Bi-directional screening of tuberculosis patients for type 2 diabetes mellitus and diabetes patients for tuberculosis in Bhubaneswar, Odisha

Abstract

Background: The aim of the study was to assess the feasibility and results of screening diabetes mellitus (DM) patients for tuberculosis (TB) and TB patients for DM within the routine health care settings. Methods: Prospective observational study was carried out within the Diabetes Centre and TB division from June, 2014 to June, 2016. The screening for active TB in DM and DM in TB patients is followed as per the guidelines of the revised national tuberculosis control programme and national programmes in India. Results: 350 patients with active TB disease were screened for diabetes during the study period. Among the TB patients, 28% patients were having pre-diabetes and 17% patients were having diabetes. Both the conditions, pre-Diabetes or diabetes, were more common among males, married patients, advancing age, having less education, no specific job, sedentary life style, smoking / drinking, living in crowded areas, poor living conditions as well as unhygienic environment. 350 patients with diabetes were screened for TB in which 8 (2.2%) patients found to have TB. The various socio-demographic factors appeared to be significant factors. RBG levels, cholesterol and triglycerides were raised among most of the diabetes patients. Age, male gender and Cat-I status appeared to be significant factors among patients having both conditions The incidence of TB among T2DM patients is less than that reported from other regions. Conclusions: Bi-directional screening of TB patients for DM and DM patients for active TB leads to earlier detection of DM as well as TB, better TB-specific treatment, favourable outcome for TB as well as DM and prevention of DM complications. This study is the first of its kind in this State.

<p>Incidence and Predictors of Tuberculosis among Adult Diabetic Patients, Debre Markos Referral Hospital, Northwest Ethiopia, 2018: A Retrospective Cohort Study</p>

“…This is supported by other studies showing that sophisticated screening and diagnostic techniques for early testing and detection reduced the incidence of TB disease. 7,14 Though the findings of this study are consistent with a study conducted in India (2.2 per 100 PYs), 15 they are inconsistent with one in north India (0.655 per 100 PYs). 16 This might be due to differences in population and study layout (a prospective study was conducted on patients with type 2 DM) in north India, which had relatively decent insulin secretion and glycemic control that prevented the development of complications and coinfections compared to type 1 DM.…”

Relationship Between Clinical, Laboratory, and Radiological Symptoms with The Incidence of Active Pulmonary Tuberculosis in People with Type 2 Diabetes Mellitus

“…The results of this study indicate that most of the subjects were aged 45 years in both DM-TB and DM without TB[12].Other research byPutra et al, (2018) in Bali, has the same age characteristics, namely out of 365 subjects of type 2 DM who screened as many as 335 aged> 45 years[13]. Research byDas et al, (2017) in Bhubaneswar, Odisha screened for type 2 DM in subjects with pulmonary TB, out of 350 samples as many as 236 were aged 45[14] .The results of statistical analysis that are not related between these two studies can be caused by first the number of age samples in DM-TB and DM subjects without TB is the same, second 45 years of age is one of the risk factors for type 2 DM, third 45 years of age is a productive age with high activity and mobility so that it has a high probability of contact with other people. A systematic review shows that age is a risk factor for the development of TB disease in people with type 2 DM, as increasing age can reduce the immune system so that it is vulnerable to…”

Kendali Glikemik pada Pasien Diabetes Melitus Tipe 2 dengan dan tanpa Tuberkulosis Paru

“…Berbagai penelitian terhadap pasien DMT2 dengan TB paru telah dilakukan diantaranya di Shandong Cina pada pasien DMT2 berusia 25 tahun ke atas mendapatkan rerata usia pasien DMT2 dengan TB yakni 64.2 tahun, di Taiwan pada pasien berusia ≥65 tahun menemukan rerata usia pasien 75,15 tahun, Penelitian di Bangalore India menemukan proporsi usia terbanyak pada ≥40 tahun yakni 74,47% dibandingkan usia <40 tahun, di Telengana, India mendapatkan proporsi terbanyak pada kelompok usia 55-64 tahun yakni 26,4%, serta 45-54 tahun sebesar 23,6%, di India Selatan mendapatkan rerata usia pasien TB-DM yakni 48,6 ± 9,3 tahun, di Bhubaneswar Odisha India rerata usia 51,92 ± 11,76 tahun serta penelitian di Luzaka Zambia menemukan proporsi 50,0% pada usia antara 35-50 tahun. [13][14][15][16][17][18][19] Perbedaan rerata usia yang terjadi pada beberapa penelitian di dunia disebabkan perbedaan populasi dari penelitian.…”

“…20 Berdasarkan jenis kelamin pasien DMT2 dengan TB paru umumnya didominasi oleh lakilaki misalnya di Shandong Cina sebesar 71,4%, di Taiwan 76,7%, di Banglaore India 68,08%, Telengana India 70,83%, India Selatan 72,0%, Bhubaneswar Odisha India 75%. [13][14][15][16][17][18] Dua penelitian di Indonesia lainnya juga mendapatkan proporsi yang lebih banyak pada laki-laki dibandingkan perempuan yakni di Jakarta (55,1%) dan di Padang (58,62%). 9,10 Penelitian ini mendapatkan hasil yang serupa di Luzaka Zambia yang menemukan perempuan lebih banyak yakni 83,3%.…”