The Risk of Tuberculosis Disease Among Persons With Diabetes Mellitus: A Prospective Cohort Study

Baker, Meghan A; Lin, Hsien Ho; Chang, Hsing Yi; Murray, Megan

doi:10.1093/cid/cir939

Cited by 113 publications

(110 citation statements)

References 32 publications

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“…Evidence shows that diabetes is associated with an increased risk of developing active tuberculosis [22,23] and those with diabetes have poorer tuberculosis treatment outcomes [24,25]. Although we cannot confer causality with our data, we did find a significant association between tuberculosis and diabetes in the two Asia regions.…”

Section: Discussioncontrasting

confidence: 58%

Diabetes Among United States-Bound Adult Refugees, 2009–2014

Benoit

Gregg

Zhou

et al. 2016

J Immigrant Minority Health

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We reported diabetes prevalence among all US-bound adult refugees and assessed factors associated with disease. We analyzed overseas medical evaluations of US-bound refugees from 2009 through 2014 by using CDC's Electronic Disease Notification System. We identified refugees with diabetes by searching for diabetes-related keywords and medications in examination forms with text-parsing techniques. Age-adjusted prevalence rates were reported and factors associated with diabetes were assessed by using logistic regression. Of 248,850 refugees aged ≥18 years examined over 5 years, 5767 (2.3 %) had diabetes. Iraqis had the highest crude (5.1 %) and age-adjusted (8.9 %) prevalence of disease. Higher age group and body mass index were associated with diabetes in all regions. Diabetes prevalence varied by refugee nationality. Although the absolute rates were lower than rates in the United States, the prevalence is still concerning given the younger age of the population and their need for health services upon resettlement.

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Section: Discussioncontrasting

confidence: 58%

Diabetes Among United States-Bound Adult Refugees, 2009–2014

Benoit

Gregg

Zhou

et al. 2016

J Immigrant Minority Health

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“…Diabetes mellitus is long known to be a medical condition that impairs immunity to MTB but has, to date, received little attention. Irrespective of the chosen study design, diabetes mellitus is generally associated with a two-to-threefold increased risk of both pulmonary and extrapulmonary TB [101][102][103].…”

Section: Ltbis In Patients With Diabetes Mellitusmentioning

confidence: 99%

Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination

Diel

Loddenkemper

Zellweger³

et al. 2013

Eur Respir J

156

133

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The introduction of new rapid diagnostic tools for tuberculosis (TB) and the promising TB drugs pipeline together with the development of a new World Health Organization Strategy post 2015 allows new discussions on how to direct TB control. The European Respiratory Society's European Forum for TB Innovation was created to stimulate discussion on how to best take advantage of old and new opportunities, and advances, to improve TB control and eventually progress towards the elimination of TB.While TB control is aimed at reducing the incidence of TB by early diagnosis and treatment of infectious cases of TB, TB elimination requires focus on sterilising the pool of latently infected individuals, from which future TB cases would be generated.This manuscript describes the three core components that are necessary to implement the elimination strategy fully. 1) Improve diagnosis of latent TB infected individuals. 2) Improve regimens to treat latent TB infection. 3) ensure public health commitment to make both 1) and 2) possible. Old and new evidence is critically described, focusing on the European commitment to reach elimination and on the innovative experiences and best practices available. @ERSpublications Diagnosis and treatment of latent TB infection is the core intervention to reach elimination

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“…However, the analysis was biased by excluding multidrug resistant-TB and HIV-infected subjects, which are known to increase mortality [3,4,24,25]. Also, other comorbidities were not included in their score and diabetes was not significantly associated to death (possibly due to the small sample size), contrarily to the majority of other studies [26][27][28], including the present one. By including coexistent conditions in TReAT, the weight given to age was attenuated, as young patients with diseases, like HIV/AIDS and liver failure/cirrhosis, were also considered at risk.…”

Section: Discussionmentioning

confidence: 79%

A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis

et al. 2016

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Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8-7.9), age 50 years (OR 2.9, 95% CI 1.7-4.8), bilateral lung involvement (OR 2.5, 95% CI 1.4-4.4), 1 significant comorbidity-HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease-(OR 2.3, 95% CI 1.3-3.8), and hemoglobin <12 g/dL (OR 1.8, 95% CI 1.1-3.1). A tuberculosis risk assessment tool (TReAT) was developed, stratifying patients with low (score 2), moderate (score 3-5) and high (score 6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment.

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The Risk of Tuberculosis Disease Among Persons With Diabetes Mellitus: A Prospective Cohort Study

Abstract: The risk of developing tuberculosis increased among those with increasing diabetes severity.

Cited by 113 publications

References 32 publications

Diabetes Among United States-Bound Adult Refugees, 2009–2014

Diabetes Among United States-Bound Adult Refugees, 2009–2014

Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination

A prediction rule to stratify mortality risk of patients with pulmonary tuberculosis

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