Diabetes mellitus and risk of all-cause mortality among patients with tuberculosis in the state of Georgia, 2009–2012

Magee, Matthew J.; Foote, M; Maggio, DM; Howards, Penelope P.; Narayan, K.M. Venkat; Blumberg, Henry M.; Ray, Susan M.; Kempker, Russell R.

doi:10.1016/j.annepidem.2014.01.012

Cited by 30 publications

(31 citation statements)

References 25 publications

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“…Diabetes mellitus was a strong indicator for treatment failure and mortality in general pulmonary tuberculosis patients (34)(35)(36)(37). No studies in acute respiratory failure confirmed this finding.…”

Section: Discussionmentioning

confidence: 70%

Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review

Bhurayanontachai¹,

Maneenil²

2016

J. Thorac. Dis.

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Background: Pulmonary tuberculosis with acute respiratory failure is fatal and is a burden in the intensive care units and leads to mortality. This retrospective study identifies the factors influencing the development of pulmonary tuberculosis requiring mechanical ventilation (TBMV) and mortality in the hospitalized patients with pulmonary tuberculosis. Methods:The medical records of hospitalized adult patients with pulmonary tuberculosis were retrospectively reviewed. Demographic data, clinical presentations, radiographic findings, biochemical tests, and clinical outcomes were collected. Data were compared by Student's t-test and Chi-square test between groups. Select variables that were statistically significant with P values <0.1 were introduced into a forward, stepwise, logistic regression model. Odds ratios (ORs) and their 95% confidence intervals (CIs) identified the independent influencing factors in the development of TBMV and mortality.Results: Of 268 enrolled patients, 185 (69.0%) were male. The patients were equally divided between the TBMV and non-TBMV groups. The shorter duration of illness (OR, 0.99; 95% CI, 0.98-0.99), underlying disease of AIDS (OR, 14.55; 95% CI, 1.71-123.91), presentation of fever (OR, 2.11; 95% CI, 1.20-3.71) and dyspnea (OR, 3.51; 95% CI, 2.02-6.11), large amount of acid fast bacilli on sputum smear (OR, 3.76; 95% CI, 1.90-7.47), lower serum albumin level (OR, 0.39; 95% CI, 0.26-0.59), and delayed initiation of antituberculosis agents (OR, 1.06; 95% CI, 1.00-1.12) were independent factors to develop TBMV. Male gender (OR, 2.16; 95% CI, 1.01-4.61), consolidation pattern on chest X-ray (OR, 2.41; 95% CI, 1.17-4.98), and lower serum albumin (OR, 0.39; 95% CI, 0.21-0.71) were correlated to mortality. Conclusions:The incidence and mortality rate of TBMV patients were high. Acute tuberculous pneumonia, underlying disease of AIDS, amount of acid fast bacilli, and delayed administration of antituberculosis agents were independent risk factors to develop TBMV. Male gender, consolidation on chest X-ray, and low serum albumin were significantly related to mortality.

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Section: Discussionmentioning

confidence: 70%

Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review

Bhurayanontachai¹,

Maneenil²

2016

J. Thorac. Dis.

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“…13–15 Other studies have not observed significant differences between these groups. 16, 17 An important limitation of most studies to date is the reliance on self-reported DM status. Further, few studies have investigated the prevalence of pre-DM among patients with TB.…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia

Magee¹,

Kempker²,

Kipiani³

et al. 2015

int j tuberc lung dis

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SUMMARY Setting National tuberculosis (TB) treatment facility, country of Georgia. Objective To determine the prevalence of diabetes mellitus (DM) and pre-DM among patients with TB using glycosylated-hemoglobin (HbA1c), and to estimate the association between DM and clinical characteristics and response to TB therapy. Design A cohort study was conducted (2011–2014) at the National Center for TB and Lung Disease in Tbilisi. Patients ≥35 years with pulmonary TB were included. HbA1c was used to define DM (≥6.5%), pre-DM (≥5.7%–6.4%), and no DM (<5.7%). Interviews and medical chart abstraction were performed. Regression analyses estimated associations between DM and 1) baseline TB characteristics and 2) TB treatment outcomes. Results A total of 318 newly diagnosed patients with TB were enrolled. Prevalence of DM was 11.6% and pre-DM prevalence was 16.4%. In multivariable analyses, patients with TB-DM had more cavitation (aOR 2.26), higher smear (aOR 2.37), and more MDR-TB (aOR 2.27) compared to patients without DM. Risk of poor TB treatment outcome was similar among patients with and without DM (28.1% vs. 23.6%). Conclusion Diabetes and pre-DM were common among adults with newly diagnosed pulmonary TB in Tbilisi, Georgia and DM was associated with more clinical symptoms at presentation including MDR-TB.

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“…However, recent studies have shown that DM prevalence among TB cases is variable. It ranges from about 50% reported by some studies in India, about 30% in Mexico, less than 10% in the United States, to even lower values in certain African countries, Spain and China10111213141516. As reported levels of co-morbidity vary highly, National TB Control Programmes (NTPs) will need to decide whether such DM screening is needed.…”

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confidence: 99%

Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

Ekeke¹,

Ukwaja

Chukwu³

et al. 2017

Sci Rep

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Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients. We report on a multi-centre implementation study carried-out in 13 health facilities in six States of Southern Nigeria. All newly diagnosed TB patients registered from March to October 2015 were screened for DM using current World Health Organisation guidelines. Overall, 2094 TB patients were evaluated, 196 (9.4%) were found to have DM. The prevalence of newly diagnosed DM was 5.5% (115/2094). DM prevalence varied according to age group; occurring in 2.2% of patients aged ≤ 25 years and 16.9% in patients aged (56–65) years. The additional yield of DM was 59% while the number needed to screen to detect a new case of DM was 18. Factors associated with DM were; age >40 years (aOR2.8, CI 2.1–3.9), rural residence (aOR2.3, 1.6–3.2), private health facility care (aOR2.0, 1.4–2.7), and having an occupation that engages in vigorous activity (aOR0.6, 0.4–0.9). The burden of DM among TB patients is high. Prioritization of DM screening for TB patients is indicated.

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Diabetes mellitus and risk of all-cause mortality among patients with tuberculosis in the state of Georgia, 2009–2012

Cited by 30 publications

References 25 publications

Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review

Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review

Diabetes mellitus is associated with cavities, smear grade, and multidrug-resistant tuberculosis in Georgia

Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

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