Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis
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AbstractBackground and objective:
With the colliding global epidemics of diabetes mellitus (DM) and tuberculosis (TB), we studied the effects of DM on the presentation of TB and its response to treatment.
Methods:
Consecutive TB patients from 2006 to 2010 in a territory-wide treatment programme offering 9-month extended treatment for TB patients with DM were examined and followed up prospectively to assess their treatment response. Successful treatment completers were tracked through the TB registry and death registry for relapse, death or till 31 December 2014, whichever was the earliest.
Results:
DM was independently associated with more chest symptoms (adjusted OR (AOR): 1.13) and systemic symptoms (AOR: 1.30) but less with other site-specific symptoms (AOR: 0.58) at TB presentation. There was more frequent pulmonary involvement (AOR: 1.69), with more extensive lung lesion (AOR: 1.25), lung cavity (AOR: 2.00) and positive sputum smear (AOR: 1.83) and culture (AOR: 1.38), but no difference in the proportion of retreatment cases or isoniazid and/or rifampicin resistance. After treatment initiation, there was higher overall incidence (AOR: 1.38) of adverse effects (mainly gastrointestinal symptoms, renal impairment and peripheral neuropathy but less fever and skin hypersensitivity reactions), more smear non-conversion (AOR: 1.59) and culture non-conversion (AOR: 1.40) at 2 months, and lower combined cure/treatment completion rate at 12 months (AOR: 0.79), but no difference in the relapse rate after having successfully completed treatment.
Conclusion:
DM adversely affected the clinical presentation and treatment response of TB, but there was no difference in the drug resistance and relapse rates.
All Author(s) ListLeung CC, Yew WW, Mok TYW, Lau KS, Wong CF, Chau CH, Chan CK, Chang KC, Tam G, Tam CM
Journal nameRespirology
Year2017
Month8
Volume Number22
Issue Number6
PublisherWiley
Pages1225 - 1232
ISSN1323-7799
LanguagesEnglish-United Kingdom

Last updated on 2020-12-08 at 02:42