Diabète chez les nouveaux cas de tuberculose pulmonaire à Hanoï, Vietnam

Abstract

The aim of this study was to analyze all new pulmonary tuberculosis cases and to assess the frequency and consequences of associated diabetes mellitus. Although apparently distinct, these two diseases could be linked, as suspected since decades. The context is the persistent endemicity of tuberculosis and the recent emergence of diabetes, two major health events for developing countries. The study was conducted at National TB hospital in Hanoï, Vietnam, and retrospectively included tuberculosis patients, cases with diabetes and controls without diabetes, collected during a three-year period 2006-2008. Cases associated with HIV infection or other comorbidities potentially affecting mortality were excluded. Among 2867 new pulmonary TB cases, 254 (8.8%) had associated diabetes. Eighty-six cases and 86 matched controls were included. Among cases mean blood glucose at admission was 14.4 mmol/dl, and patients were mostly urban (50% cases vs 32.5% controls, p=0.03). Clinical symptoms were similar in both groups. However, chest X-Ray cavitary images were significantly more frequent among cases (38.3% vs 16.3%, p=0.002, OR=4.1), as did infiltrative images (78% vs 62%, p=0.017, OR=2.55) and positive sputum smears (67.4% vs 47.8%, p=0.014, OR=2.21). In Vietnam, DM is found in quasi 9% of patients with a new diagnosis of primary pulmonary TB. The diabetes-TB patients may have more severe radiologic findings and a higher smear positivity rate. We suggest that in addition to the systematic HIV screening, all new TB patients should also be screened for diabetes.

Prevalence and associated factors of diabetes mellitus among tuberculosis patients in Hanoi, Vietnam

“…The prevalence of DM among TB patients in this study was 13.7% (95% CI: 11.4–16.1%), which is much higher than the estimated prevalence of DM among people aged 18–99 in the general population of Vietnam in 2016 (5.34%; 95% CI: 4.32–7.32%) [ 13 ]. The prevalence of DM amongst TB patients is also higher than in the previous study in 2006–2008, in Hanoi, Vietnam (8.8%) [ 9 ].…”

“…A previous study conducted in 2006–2008, at the National Lung Hospital in Hanoi, investigated the DM prevalence among 2867 newly diagnosed TB patients and discovered the DM prevalence to be 8.8% [ 9 ]. A similar DM prevalence was assumed for this study, with a 95% confidence interval and 20% relative precision.…”

“…Currently, in Vietnam, there is no systematic screening for DM amongst TB patients and limited studies investigating the prevalence of DM amongst TB patients. One study conducted in the National Lung Hospital in 2006–2008 found the prevalence of DM among TB patients to be 8.8% [ 9 ].…”

The effect size of type 2 diabetes mellitus on tuberculosis drug resistance and adverse treatment outcomes

“…In addition, T2DM has been recognized as an important risk factor for transmission, treatment failure, hospitalization, relapse, drug (DR), multidrug resistance (MDR), and delay in smear conversion (Baker et al, 2011;Dooley & Chaisson, 2009;Perez-Navarro et al, 2015;Thanh, Khue, Sy, & Strobel, 2015). However, these outcomes are not consistent across studies, perhaps due to variations in study populations (Balde et al, 2006; Magee et al, 2013;Shetty et al, 2006).…”

“…de.Vigilancia.Epidemiológica, 2013). Meanwhile, the World Health Organization (WHO) reported 9.5 million new cases of TB in 2014 and 1.5 million deaths.( WHO, 2015) In Mexico, the tuberculosis (TB) incidence was 23 per 100,000, reflecting a serious public health problem (Delgado-Sanchez et al, 2015).The increase in prevalence of T2DM has had a significant impact on tuberculosis comorbidity, with prevalence rates ranging from 10% to 30%, mainly affecting developing countries, including Some studies report that T2DM increased two to three times the risk of TB (Dooley & Chaisson, 2009;Jeon & Murray, 2008;Perez-Navarro et al, 2015), and diminishes the success of treatment cure (Baker et al, 2011;Jimenez-Corona et al, 2013).In addition, T2DM has been recognized as an important risk factor for transmission, treatment failure, hospitalization, relapse, drug (DR), multidrug resistance (MDR), and delay in smear conversion (Baker et al, 2011;Dooley & Chaisson, 2009;Perez-Navarro et al, 2015;Thanh, Khue, Sy, & Strobel, 2015). However, these outcomes are not consistent across studies, perhaps due to variations in study populations (Balde et al, 2006; Magee et al, 2013;Shetty et al, 2006).…”