Analysis of Some Risk Factors of Active Tuberculosis in Three South Florida Counties.

Abstract

BackgroundWith tuberculosis (TB) being among the top 13 leading cause of death and second leading infectious disease killer next to COVID-19 globally, there is a need for continued study and a better understanding of the risk factors and management approaches. One in five tuberculosis (TB) deaths occurs in individuals who have contracted human immunodeficiency virus (HIV). However, other risk factors play a role in its morbidity pattern. Therefore, descriptions of these comorbidities between TB, HIV, and other risk factors such as diabetes are needed.MethodA retrospective, descriptive study was conducted to evaluate the prevalence of TB and its relationship with some risk factors (HIV, diabetes, race, ethnicity, end-stage renal disease, post-organ transplant, recent contact with active TB, and other non-HIV immunosuppressive conditions) using data from three South Florida counties (Dade, Broward, and Palm Beach) from 2010 to 2019 retrieved from the CDC’s Report of Verified Case of Tuberculosis (RVCT).ResultsA total of 2437 cases of TB were reported between 2010 and 2019. There was approximately a 14% positive rate among the three counties for HIV. In contrast, 47% of the individuals with active TB in all three counties were also diagnosed with diabetes mellitus. An average of 25% of the active TB cases in these counties had a concurrent immunosuppressive condition other than HIV. Known contact with another active TB case was an identified risk factor in 18%, 17%, and 29% of reported TB cases in Dade, Broward, and Palm Beach counties, respectively.DiscussionThe HIV status of patients with TB in these three counties was predominantly negative, in contrast to initial theories. The presence of diabetes mellitus was associated with a diagnosis of TB or latent tuberculosis infection (LTBI) within the studied population.ConclusionScreening for latent tuberculosis infection (LTBI), compliance, and promotion of LTBI management in newly diagnosed and uncontrolled diabetics may be a successful prevention strategy for this high-risk group.