Diabetes and Tuberculosis Pilot

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Screening for Mycobacterium tuberculosis infection in those at high risk for developing clinical tuberculosis (TB) is a key strategy of the Centers for Disease Control and Prevention (CDC) to control the spread of TB in the US. This is particularly important at the US/Mexico border, where converging socioeconomic and demographic factors contribute to the higher burden of TB when compared to the US national average. This region also has high prevalence of type II diabetes (DB), which has long been known to predispose to active tuberculosis. Based on this information, we hypothesize that DB contributes to the burden of TB in the Hispanic population from four Texan counties along the Mexican-American border. Four counties in the Lower Rio Grande Valley (LRGV) will be analyzed in this pilot project: Hidalgo, Cameron, WilIacy and Starr. A secondary analysis of the Texas hospital discharges during 2001 will be implemented using ICD 9 codes for case and control selection. Unconditional multiple logistic regression analysis will be used to evaluate the relationship between tuberculosis and tentative associated factors. Health production functions will be estimated, using unconditional multiple logistic regression as well. The specific aims of the project are: Aim 1: Determine the degree of association of DB and TB in Hispanics in the LRGV Aim 2: Determine the strength of the association between TB and its associated risk factors (besides DB), with emphasis on underlying medical conditions. Aim 3: Estimate health production function that will identify relevant socio-economic indicators of TB and DB.