Global prevalence of diabetes mellitus in patients with tuberculosis: a systematic review and meta-analysis protocol

Abstract

IntroductionDiabetes mellitus (DM) is an important risk factor for active tuberculosis (TB), which also adversely affect TB treatment outcomes. The escalating global DM epidemic is fuelling the burden of TB and should therefore be a major target in the strategy for ending TB. This review aims to estimate the global prevalence of DM in patients with TB.Methods and analysisThis systematic review will include cross-sectional, case–control or cohort studies of populations including patients diagnosed with TB that have reported the prevalence of DM using one of the fourth standard recommendations for screening and diagnosis. This protocol is written in accordance with recommendations from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. Relevant abstracts published in English/French from inception to 31 December 2016 will be searched in PubMed, Excerpta Medica Database and online journals. Two investigators will independently screen, select studies, extract data and assess the risk of bias in each study. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence of diabetes across the studies. Heterogeneity will be assessed, and we will pool studies judged to be clinically homogenous. On the other hand, statistical heterogeneity will be evaluated by the χ² test on Cochrane’s Q statistic. Funnel-plots analysis and Egger’s test will be used to investigate publication bias. Results will be presented by continent or geographic regions.Ethics and disseminationThis study is based on published data. An ethical approval is therefore not required. This systematic review and meta-analysis is expected to inform healthcare providers as well as general population on the co-occurrence of DM and TB. The final report will be published as an original article in a peer-reviewed journal, and will also be presented at conferences and submitted to relevant health authorities. We also plan to update the review every 5 years.Protocolregistration numberPROSPERO International Prospective Register of Systematic Reviews (CRD42016049901).

Novel stepwise approach to assess representativeness of a large multicenter observational cohort of tuberculosis patients: The example of RePORT Brazil

“…These disparities may not necessarily reflect differences in the prevalence of these conditions in the study populations, but rather more frequent diagnosis and notification in RePORT because of uniform HbA1c and HIV testing. These comorbidities are known to be more frequent in patients with TB (Saraceni et al, 2018;Tankeu et al, 2017).…”

Global prevalence of diabetes in active tuberculosis: a systematic review and meta-analysis of data from 2·3 million patients with tuberculosis

“…The diagnosis of diabetes had to be made by a physician, or defined on the basis of measured fasting plasma glucose, oral glucose tolerance test according to WHO criteria, or selfreported. 8 The pub lished protocol was amended 9 to further permit inclusion of studies in which diabetes was diagnosed on the basis of A 1c haemoglobin. 10 Tuberculosis cases must have been diagnosed on the basis of WHO criteria.…”

Characterisation of impaired wound healing in a preclinical model of induced diabetes using wide‐field imaging and conventional immunohistochemistry assays

“…36 We determined the wounded region of interest by first performing a Gaussian blur, σ = 2, and thresholding the image based on the 95-percentile intensity in order to segment approximately 5 % of the pixels in frame. 37 We calculated I ROI as the average intensity of the thresholded region and I Background as the average of the non-thresholded region for Equation (1). At each time point, we calculated and compared contrast values between both groups as the wound healed.…”

“…Diabetes is a worldwide epidemic, affecting almost 194 million people, including 20.8 million in the United States . A main cause for hospital admissions for diabetic patients is morbidity related to foot ulcers, where 15% of diabetic patients suffer foot ulcers, of which 84% will progress to lower‐leg amputations .…”

“…Diabetes is a worldwide epidemic, affecting almost 194 million people, including 20.8 million in the United States. 1 A main cause for hospital admissions for diabetic patients is Abbreviations: ATP, adenosine triphosphate; ECM, extracellular matrix; Hb, deoxyhaemoglobin concentration; HbO 2 , oxyhaemoglobin concentration; iNOS, inducible nitric oxide synthase; SFDI, Spatial Frequency Domain Imaging; StO 2 , oxygen saturation morbidity related to foot ulcers, 2 where 15% of diabetic patients suffer foot ulcers, 2 of which 84% will progress to lower-leg amputations. 3 A principal cause of foot ulcers is delayed wound healing 4 that was not caught clinically.…”