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Effect of diabetes on tuberculosis presentation and outcomes in Kiribati
Author(s) -
Cavanaugh J.,
Viney K.,
Kienene T.,
Harley D.,
Kelly P. M.,
Sleigh A.,
O'Connor J.,
Mase S.
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12468
Subject(s) - tuberculosis , medicine , diabetes mellitus , presentation (obstetrics) , geography , environmental health , surgery , pathology , endocrinology
Objectives To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati. Methods We enrolled consecutive patients with TB who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by haemoglobin A1c assay. Poor outcome was defined as death, default or treatment failure, and good outcome as treatment success or cure. Results Two hundred and seventy‐five eligible persons with TB disease were enrolled; 101 (37%) had diabetes. TB patients with diabetes were more likely to have acid‐fast bacilli ( AFB ) seen on sputum smear microscopy ( RR : 1.3; 95% CI : 1.03–1.62). The risk of poor outcome did not differ between patients with or without diabetes ( RR : 1.1; 95% CI : 0.5–2.7). Conclusion TB patients with diabetes are more likely than those without to have sputum with AFB on microscopy. This could increase transmission in the community. Early detection of TB by screening patients with diabetes, and the converse, could be important public health interventions where diabetes and TB are prevalent.