[A retrospective cohort study of epidemiological characteristics of rheumatic disease patients complicated with tuberculosis in 4 provinces based on hospital registration system].

Objective

To analyze the epidemiological characteristics of rheumatic disease patients complicated with tuberculosis (TB) in Hubei, Hunan, Chongqing and Guizhou provinces from 2019 to 2023, and provide data support for the development of TB prevention and control strategies for the patients with rheumatic diseases.

Methods

Information of rheumatic disease patients complicated with TB diagnosed from January 1, 2019 to December 31, 2023 were collected from National Rheumatism Data Center, National Infectious Disease Reporting System and National Tuberculosis Information Management System. A retrospective cohort study was conducted, and χ2 test, Fisher's exact test or Poisson test was used to compare rates/constituent ratios. The annual incidence probability of TB in patients with rheumatic diseases was calculated by using life table method and the survival curve was plotted.

Results

A total of 10 015 patients with rheumatic diseases were included in the 4 provinces from 2019 to 2023, in whom 76 complicated with TB. The proportion of the patients with bacteriologically confirmed was 69.74% (53/76). The M(Q1,Q3) of time interval between the diagnoses of rheumatic diseases and TB was 1.20 (0.39, 2.21) years, and more than 50% of the patients complicated with TB within 1.5 years. The incidence of TB in patients with rheumatic diseases decreased over the observation time, and the cumulative incidence rate was 312.46 per 100 000 person-years. Survival analysis showed that the cumulative risk of TB in patients with rheumatic diseases increased over the observation time. The incidence rate of TB in patients with rheumatic diseases in Guizhou was highest (434.51 per 100 000 person-years, P=0.018); the incidence rate in men (528.57 per 100 000 person-years) was approximately twice than that in women (243.78 per 100 000 person-years, P<0.001); and the incidence rate in patients aged ≥65 years (726.08 per 100 000 person-years) was significantly higher than that in other age groups (P=0.003). The incidence rate of TB was relatively high in patients with rheumatoid arthritis (324.76 per 100 000 person-years), especially in those in highly active status.

Conclusions

The incidence rate of TB in patients with rheumatic diseases in Hubei, Hunan, Chongqing and Guizhou from 2019 to 2023 was significantly higher than the average level in general population. It is necessary to strengthen the active screening of TB in patients with rheumatic diseases based on medical institutions, and develop targeted prevention and control strategies according to the actual incidence of TB in patients with different types of rheumatic diseases in different areas and populations.