Diabetes mellitus and pulmonary tuberculosis

Boucot, Katharine R.

doi:10.1016/0021-9681(57)90007-3

Cited by 22 publications

(17 citation statements)

References 55 publications

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“…TB was more prevalent in males, both in diabetic and nondiabetic subjects. Historically, a higher number of males have been found among TB patients compared to females [6]. In our study, nondiabetic patients infected with TB were younger than diabetic patients, which was in agreement with another study [3] and may be attributable to the fact that, while TB typically affects a younger population, DM affects older individuals.…”

Section: Discussionsupporting

confidence: 92%

Role of Diabetes in the Prognosis and Therapeutic Outcome of Tuberculosis

Suleiman

Aweis

Mohamed

et al. 2012

International Journal of Endocrinology

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Background. Increased susceptibility of diabetic mellitus (DM) patients to infection, including tuberculosis (TB), is well documented. The prevalence of DM in Malaysia is reaching epidemic proportions. In this study, we sought to assess risk factors for TB and the impact of DM on the outcome of TB treatment. Methods. TB patients, diabetic patients, and diabetic patients with TB were divided into three groups of 200 subjects each. Data were obtained from patients' medical files at the beginning and end of the study period. Prevalence rates of DM and HIV among TB patients were assessed. Prognosis, TB-related complications, anatomical site of infection, and duration of infection and diabetes were also examined. Results. The prevalence rates of HIV and DM amongst TB patients were 7.7 and 30%, respectively. The diabetic TB patient group contained more males (72%) and smokers (45.5%) compared to the nondiabetic group (58.3% and 33.5%, resp.). Approximately 74% of diabetic patients were Mycobacterium sputum positive compared to only 51% of nondiabetic patients. Diabetic patients were also more likely to develop pulmonary TB (87%) compared to nondiabetic TB patients (59%). Diabetic TB patients had a higher mortality rate (7.5%) compared to the TB only and DM only groups (1 and 2%, resp.). The duration of TB symptoms was longer in nondiabetic TB patients compared to diabetic TB patients (4.5 versus 2.6 months, resp.). Diabetes antedated TB by a mean time of 4 years. Conclusions. We found a higher number of sputum-smear-positive cases and pulmonary TB cases as well as a greater number of males and higher mortality rate in diabetic patients compared to nondiabetic patients.

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Section: Discussionsupporting

confidence: 92%

Role of Diabetes in the Prognosis and Therapeutic Outcome of Tuberculosis

Suleiman

Aweis

Mohamed

et al. 2012

International Journal of Endocrinology

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“…Latent tuberculosis (TB) infection is defined as infection with M. tuberculosis as manifested by a positive TST or IGRA result, but without evidence of active TB disease including symptoms, progressive 11,12 Transplantation (related to immune-suppressant therapy) 20-74 [13][14][15][16] Silicosis 30 17,18 Chronic renal failure requiring hemodialysis 10-25 [19][20][21][22] Carcinoma of head and neck 16.0 23 Recent TB infection (<2 years) 15.0 24,25 Abnormal chest x-ray-with upper lobe fibronodular disease typical of healed TB infection 6-19 [26][27][28] TNF-alpha inhibitors 1.7-9.0 [29][30][31][32] Moderate risk (testing and treatment for LTBI recommended if age <65 years † ) Treatment with glucocorticoids 4.9 33 Diabetes mellitus (all types) 2-3.6 [34][35][36][37] Young age when infected (0-4 years) 2.2-5 38 Slightly increased risk (testing and treatment for LTBI recommended if age <50 years † ) Underweight (<90% ideal body weight; for most persons, this is a BMI Յ 20)…”

Section: Isoniazid For Latent Tuberculosis Infection Treatmentmentioning

confidence: 99%

Treatment of latent tuberculosis infection: An update

2010

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Isoniazid (INH) has been the mainstay of treatment of latent tuberculosis infection for almost 50 years. The currently recommended preferred regimen is 9 months daily self-administered INH (9H); this has efficacy of more than 90% if completed properly. Unfortunately, INH is associated with serious adverse events, including hepatotoxicity. Although risk factors for this complication are well established, allowing for better selection of candidates for therapy, this complication still occurs, and is occasionally fatal. Hence close follow up of patients is necessary, increasing the cost and complexity of treatment. This problem, plus the lengthy duration, results in poor acceptance by patients and providers, and poor adherence by patients. As a result, many preventable cases of tuberculosis continue to occur, and the public health impact of latent tuberculosis infection treatment is suboptimal. These problems have spurred interest in finding shorter, safer and cheaper alternative regimens, with similar efficacy. Of the many regimens that have been examined, 2 months of rifampin and pyrazinamide has excellent efficacy-in experimental studies in mice and randomized trials, largely in HIV-infected persons. However, while the safety of 2 months of rifampin and pyrazinamide appears acceptable in HIV-infected persons and children, in non-HIV-infected adults this regimen is associated with an unacceptably high rate of severe liver toxicity. Three to four months of INH and rifampin has had equivalent effectiveness as 6 months INH in several randomized trials. However, completion of therapy and toxicity has been the same as with INH-possibly because two drugs are taken rather than one.The fourth commonly studied regimen is 4 months rifampin. This has been found to have significantly better completion than 9H, with significantly less toxicity, especially hepatotoxicity. However, only one trial has evaluated efficacy and effectiveness of mono-rifampin therapy. In this trial, 3 months rifampin had somewhat better efficacy than either 3 months of isoniazid and rifampin (3HR) or 6 months isoniazid. Two large scale trials are ongoing; one is comparing efficacy and effectiveness of 9H with 4 months rifampin (both daily and self-administered), while the second, which is nearing completion, compares daily self-administered 9H with 3 months directly observed once weekly INH combined with rifapentine. The results of these two trials will likely shape future recommendations substantially.r esp_1751 603..622

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“…Treatment with glucocorticoids 4.9 67 Diabetes mellitus (all types) 2.0-4.1 [68][69][70][71] Young when infected (0-4 yr) 2. Review owing to cross-reactivity. 15 With tuberculin skin tests, the likelihood of a false-positive result caused by BCG decreases with time since vaccination, but it also depends on the age when the person was vaccinated.…”

Section: Screening Testsmentioning

confidence: 99%

Tuberculosis: evidence review for newly arriving immigrants and refugees

Greenaway

Sandoe²,

Vissandjée³

et al. 2010

Canadian Medical Association Journal

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The casesOusman, a 32-year-old man; his 8-year-old daughter, Nene; and his 65-year-old mother, Mariama, from Casamance, Senegal, speak only Wolof and arrived in Canada six months ago from a refugee camp. What, if any, screening for latent tuberculosis should be done for this family?Active pulmonary tuberculosis was recently diagnosed in Harjit, a 65-year-old man who immigrated to Canada from India at age 32. Diabetes was diagnosed when he was 40 years old, and chronic renal failure developed one year ago that required dialysis because of the diabetes. Should screening for latent tuberculosis have been done for this man, and if so when?

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Diabetes mellitus and pulmonary tuberculosis

Cited by 22 publications

References 55 publications

Role of Diabetes in the Prognosis and Therapeutic Outcome of Tuberculosis

Role of Diabetes in the Prognosis and Therapeutic Outcome of Tuberculosis

Treatment of latent tuberculosis infection: An update

Tuberculosis: evidence review for newly arriving immigrants and refugees

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