ABSTRACT
PURPOSE: To estimate the association between diabetes mellitus (DM) and all-cause mortality during tuberculosis (TB) treatment. METHODS: From 2009 to 2012, a retrospective cohort study among reported TB cases in Georgia was conducted. Patients aged 16 years or older were classified by DM and human immunodeficiency virus (HIV) status at the time of TB diagnosis and followed during TB treatment to assess mortality. Hazard ratios were used to estimate the association between DM and death. RESULTS: Among 1325 patients with TB disease, 151 (11.4%) had DM, 147 (11.1%) were HIV-infected, and seven (0.5%) had both DM and HIV. Patients with TB-DM were more likely to have cavitary lung disease compared with those with TB alone (51.0% vs. 34.7%) and those with TB-HIV were more likely to have military/disseminated disease (12.9% vs. 3.4%) and resistance to rifampin or isoniazid (21.8% vs. 9.0%) compared with those without HIV infection (P < .05). In multivariable analysis, DM was not associated with death during TB treatment (hazard ratio, 1.22; 95% confidence interval, 0.70-2.12) or any death (adjusted odds ratio, 1.05; 95% confidence interval, 0.60-1.84). CONCLUSIONS: Among TB patients in Georgia, the prevalence of comorbid DM and coinfection with HIV was nearly identical. In adjusted models, TB patients with DM did not have increased risk of all-cause mortality.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Tuberculosis/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Antitubercular Agents/therapeutic use , Cause of Death , Coinfection/drug therapy , Coinfection/epidemiology , Coinfection/mortality , Comorbidity , Female , Follow-Up Studies , Georgia/epidemiology , HIV Infections/epidemiology , HIV Infections/mortality , Humans , Logistic Models , Male , Middle Aged , Prevalence , Proportional Hazards Models , Retrospective Studies , Risk Factors , Self Report , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Young AdultABSTRACT
Standard tuberculosis case reporting captures incarceration at diagnosis only. This retrospective analysis of 106 US-born adults with prevalent tuberculosis in 2011 found that 46.2% had documented histories of being in jail or prison, including 16.0% during the year before diagnosis.
ABSTRACT
Drawing on individuals who volunteer in US prisons to mentor HIV-infected inmates returning to the community may promote successful transitions. Evaluations published in the scientific literature of such community linkage programs are scant. Our quantitative and qualitative methods needs analysis and pilot study entailed interviewing convenience samples of 24 HIV-positive persons recently released from Georgia correctional facilities and 12 potential volunteer mentors. Both releasees and potential mentors were open to the establishment of a mentoring program. Releasees wanted nonjudgmental mentors. Releasees and volunteers had statistically significant differences in marital status, education, current employment, and possession of a driver's license but not in degree of religious involvement and attitudes toward condom use. A volunteer-staffed program, perhaps more aptly named "life coaching" than mentoring, to help HIV-infected persons to transition from prison to the community may be feasible. Success will require adequately trained volunteers and a straightforward program.
Subject(s)
HIV Infections/rehabilitation , Mentors , Needs Assessment/statistics & numerical data , Prisoners/statistics & numerical data , Volunteers/organization & administration , Adult , Female , Focus Groups , Georgia , HIV Infections/psychology , Health Promotion , Humans , Male , Middle Aged , Pilot Projects , Prisoners/psychology , Prisons , Program Evaluation , Urban Population , Volunteers/psychologyABSTRACT
BACKGROUND: The relationship between food aid and acute malnutrition among children under 5 years of age was assessed in northern Pakistan following the 2005 earthquake. METHODS: Separate cross-sectional household-based surveys were performed in Mansehra and Muzaffarabad districts. Probability proportional to size (PPS) was used to select clusters in each district, and households were randomly selected within each cluster. Information collected included receipt of food aid, child health, level of household damage, water sources, and excreta disposal. RESULTS: Children in households receiving food aid had a lower prevalence of acute malnutrition in Mansehra (adjusted OR, controlled for confounders, 0.40; 95% CI, 0.13 to 1.22) and Muzaffarabad (adjusted OR, 0.72; 95% CI, 0.36 to 1.44). Communities with higher levels of complete household destruction were more likely to receive food aid. CONCLUSIONS: Children in households receiving food aid had a lower prevalence of acute malnutrition than those in households not receiving food aid, even after accounting for various confounding variables, although this difference was not statistically significant.
