existing DM prior to PTB diagnosis. In contrast, HIV and Hepatitis C infection were primarily undiagnosed prior to PTB diagnosis. Among 132 patients with pre-existing chronic medical illnesses prior to PTB diagnosis, 92 cases had confirmed follow up centres. Notably, less than one third of PTB subjects were under regular follow up at healthcare facilities in Manjung District prior to PTB diagnoses.
CONCLUSION
Overall, DM was the most prevalent comorbid among PTB subjects. However, majority of PTB subjects did not have pre- existing TB related medical comorbid and were not under healthcare facilities regular follow up prior to PTB diagnoses.
Our research provides evidence on the existence of wide variation in the clinical backgrounds among active PTB subjects.
We recommend future researches to analyse the non-clinical aspects of PTB subjects. Also, future PTB control programme should focus on both populations under healthcare follow up as well as the community at large.
electronic-Perak Medical Journal. August 2019; Volume 1, Special Issue 2
Journal homepage: http://gids.mohe.gov.my/index.php/pmj
19
CONFERENCE PROCEEDINGS
This abstract was submitted to Perak Research Conference 2019 20 August 2019
Keywords
active pulmonary tuberculosis, follow up status, pre-existing chronic medical illnesses NMRR-17-1052-36174
Correspondence to:
Tan Thai Lun [email protected] Back to Content Page
