Characteristics of patients with diabetes screened for tuberculosis in a tertiary care hospital in South India

Kumpatla, Satyavani; Sekar, A.; Achanta, Shanta; Sharath, B. N.; Kumar, Ajay M. V.; Harries, Anthony; Viswanathan, Vijay

doi:10.5588/pha.13.0035

Cited by 43 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regardless of the source of care, very low proportions of DM patients in Cambodia reach their treatment targets [14,15], which in turn may increase their risk of TB [16][17][18]. The reliance on the private sector for diabetes care combined with limiting TB services to the public sector presents a unique challenge for integrating service delivery.…”

Section: Resultsmentioning

confidence: 99%

Bidirectional Screening of Diabetes Mellitus and Tuberculosis in Cambodia

Kheang¹,

Theang²,

Eam³

et al. 2019

J Trop Dis

View full text Add to dashboard Cite

Background: Cambodia has a high burden of Tuberculosis (TB) with an incidence rate of 326 per 100,000 population in 2018 and rapidly increasing rates of Diabetes Mellitus (DM) with prevalence rate 9.6% in 2016. The introduction of the first national guidelines for the management of TB/DM co-morbidity in 2014 has resulted in the introduction of coordinated service delivery. Objective: This study aimed to assess the performance and the results of bidirectional TB/DM screening, diagnosis of co-morbidity, and enrollment in treatment in 7 health operational districts in 5 provinces in Cambodia. Methods: The retrospective study reviewed patient records of 6,463 DM patients and 8,403 TB patients who received treatment between July 2016 and February 2019 in 7 referral hospitals and 113 health centers. Results: Forty percent of DM patients were screened for TB, and 55% of TB patients were screened for DM. Of the screened DM patients, 4.6% were diagnosed with TB. Of screened TB patients, 3.7% were diagnosed with DM. All DM patients diagnosed with TB were enrolled in TB treatment and 95% of TB patients diagnosed with DM began receiving treatment for DM. Conclusion: This is the first study examining TB/DM co-morbidity and coordinated service delivery in Cambodia.The gaps in the performance of bidirectional screening suggest areas for further intervention. To increase the rate of bidirectional screening, provider compliance with standards needs to be improved by strengthening providers competencies. Strengthened data collection and reporting systems will also contribute to increasing provider accountability. Secondly, the current structure of TB and DM service delivery with TB services only available from the public sector and public DM services only available at the referral level creates a challenging environment for effective referrals and coordinated care and should be reconsidered. In addition to improved coordination between the public and private sectors, expansion of public DM services to health centers and to the community level warrants exploration. Finally, the increased focus needs to be given to addressing the high levels of pre-diabetes.Cambodia has a limited window of opportunity to build capacity and develop systems to effectively manage TB/DM co-morbidity.

show abstract

Section: Resultsmentioning

confidence: 99%

Bidirectional Screening of Diabetes Mellitus and Tuberculosis in Cambodia

Kheang¹,

Theang²,

Eam³

et al. 2019

J Trop Dis

View full text Add to dashboard Cite

show abstract

“…The controls, however, used oral hypoglycemics more, whereas the cases, oral hypoglycemic and insulin concomitantly, which suggests the need for more than one class of medication to achieve glycemic control. Studies show that the risk of TB is three times higher in those with DM complications 19,26 , and that diabetic patients with TB have a longer time of DM diagnosis and use insulin combined with oral hypoglycemic more than diabetics without TB 27 . However, in this study, these variables were similar across the groups.…”

Section: Discussionmentioning

confidence: 99%

Fatores associados à tuberculose em população de diabéticos: um estudo caso-controle

Leal

Maciel

Cadê

2019

Ciênc. saúde coletiva

View full text Add to dashboard Cite

Resumo Este estudo analisou os fatores associados à tuberculose em diabéticos atendidos nas unidades de saúde de Vitória/ES, Brasil. Trata-se de um estudo caso-controle, sendo 45 casos de diabéticos atendidos nas 30 unidades do município e notificados no SINAN com diagnóstico de tuberculose no período de 2007 a 2013 e 90 de controles diabéticos. Utilizaram-se dados do SINAN, do Sistema de Informação em Saúde de Vitória e do Laboratório Central Municipal, e uma entrevista estruturada. Foram realizadas análises bivariada e multivariada, mediante regressão logística com as variáveis significativas (p < 0,05). O grupo caso apresentou maior frequência de hábitos de vida danosos à saúde em comparação com o grupo controle, como consumo compulsivo de álcool (p < 0,001) e tabagismo (p = 0,060), além de piores parâmetros bioquímicos, como glicemia de jejum (p < 0,001) e hemoglobina glicosilada (p = 0,034). A ingestão regular de bebida alcoólica (OR 6,612; IC 2,151-20,330), o contato prévio com pessoas com tuberculose (OR 4,418; IC 1,678-11,631) e a glicemia de jejum (OR 1,017; IC 1,007-1,026) foram associados à tuberculose nos diabéticos. O estudo revela que piores hábitos de vida e controle glicêmico, e o contato anterior com tuberculose ativa aumentam a chance de o diabético desenvolver tuberculose.

show abstract

“…DM-TB comorbidity is more common in men, elderly persons, married [4, [7][8][9][10][11]. These patients are usually smokers, alcohol consumers, sedentary persons, who live in an urban environment, in crowded areas and in insanitary conditions [11][12][13][14]. They have a reduced level of education, a reduced economic status and no stable job [13].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Tuberculosis Characteristics in a Patient with Type 2 Diabetes Mellitus

Firănescu

Moța

2019

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

View full text Add to dashboard Cite

Tuberculosis (TB) and diabetes mellitus (DM) are two chronic diseases with major impact on worldwide morbidity and mortality. DM significantly increases the risk of death, therapeutic failure and relapse of TB, requiring a much more careful monitoring of these patients. In this article we present the case of a patient with type 2 DM in the stage of major chronic complications, with numerous risk factors for TB and atypical symptomatology, pulmonary X-ray showing active TB lesions. The patient did not follow the diabetologist's recommendations, discontinuing the antidiabetic treatment on his own initiative. The glycemic imbalance and chronic alcoholism caused the failure of the anti TB therapy.

show abstract

Characteristics of patients with diabetes screened for tuberculosis in a tertiary care hospital in South India

Abstract: Screening of DM patients for TB was feasible in a tertiary care hospital. The yield of new TB cases was low and merits further investigation. Socio-demographic and clinical characteristics were different in patients with DM and TB compared to those with DM only.

Cited by 43 publications

References 17 publications

Bidirectional Screening of Diabetes Mellitus and Tuberculosis in Cambodia

Bidirectional Screening of Diabetes Mellitus and Tuberculosis in Cambodia

Fatores associados à tuberculose em população de diabéticos: um estudo caso-controle

Pulmonary Tuberculosis Characteristics in a Patient with Type 2 Diabetes Mellitus

Contact Info

Product

Resources

About