Observation Study Design
Leazaun Thornton
Walden University
In partial fulfillment of the requirements for
Epidemiology
CLRA-6235-2
Dr. Aaron B. Mendelsohn, PhD, MPH
Abstract
Tuberculosis continues to infect a large percentage of the world's population, infecting more than 8.8 million people per year, and killing 1.6 million people per year. A major risk factor of tuberculosis is Diabetes Mellitus causing complications involving the circulation and the body's ability to fight infection. There is major concern in low- to middle- income countries about the increase of both diabetes and tuberculosis. An assessment is necessary due to the public health inference there is a casual link between diabetes and tuberculosis. So, observational studies were conducted that proposed diabetes increases the risk of tuberculosis. Background Tuberculosis continues to infect a large percentage of the world's population, infecting more than 8.8 million people per year, and killing 1.6 million people per year. Experts have observed an association between tuberculosis and diabetes since the beginning of the 20th century. The growing worldwide burden of diabetes is expected to rise from an estimated 180 million prevalent cases currently to a predicted 366 million by 2030. Clinicians have raised concerns about the merging epidemics of diabetes and tuberculosis, especially in countries, such as India and China that are experiencing the fastest increase in diabetes prevalence and the highest burden of tuberculosis in the world (Jeon &Murray, 2008). An assessment is necessary due to the public health inference there is a casual link between diabetes and tuberculosis. So, observational studies were conducted that proposed diabetes increases the risk of tuberculosis. Methods and Findings A search was conducted in the PubMed and EMBASE databases from 1965 to March 2007 which returned 13 observational studies (n = 1,786,212 participants) with 17,698 tuberculosis cases. The studies included three prospective cohort studies, eight case-control studies, and two studies for which study design could not be classified as either cohort or case control. The studies were held in Canada, India, Mexico, Russia, South Korea, Taiwan, the UK, and the US, and all studies were reported in English. Two of the cohort studies were among renal transplant patients, and three of the case-control studies were hospital-based or based on discharge records (Jeon & Murray, 2008). Peer-reviewed reports of cohort, case-control, or cross-sectional studies that allowed computation of a quantitative effect estimate of the relationship between diabetes and active tubercolosis and that controlled for possible confounding by …show more content…
The cohort studies revealed that compared with people who do not have diabetes; people with diabetes have an approximately 3-fold risk of developing active tuberculosis (Jeon & Murray, 2008). Higher increases in risk were seen among younger people, in populations with high background tuberculosis incidence, and in non-North American populations. According to Jeon & Murray (2008), heterogeneity of strengths of association may reflect true geographic/ethnic differences in severity of diabetes, transmission dynamics of tuberculosis, and the distribution of effect modifiers such as age, or it may be due to differences in study methodology or rigor. The summary estimate may not be correct to all populations as all cohort studies were conducted in Asia. Finally, people with diabetes may be important targets for interventions such as active case finding and treatment of latent tuberculosis and efforts to diagnose, detect, and treat diabetes may have a beneficial impact on tuberculosis control (Murray,
Leazaun Thornton
Walden University
In partial fulfillment of the requirements for
Epidemiology
CLRA-6235-2
Dr. Aaron B. Mendelsohn, PhD, MPH
Abstract
Tuberculosis continues to infect a large percentage of the world's population, infecting more than 8.8 million people per year, and killing 1.6 million people per year. A major risk factor of tuberculosis is Diabetes Mellitus causing complications involving the circulation and the body's ability to fight infection. There is major concern in low- to middle- income countries about the increase of both diabetes and tuberculosis. An assessment is necessary due to the public health inference there is a casual link between diabetes and tuberculosis. So, observational studies were conducted that proposed diabetes increases the risk of tuberculosis. Background Tuberculosis continues to infect a large percentage of the world's population, infecting more than 8.8 million people per year, and killing 1.6 million people per year. Experts have observed an association between tuberculosis and diabetes since the beginning of the 20th century. The growing worldwide burden of diabetes is expected to rise from an estimated 180 million prevalent cases currently to a predicted 366 million by 2030. Clinicians have raised concerns about the merging epidemics of diabetes and tuberculosis, especially in countries, such as India and China that are experiencing the fastest increase in diabetes prevalence and the highest burden of tuberculosis in the world (Jeon &Murray, 2008). An assessment is necessary due to the public health inference there is a casual link between diabetes and tuberculosis. So, observational studies were conducted that proposed diabetes increases the risk of tuberculosis. Methods and Findings A search was conducted in the PubMed and EMBASE databases from 1965 to March 2007 which returned 13 observational studies (n = 1,786,212 participants) with 17,698 tuberculosis cases. The studies included three prospective cohort studies, eight case-control studies, and two studies for which study design could not be classified as either cohort or case control. The studies were held in Canada, India, Mexico, Russia, South Korea, Taiwan, the UK, and the US, and all studies were reported in English. Two of the cohort studies were among renal transplant patients, and three of the case-control studies were hospital-based or based on discharge records (Jeon & Murray, 2008). Peer-reviewed reports of cohort, case-control, or cross-sectional studies that allowed computation of a quantitative effect estimate of the relationship between diabetes and active tubercolosis and that controlled for possible confounding by …show more content…
The cohort studies revealed that compared with people who do not have diabetes; people with diabetes have an approximately 3-fold risk of developing active tuberculosis (Jeon & Murray, 2008). Higher increases in risk were seen among younger people, in populations with high background tuberculosis incidence, and in non-North American populations. According to Jeon & Murray (2008), heterogeneity of strengths of association may reflect true geographic/ethnic differences in severity of diabetes, transmission dynamics of tuberculosis, and the distribution of effect modifiers such as age, or it may be due to differences in study methodology or rigor. The summary estimate may not be correct to all populations as all cohort studies were conducted in Asia. Finally, people with diabetes may be important targets for interventions such as active case finding and treatment of latent tuberculosis and efforts to diagnose, detect, and treat diabetes may have a beneficial impact on tuberculosis control (Murray,