Pulmonary tuberculosis in patients with diabetes mellitus in Bangladesh [Correspondence]

Rahim, Zeaur; Ms, Momi; Sk, Saha; Zaman, Khalequ; Kn, Uddin; Sn, Jamil; Nahar, Nazmun; Ak, Khan; Ea, Cooreman; Ahmed, Mohamed; Ag, van der Zanden; Nakajima, Chie; Suzuki, Yasuhiko

doi:10.5588/ijtld.11.0846

Cited by 7 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of PTB was approximately 2-3 times higher in T2DM patients aged 35 or above than in the general population in Shanghai, China, from 2010 to 2015. Our results are consistent with a prospective study conducted in Dhaka, which reported that the incidence rate of confirmed PTB cases among DM patients was www.nature.com/scientificreports www.nature.com/scientificreports/ double than that observed in the general population 26 . Another prospective study, conducted in Yunnan province, China, demonstrated that the rate of TB incidence was almost 3 times higher than that found in the general population 12 .…”

Section: Discussionsupporting

confidence: 92%

Incidence of pulmonary tuberculosis in Chinese adults with type 2 diabetes: a retrospective cohort study in Shanghai

Guo

Xia

et al. 2020

Sci Rep

View full text Add to dashboard Cite

To estimate the incidence of pulmonary tuberculosis (PTB) in Chinese diabetes patients and to evaluate the effect of blood glucose on PTB risk, a retrospective cohort study was built based on the diabetes management system in Shanghai and included 240,692 adults aged 35 or above. Incidences of PTB in all diabetes patients and by subgroups were calculated and compared. Multivariable Cox regression models with restricted cubic splines were used to evaluate the association of fasting plasma glucose (FPG) with the risk of PTB. A total of 439 incident PTB cases were identified in the cohort after an average of 3.83 years of follow-up. The overall PTB incidence rate was 51.3/100,000 in diabetes patients, and annual incidence remained higher than that in general population. The PTB incidence rate of diabetes patients was higher in men than in women (86.2 vs. 22.1 per 100,000) and was highest in patients with body mass index (BMI) < 18.5 kg/m 2 (215.2/100,000) or FPG ≥ 10 mmol/L (143.2/100,000). Our results suggest that the risk of tuberculosis may be greater at higher levels of FPG in diabetes patients of normal weight. Specific tuberculosis screening strategies for different characteristic diabetes population should be provided to prevent and control tuberculosis in China. Tuberculosis (TB) remains a major global public health issue despite its slowly decreased incidence, particularly in developing countries. The World Health Organization (WHO) reported that an estimated 10 million people developed TB and 1.6 million people died of TB worldwide in 2017 1. At the same time, type 2 diabetes mellitus (T2DM) is a global epidemic. It is estimated that there were around 425 million prevalent diabetes patients worldwide in 2017, and the number is expected to be almost 700 million by 2045 2. The associations of T2DM with the incidence, severity and clinical outcome of TB have been well documented 3-7. The estimated number of incident TB attributable to T2DM increased from 10% in 2010 to 15% in 2013, globally, and almost 17% of diabetes-associated TB cases occurred in China 8. A recent meta-analysis demonstrated that T2DM was associated with a two-to four-fold increased risk of active TB 9. Shanghai, a typical megacity of China, experiencing rapid population aging, urbanization, industrialization and changes in lifestyle, is bearing heavy dual burden of prevention and control for diabetes and TB. Although TB incidence rate is relatively low in Shanghai, approximately 26.9 per 100,000 in 2015, the prevalence of diabetes is dramatically increasing. A cross-sectional investigation in 2013 reported that overall weighted prevalence of diabetes was 17.6% among Shanghai residents aged 35 or above, which was much higher than the nationwide average level 10. Therefore, to realize the WHO's END TB Strategy, which was approved by the 67 th World Health Assembly in 2014 11 , the Shanghai Municipal Commission of Health and Family Planning launched "Plan for Hierarchical

show abstract

Section: Discussionsupporting

confidence: 92%

Incidence of pulmonary tuberculosis in Chinese adults with type 2 diabetes: a retrospective cohort study in Shanghai

Guo

Xia

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…A prospective study conducted in Dhaka, Bangladesh in 2011 included 17,344 DM patients screened for pulmonary TB and found that the incidence of confirmed TB cases among DM patients was double the one observed in the general population (213.33/100,000) [ 56 ]. In China, TB case notification rates in screened DM patients were several times higher than those of the general population (774/100,000) [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

Diabetes and pulmonary tuberculosis: a global overview with special focus on the situation in Asian countries with high TB-DM burden

Zheng

Gao

2017

Global Health Action

View full text Add to dashboard Cite

Background: The double burden of tuberculosis (TB) and diabetes mellitus (DM) is hitting certain Asian countries harder than other areas. In a global estimate, 15% of all TB cases could be attributable to DM, with 40% of those cases coming from India and China. Many other countries of South, East, and South-East Asia are of particular concern given their TB burdens, large projected increases in DM prevalence, and population size. Objective: In this narrative review, we aimed to: (i) give an overall insight into the evidence on TB-DM epidemiology from high double burden Asian countries, (ii) present the evidence on bi-directional screening implementation in this region, (iii) discuss possible factors related to higher TB susceptibility of Asian diabetic patients, and (iv) identify TB-DM comorbidity treatment challenges. Methods: The PubMed and Google Scholar databases were searched for all studies addressing DM/TB epidemiology, bi-directional screening and management in South, East and South-East Asia. Results: We identified the DM prevalences among TB patients as ranging from approximately 5% to more than 50%, whereas TB prevalences among diabetic patients were 1.8–9.5 times higher than in the general population in developing Asian countries. Evidence from studies designed to address diagnosis and treatment of the dual disease in these critical regions is scarce as well as the evidence related to possible DM patients’ genetic and acquired predisposition for TB. Conclusion: More prospective studies specifically designed to address adequate screening techniques, identify patients at risk, and define an adequate treatment of dual disease in this region are needed without delay.

show abstract

“…The only other previous study of TB and DM diagnosis in Bangladesh was conducted from 2010 to 2011 and described the utility of screening for TB among patients admitted to a tertiary diabetes hospital in Dhaka ( Rahim et al, 2012 ). The present study findings suggest that the corollary, screening for DM among people with symptoms of TB, was not only effective but applicable to an ambulatory population seeking healthcare in a mix of public and private clinics throughout the city.…”

Section: Discussionmentioning

confidence: 99%

A public-private model to scale up diabetes mellitus screening among people accessing tuberculosis diagnostics in Dhaka, Bangladesh

Paul

Alkabab

Rahman

et al. 2020

International Journal of Infectious Diseases

View full text Add to dashboard Cite

Background: Data are scarce regarding the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients in Bangladesh. This study was undertaken to estimate the number needed to screen (NNS) to identify a case of DM among those with TB symptoms and those with confirmed TB disease, and to identify factors predicting treatment outcomes of TB patients with and without DM. Methods: Persons attending public-private model screening centres in urban Dhaka for the evaluation of TB were offered free blood glucose testing in addition to computer-aided chest X-ray and sputum Xpert MTB/RIF. Results: Among 7647 people evaluated for both TB and DM, the NNS was 35 (95% confidence interval (CI) 31-40) to diagnose one new case of DM; among those diagnosed with TB, the NNS was 21 (95% CI 17-29). Among those with diagnosed TB, patients with DM were more likely to have cavitation on chest X-ray compared to those without DM (31% vs 22%). Treatment failure (odds ratio (OR) 18.9, 95% CI 5.43-65.9) and death (OR 2.08, 95% CI 1.11-3.90) were more common among TB patients with DM than among TB patients without DM. DM was the most important predictor of a poor treatment outcome in the classification analysis for TB patients aged 39 years and above. Conclusions: A considerable burden of DM was found among patients accessing TB diagnostics through a public-private model in urban Bangladesh, and DM was associated with advanced TB disease and a high rate of poor treatment outcome.

show abstract

Pulmonary tuberculosis in patients with diabetes mellitus in Bangladesh [Correspondence]

Cited by 7 publications

References 0 publications

Incidence of pulmonary tuberculosis in Chinese adults with type 2 diabetes: a retrospective cohort study in Shanghai

Incidence of pulmonary tuberculosis in Chinese adults with type 2 diabetes: a retrospective cohort study in Shanghai

Diabetes and pulmonary tuberculosis: a global overview with special focus on the situation in Asian countries with high TB-DM burden

A public-private model to scale up diabetes mellitus screening among people accessing tuberculosis diagnostics in Dhaka, Bangladesh

Contact Info

Product

Resources

About