The challenge of worldwide tuberculosis control: and then came diabetes

Amberbir, Alemayehu

doi:10.1016/s2214-109x(19)30053-1

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…Elsewhere, other factors associated with TB have mostly been reported from developed settings and these include tobacco and illicit drugs use, lifestyle and harmful alcohol consumption [ 8 , 9 , 13-15 ]. In the current study, smoking was associated with TB in bivariate analysis, but this was not confirmed after adjusting for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

“…A modelling analysis showed that an increase by 25% of DM worldwide would reverse the current downward trend of TB incidence, which would be increased by 8% by 2035 [ 7 ]. Unfortunately, the DM epidemic, especially in sub- Saharan Africa where health service provision for chronic diseases is poor, constitutes a serious threat for TB control [ 8 ]. Assessing the burden of TB in DM patients is therefore crucial at country/regional level to inform decisions on how to better control the dual epidemic of DM and TB [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries

Wachinou

Adè

Mbaye³

et al. 2021

Multidis Res Med

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Background: To determine the prevalence of tuberculosis (TB) and associated factors in persons with diabetes mellitus (DM) in Benin, Guinea and Senegal.Methods: A cross-sectional study was conducted in the largest DM center in each country. Participants systematically underwent clinical screening and chest radiography. Participants who were symptomatic or with abnormal radiography underwent bacteriological investigations (sputum smear, Xpert MTB/RIF and culture) on sputum. Participants with no TB at enrolment were re-examined for TB six months later. Logistic regression was performed to identify factors associated with TB.Results: There were 5870 DM patients: 1881 (32.0%) in Benin, 1912 (32.6%) in Guinea and 2077 (35.4%) in Senegal. Of these, 114 had bacteriologically-confirmed TB, giving a pooled prevalence of 1.9% (95%CI=1.6-2.3). TB prevalence was 0.5% (95%CI=0.3-1.0), 2.4% (95%CI=1.8-3.2) and 2.8% (95%CI=2.2-3.6), respectively, in Benin, Guinea and Senegal. Factors associated with an increased odds of TB diagnosis were a usual residence in Guinea (aOR=2.62;95%CI=1.19-5.77; p=0.016) or in Senegal (aOR=3.73;95%CI=1.85-7.51; p<0.001), the age group of 35-49 years (aOR=2.30;95%CI=1.11-4.79; p=0.025), underweight (aOR=7.34;95%CI=4.65-11.57; p<0.001) and close contact with a TB case (aOR=2.27;95%CI=1.37-3.76; p=0.002). Obesity was associated with lower odds of TB (aOR=0.20; 95%CI=0.06-0.65; p=0.008).Conclusion: TB is prevalent among DM patients in Benin, Guinea and Senegal and higher than among the general population. The findings support the need for intensified case finding in DM patients in order to ensure systematic early detection of TB during the routine consultation process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries

Wachinou

Adè

Mbaye³

et al. 2021

Multidis Res Med

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“…In addition, one‐quarter of the global population has latent TB infection (LTBI) 1 . The absence of an effective life‐long vaccine, the emergence of drug‐resistant Mtb strains and comorbid immunosuppressive conditions pose a challenge to the current global TB eradication commitments 2 . Recent studies reported that people living with the metabolic disease type 2 diabetes (T2D) have a 3‐ to 4‐fold increased risk of developing active TB 3 and that its impact on the global TB burden is much higher than human immunodeficiency virus (HIV) coinfection, the most potent known risk factor for TB 4 .…”

Section: Introductionmentioning

confidence: 99%

A murine model of tuberculosis/type 2 diabetes comorbidity for investigating the microbiome, metabolome and associated immune parameters

Sathkumara

Eaton

Field

et al. 2021

Anim Models and Exp Med

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Tuberculosis (TB) is one of the deadliest infectious diseases in the world. The metabolic disease type 2 diabetes (T2D) significantly increases the risk of developing active TB. Effective new TB vaccine candidates and novel therapeutic interventions are required to meet the challenges of global TB eradication. Recent evidence suggests that the microbiota plays a significant role in how the host responds to infection, injury and neoplastic changes. Animal models that closely reflect human physiology are crucial in assessing new treatments and to decipher the underlying immunological defects responsible for increased TB susceptibility in comorbid patients. In this study, using a diet‐induced murine T2D model that reflects the etiopathogenesis of clinical T2D and increased TB susceptibility, we investigated how the intestinal microbiota may impact the development of T2D, and how the gut microbial composition changes following a very low‐dose aerosol infection with Mycobacterium tuberculosis (Mtb). Our data revealed a substantial intestinal microbiota dysbiosis in T2D mice compared to non‐diabetic animals. The observed differences were comparable to previous clinical reports in TB patients, in which it was shown that Mtb infection causes rapid loss of microbial diversity. Furthermore, diversity index and principle component analyses demonstrated distinct clustering of Mtb‐infected non‐diabetic mice vs. Mtb‐infected T2D mice. Our findings support a broad applicability of T2D mice as a tractable small animal model for studying distinct immune parameters, microbiota and the immune‐metabolome of TB/T2D comorbidity. This model may also enable answers to be found to critical outstanding questions about targeted interventions of the gut microbiota and the gut‐lung axis.

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“…1 Whilst infections with drug-susceptible Mycobacterium tuberculosis (Mtb), the causative agent of TB, can be treated with long-term antibiotic therapy, emergence of drug-resistant strains and increasing incidence of comorbid conditions, such as diabetes mellitus (DM), pose a great challenge to TB eradication. 2 It is estimated that 463 million people are currently living with diabetes 3 and have a threefold increased risk of developing active TB 4 and demonstrated a strong link with multi-drug-resistant (MDR) TB. 5 Poor treatment adherence, clinical complications and continuous exposure to conventional anti-TB monotherapy often lead to drug tolerance and resistance.…”

Section: Introductionmentioning

confidence: 99%

Disparate Effects of Metformin on Mycobacterium tuberculosis Infection in Diabetic and Nondiabetic Mice

Sathkumara

Hansen

Miranda-Hernandez

et al. 2020

Antimicrob Agents Chemother

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Comorbid type 2 diabetes poses a great challenge to the global control of tuberculosis. Here we assessed the efficacy of metformin (MET); an anti-diabetic drug, in mice infected with a very-low dose of Mycobacterium tuberculosis. In contrast to diabetic mice, infected non-diabetic mice that received the same therapeutic concentration of MET presented with significantly higher disease burden. This warrants further studies to investigate the disparate efficacy of MET against tuberculosis in diabetic and non-diabetic individuals.

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The challenge of worldwide tuberculosis control: and then came diabetes

Cited by 6 publications

References 10 publications

Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries

Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries

A murine model of tuberculosis/type 2 diabetes comorbidity for investigating the microbiome, metabolome and associated immune parameters

Disparate Effects of Metformin on Mycobacterium tuberculosis Infection in Diabetic and Nondiabetic Mice

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