Tuberculosis and diabetes in Guyana

Alladin, Bibi; Mack, Steve; Singh, Apoorv; Singh, Chaitra; Smith, Belinda; Cummings, Emmanuel; Hershfield, Earl S.; Mohanlall, Jeetendra; Ramotar, Karam; Fleur, Curtis La

doi:10.1016/j.ijid.2011.07.006

Cited by 20 publications

(20 citation statements)

References 8 publications

(12 reference statements)

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“…Similar results were reported by Patel et al during his study conducted in Indian population that majority patients of TB-DM were male (73.68%) while female were the minority (26.32%). Moreover, similar results were obtained from another study conducted in Pakistan by Jabbar et al revealed that 60.21% male patients out numbered the female participants (39.78%) in terms of TB-DM co-incidence 18 . The perevelnce of higher ratio of TB-DM may be due to the case that male are exposed to the outer environment more as compared to female and encountered by multiple infections.…”

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confidence: 85%

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Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan

Tahir¹,

Ahmad²,

Akhtar

et al. 2017

Afr H. Sci.

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Background: The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of morbidity. Objective: To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors associated with TB-DM co-occurrence . Methods: We enrolled 500 TB patients from September, 2014 to August 2015 at four major public sector hospitals of Lahore, Pakistan. A questionnaire was used to collect information regarding associated socio-demographic and behavioral factors of the patients. We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed by an HbA1c level check of all hyperglycemic patients. Results: The prevalence of TB-DM co-occurrence was 14.8%. The prevalence of TB-DM was higher (62.2%) among males. The >57 year age group had the highest proportion of patients (35.1%), with co-existent TB-DM. Most were illiterate (73.0%) and unemployed (48%). Moreover, among the 74 patients positive for TB-DM had a history of smoking. Age and education level were significantly associated with DM-TB while gender, occupation and smoking were not associated. Conclusion:The study revealed a 14.8% prevalence of DM among TB patients. This was associated with several socio-demographic factors, including age, unemployment, literacy and polluted environment. Thus, poor and unhealthy lifestyles were the factors associated with DM among immunologically compromised individuals due to TB. Keywords: Tuberculosis (TB), diabetes mellitus (DM), socio-demographic and behavioral factors.

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supporting

confidence: 85%

“…The results of present study are similar to those of Amin et al that reported co-occurrence of TB and DM in 14% patients of Peshawar, Pakistan 6 . Similarly, another study of Pakistani population conducted by Jabbar et al in 2006 showed co-occurrence of TB and DM among 11.9% study participants 18 .…”

Section: Fig1 Overall Prevalence Of Diabetes Among Tb Patientsmentioning

confidence: 77%

Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan

Tahir¹,

Ahmad²,

Akhtar

et al. 2017

Afr H. Sci.

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“…There were five (6.4%) studies from Oceania that showed prevalence rates ranging from 12% in Fiji [104] to 45% in Ebeye-Marshall Islands [103] and the overall median prevalence in this area was 23.2% (IQR 12.8%-39.0%). Three (3.8%) studies conducted in South America indicated prevalence rates ranging from 6.1% in Brazil to 14% in Guyana [98,101]. This amounted to an overall median prevalence of 11.1% (IQR 6.1%-14.0%).…”

Section: Resultsmentioning

confidence: 99%

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

2017

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IntroductionThe dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels.MethodsOvid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described.ResultsThe prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity.ConclusionThis systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services.

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“…18,19 Studies that have assessed radiological differences between TB patients with and without DM have noted that cavities are more common in TB patients with DM; this may also influence sputum smear status. 20,21 While data may be conflicting, there is some evidence to suggest that DM influences the clinical presentation of TB.…”

Section: Public Health Action Tb and Diabetes In Fiji 161mentioning

confidence: 99%

Sputum smear conversion and treatment outcomes for tuberculosis patients with and without diabetes in Fiji

Prasad

Gounder

Varman

et al. 2014

public health action

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Fiji is a low tuberculosis (TB) burden country, with a TB incidence rate of 24 cases per 100 000 population and a high treatment success rate of 90% (2012 data). 1 However, diabetes mellitus (DM) is very common in Fiji, and its prevalence is thought to be increasing. The STEPwise approach to Surveillance (STEPs) study conducted in 2002 reported a population prevalence of 16% for DM. 2 A more recent estimate, using a different methodology, gave a DM prevalence among adults in Fiji of 10.9%, with impaired glucose tolerance in a further 11.0%. 3 This remarkably high prevalence of DM is a matter of concern for TB control in Fiji. Published data from other settings have concluded that people with DM have a significantly increased risk of developing TB and worse treatment outcomes, with a higher risk of mortality and treatment failure during anti-tuberculosis treatment than among patients without DM. [4][5][6] In response to this evidence, the Fiji National Tuberculosis Programme (NTP) introduced random blood glucose (RBG) testing to screen for DM in all registered TB patients in 2011. 7 A recent local study reported DM in 14% of TB patients in Fiji. 8 It has been noted by local clinical and public health staff that sputum smear-positive TB patients with DM take longer to convert to smear-negative than TB patients without DM, and that they thus require longer periods of hospitalisation. However, this observation has not been verified empirically, and there are no published data from Fiji reporting sputum smear conversion or treatment response in TB patients with and without DM.In the present study, we aimed to evaluate treatment outcomes and sputum smear conversion in TB patients with DM and compare these indicators in TB patients without DM. METHODS Study designThis was a retrospective descriptive study using routinely collected data from the TB register and in-patient folders from three TB treatment hospitals in Fiji. SettingFiji is an island nation, located in the Pacific Ocean, classified as an upper middle-income economy. 9 It comprises 332 islands, of which 110 are inhabited. The population of 837 231 comprises 56.8% i-Taukei (indigenous Fijians) and 37.5% Fijians of Indian descent; the remaining 5.7% are from other ethnic backgrounds. 10 The Fiji NTP is largely funded by the government, and TB diagnosis and treatment are provided free of charge. Three government hospitals provide TB services for the entire country; the private sector is not involved in TB control. All patients diagnosed with TB are registered as TB cases and treated at one of the three TB treatment centres. The majority of TB patients are admitted for the 2-month intensive phase of treatment, during which they receive anti-tuberculosis treatment and clinical follow-up. Clinical evaluation on admission routinely includes a full medical history and RBG screening if the patient is not known to have DM. If RBG is 6.1 mmol/l, fasting blood glucose (FBG) is tested. If the FBG is 7 mmol/l, 8 patients are diagnosed as having DM and referred to a ph...

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Tuberculosis and diabetes in Guyana

Cited by 20 publications

References 8 publications

Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan

Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

Sputum smear conversion and treatment outcomes for tuberculosis patients with and without diabetes in Fiji

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